4 Reasons Employees Ignore a Good Benefit
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To hear the full conversation, watch the webinar.
Many employers spend a fortune on benefits most of their employees never touch. When we asked attendees in a live poll during our recent webinar what share of their employees use the benefits they offer, the most common answer was 25% to 50%.
Heather Gelting, Executive Director of PAISBOA Health Benefit Trust, joined me to talk about why that happens and what she has done about it. PAISBOA HBT buys health coverage for 157 independent schools across Pennsylvania, so her members are spread across 157 campuses, each with their own unique HR office. Here are the four reasons she has seen employees ignore a benefit, and what she did about each one.
1. Employees don’t understand the value proposition of the benefit
A benefit that asks people to do something differently has to pay them for the trouble. Garner covers out-of-pocket costs when a member sees a Top Provider, and that reimbursement is the reason Heather signed on with Garner in October 2025 and launched it across her schools five months later, in March. "I honestly thought it was brilliant," she says. After losing $18 million in a single year, PAISBOA HBT had already made plan design changes to hold this year's renewal to 8.8%, and pushing more cost onto teachers who already accept modest salaries was not an option.
So far that is working. Through the end of July ‘26, the trust had used Garner to reimburse more than $54,000, with another $20,000 pending. Additionally, 226 members across 68 schools had received money back on a claim. That first reimbursement is what wins over the skeptics. Heather heard from a CFO who had shrugged the program off when it was first presented. But when a few things came up at home that led to more doctor visits, she wrote in to say the reimbursements had made a real difference to her family in her out-of-pocket costs.
2. The benefit only comes up at Open Enrollment
Anything mentioned once in September is forgotten by March. So Heather's team made sure people kept seeing their benefits all year. Its monthly member newsletter has a standing Garner section, and new hires see a Garner page inside the benefits administration system when they enroll in medical coverage. Members also get a home mailer reminding them to take advantage of their Garner benefit.
Email now brings in more signups than anything else, and it's the one channel Heather had never let a vendor use. "We work with lots of different vendors. We never give our email list out," she says. "So working with Garner is the first time we have ever shared employee email addresses." Garner writes and sends those campaigns throughout the year, so keeping the benefit in front of people costs her team almost nothing.
She is already planning contests for the winter, as people still need reminding long after the launch is over. "I think we're going to need to keep [Garner] front of mind," she says.
3. Local HR & managers are not promoting the benefit
Several of PAIBOA HBT's schools with the strongest Garner adoption are led by people who sit on its Board of Trustees, so they were in the room when Garner was chosen. Those leaders understand Garner and promoted Garner at their own schools - for example, sending emails encouraging members to take advantage of their benefit - which felt more personal than anything arriving from Garner or the trust's newsletter. Well over 50% of members have signed up at those schools. "The level of commitment from the on-site leader is really critical," Heather says.
That is why Garner gives clients “Train-the-Trainer” materials. A school lead who understands how Garner picks Top Providers can answer a teacher's questions in the hallway. Heather is clear about whose job that is. "The Garner team's been great to work with, but we own it," she says. "We have to be leader-led in standing behind the benefit."
The opposite happened at one school with very low engagement, where the reason turned out to be what the HR director believed about the program. She thought the whole point was to push employees toward cheap doctors, so she and Heather went through what the metrics actually measure and why price is only one small part of it.
One conversation fixed what months of email had not. "It just can't be like hit send on the email and expect it to flow," Heather says. She expects more of those conversations over the first six to nine months, one school at a time.
4. Nobody uses data to build their engagement strategy
One number across 137 schools tells you nothing about which schools need support. "It doesn't really help us to know that our population is at 23% [sign-up rate with Garner]," she says. "We need a school-by-school report." The report arrived about a week later from the Garner team to help Heather better target schools where PAIBOA HBT and local leaders needed to better promote and educate on Garner. Now she calls the larger schools that are behind, tells them where they stand against the trust average, and asks what is going on and how she can help.
Heather shares the results from the schools that are furthest ahead, which has turned adoption into some healthy competition between them. She also goes into open enrollment meetings with reimbursement totals and stories from members who have already used the benefit, rather than a pitch about what it might do.
What this means for your own engagement numbers
Heather's first five months with Garner line up with what we see across our clients. The reward has to be real, and the reminders have to keep coming. Once those two are in place, success usually isn’t far behind. Heather's team is running 97 school meetings over four weeks of Open Enrollment with the Garner QR code up on the screen, and she expects engagement to roughly double by the time it closes. Seven out of ten of her Garner members had already searched for a doctor in the app as of July, so people are not just signing up and forgetting about it.
The webinar also covers the HRA amounts behind the trust's overlay design and whether it will raise deductibles as engagement climbs, plus why Heather renewed early for an 18-month cycle instead of judging results at month twelve. Watch the full session to hear it in her own words.