For a large percentage of Americans, one of the key factors in deciding to stay at their current job is whether or not they like their health coverage. 

In fact, 50% of employees said they'll look for new jobs in the next year because they're not satisfied with their health benefits. The pandemic has further strengthened this outlook and stressed the importance of having a healthcare scheme.

A surprising number don't understand what their healthcare covers

Given the importance health insurance holds for Americans, it's surprising how many employees don't fully understand their coverage. Studies have shown that even though employees prize their benefits, 73% of employees don't have a good understanding of their healthcare benefits.

Even more concerning is that a survey of insured adults in 2018 found that low health insurance literacy led people to delay or even avoid care due to costs. A separate survey found 59% of insured Americans had put off making an appointment due to confusion over what their insurance covers and what benefits people may be entitled to.

This problem is even more pronounced among underrepresented employees. Employees of color were 1.5 times more likely to find benefits, resources, and education tools unhelpful when compared to their white counterparts-even at higher income levels.

What's more, this confusion seems to be purely about insurance. A recent survey of 2000 respondents found that 90% were confident in their ability to navigate the US health system. In contrast, 56% said they felt "completely lost" when it came to understanding health insurance.  

Typically, it is up to the Human Resources department to explain what the insurance covers, but that can be time-consuming and dependent on how well they communicate. In fact, HR professionals spend an average of nine hours per week fielding questions about benefits. All too often, employees don't take the time to research or learn about what plans cover. Research has shown that 73% of workers spend less than an hour evaluating plan information. Consequently, they don't have much understanding of their benefits or cover.

Can technology help with the issue?

Rather than constant phone calls to HR, the more obvious solution is to use technology to explain and simplify policies. Unfortunately, the problem then is that different providers have their own websites or apps that can themselves be confusing. 

However, other more user-centric solutions are starting to sprout up. A great example is Healthee, an AI-powered platform that can understand any health insurance plan, and instantly help employees find answers and navigate health benefits.

Guy Benjamin, the co-CEO and co-founder of Healthee, explains, "The way employees engage with their health benefits is broken. As a result, workers in the US are increasingly confused as they try to work out exactly what kind of coverage they have. Even though employer-supplied benefits programs are vital to individuals, they are often unnecessarily complicated. We want to help fix that."

Healthee was founded in 2020 and is a platform that uses AI to help employees instantly find out things like what is covered, what kind of doctor or specialist to see, and how to save money - regardless of which provider or health insurance plan is used. 

"Our clients no longer need to be put on hold or try to navigate a lengthy policy. This is also great for HR managers, who can save time and money while making employees happier and healthier," Benjamin says. 

"On the platform or the app, everything is made simple. Users will interact with Zoe, their 'Personal Healthcare Assistant', who can answer any question someone has about their benefits straight away, 24 hours a day. For example, Zoe can let an employee know how much a specific treatment will cost based on their coverage, sparing them the need to sift through endless policy PDFs."

Benjamin continues, "Zoe also plays a more proactive role as well, providing things like personalized health recommendations or the ability to book an appointment with a provider right from the Healthee platform. She can also remind employees to set up preventative measures such as annual health checkups, mammograms, or hearing tests."

Simplifying health insurance with technology is an approach that's getting attention

The idea has proven popular, with Healthee recently raising US$22 million in seed investment led by Group 11, with Cresson Management, Good Company, and Insurtech Israel participating. 

"The response has been incredible, and we have managed to raise a lot of funding in a very short space of time," Benjamin says. "The idea that someone can get instant answers through our AI platform and avoid being put on hold at a call center has proved appealing to HR managers and investors alike. With the funding, we are now scaling the business and growing our team with experts in the healthcare and insurance industries."

As Healthee shows, there is a strong demand for solutions that simplify health insurance benefits. Given the clear importance insurance holds for American workers, it is alarming how few know what benefits they are entitled to. Unfortunately, the average insurance provider seems in no hurry to make policies easier to understand, with the result that many are baffled, money is wasted, and HR departments are inundated with enquiries. 

Using technology to approach the issue is an obvious solution. Time will tell, but hopefully, the tide is turning in favor of American employees and their health.