The Real Problem with Benefits Utilization

The average large employer now manages roughly 16 benefit vendors, and most employees have no idea what half of those solutions are. There are plenty of aggregators in the market, but very few curators.

Chad Cruse, VP of ecosystem at Benefitfocus, frames utilization failure as the central unsolved problem in benefits administration and traces where the curation work actually has to happen. Benefits administration companies occupy a unique position in the healthcare ecosystem. They are the one platform every employee must engage with at least once a year. That mandatory touchpoint is either wasted on a transactional enrollment experience, or it becomes the foundation for year-round engagement.

Benefitfocus has spent the last several years building toward the latter, using claims data and real-time health insights to surface the right solution to the right member at the moment they actually need it, not on page 15 of an open enrollment guide they read in November.

Curation is harder than aggregation, and it shows up in how the platform's Care Partner Panel was built. The team let cost driver data determine the clinical categories worth playing in, then evaluated partners primarily on the strength of the clinical evidence behind their claims. The second filter was harder to quantify: genuine commitment to partnership over time, not just a signed contract.

Capital flooded into the digital health space after 2020 and created fragmentation that is genuinely difficult for employers and brokers to navigate. A platform sitting at the center of the benefits relationship, with access to the full member health journey, is uniquely positioned to do the curation work the market is missing.

Watch Chad Cruse walk through what curation looks like in practice and why the mandatory open enrollment touchpoint is being used wrong almost everywhere else.