Gaining access to plan claims data and expenditures can help employers identify their plan’s main cost drivers and any under- or overutilization. Employers whose plans are spending less than average can use that information as leverage if they want to negotiate for better rates or plan structure.
But how much data an employer can get — and what they can do with it — often depends on how their plan is funded. Employers who purchase group health insurance have the least amount of access to data, but if they work with their broker, they can sometimes gather important insight into what spending is driving their plan’s costs. Self-insured employers have the most access since they are the insurer and contract with administrators that handle their claims.
Fully insured vs. self-insured plans
Employers in fully insured plans can take steps to improve access to information, including:
Requesting quarterly reports from their insurer or broker showing trends in claims by category (e.g., ER visits, specialty drugs).
Asking for benchmarking data that compares their plan’s usage and cost patterns to similar companies.
Negotiating for more transparency during renewal discussions. Some carriers offer access to online dashboards or population health tools that provide at least a general overview.
Self-insured employers and those using level-funding (a hybrid arrangement between fully insured and self-insured) have more access to granular data, which they own. They typically contract with a third-party administrator to handle the plan’s expenditure and collect important data that can shed light on cost drivers.
What you can do with data
With access to the right claims information, employers can:
Identify high-cost claimants (scrubbed of identifying information) and track chronic conditions like diabetes, hypertension and musculoskeletal issues.
Break down spending by demographics to tailor benefits to age, gender and family status.
Monitor utilization patterns, such as unnecessary emergency room visits or low preventive care adherence.
Use predictive modeling to forecast future claims and adjust the plan design accordingly.
Why this data matters
Access to claims and utilization data allows employers to align their plan benefits with employee needs while controlling unnecessary costs. Here’s how employers can benefit:
Initiating targeted communication: If employees overuse the ER or underuse preventive services, employers can launch education campaigns to steer behavior.
Plan optimization: Data can show whether adding a mental health benefit or removing a redundant offering would deliver better value.
Vendor performance: Employers can evaluate if programs like telehealth, disease management or wellness initiatives are delivering a return on investment.
Smarter renewals: Employers can use their data to negotiate more effectively with vendors or consider alternative funding arrangements.
Options for smaller employers
If you’re a smaller firm and don’t have access to deep analytics, you still have options:
Ask us to request insurer data and perform analysis on your behalf and adjust your plan design if necessary.
Use carrier-provided tools, if available, such as reporting dashboards, health risk assessments or plan modeling software.
Review claims data at least quarterly to identify cost trends, any under- or overutilization or cost anomalies.
Voluntary benefits have emerged as a key differentiator for small businesses looking to stay competitive in attracting and retaining employees. These benefits, which are offered in addition to group health insurance and 401(k) plans, allow employees to opt in to coverage that fits their unique needs, often with little or no cost to the employer.
While larger companies have long embraced these options, small employers are increasingly seeing the value in building voluntary benefit programs that reflect the makeup and priorities of their workforce.
For small businesses that may not be able to afford rich employer-funded benefits, voluntary offerings help level the playing field. They increase employee satisfaction and improve recruitment, especially when competitors already provide these options.
What are voluntary benefits?
Voluntary benefits are supplemental insurance and service options that employers make available to their staff. Employees choose which benefits they want and typically pay the premiums through a payroll deduction. Some employers contribute a portion of the cost, but it’s not required.
Examples of voluntary benefits include:
Dental and vision insurance
Critical illness and cancer insurance
Hospital indemnity coverage
Accident insurance
Life and disability insurance
Legal assistance plans
Identity theft protection
Long-term care coverage
Pet insurance
Wellness benefits, caregiving support and fitness memberships
Why voluntary benefits matter
There is wide support for voluntary benefits among American workers. In fact, studies show:
More than three-quarters of employees say they are more likely to work for an employer that offers voluntary benefits.
Most small businesses with 10 to 49 employees now offer at least one voluntary benefit.
Nearly 70% of businesses with 50 to 99 employees offer several voluntary benefit options.
Employees report strong interest in products like critical illness, cancer, hospital indemnity and identity theft protection — even when they are not already enrolled in them.
However, priorities may vary depending on the age of your employees. If your workplace is like many others, you have multiple generations working together. Consider that:
Gen Z may seek mental health support and pet insurance,
Millennials might prioritize family building benefits or debt relief,
Gen X may be focused on caregiving and long-term care insurance, while
Baby Boomers may be most interested in discounts on health services or disability insurance.
Choosing benefits for your team
Adding voluntary benefits doesn’t have to be overwhelming. A thoughtful approach will ensure your offerings align with your employees’ needs and your business goals.
In addition to working with us, here are some practical steps small employers can take:
Poll your team early: At least six months before your annual open enrollment, survey employees to find out which voluntary benefits they value most. This helps you choose offerings that will see the most uptake.
Start small, then expand: Begin with a few high-demand options like dental, vision or accident insurance. You can add more over time based on your budget and employee interest.
Think generationally: Consider what different age groups might prioritize.
Work with a broker or advisor: We can guide you through the process, help manage administration and educate your employees on how to take advantage of these benefits.
Communicate regularly: Don’t assume your team knows what’s available. Use e-mails, posters and meetings to highlight benefits and remind them of enrollment deadlines.
Make enrollment easy: Choose a carrier with online enrollment and mobile access to increase participation and reduce your administrative burden.
Offering voluntary benefits isn’t just about checking a box. It’s about showing your team you understand and support their full lives. That can pay off in loyalty, morale and long-term retention.
Poor health insurance literacy among plan enrollees costs both them and plan sponsors billions of dollars each year, according to a new report by Cigna Healthcare.
According to the report, Americans with poor knowledge of how their health insurance works are twice as likely to be stressed about their health, which can worsen any health problems they are struggling with. This can also affect employers through decreased worker productivity, increased absenteeism and turnover and other indirect costs.
There is also a disconnect between employers and their plan participants: 80% of plan sponsors believe that their staff understand their benefits, while 66% of employees find it difficult to know which benefits to use and in what circumstances.
The report’s finding that employees who are confused about their benefits may suffer worse health outcomes should spur employers to ensure they are getting their money’s worth by emphasizing employee education and support.
“Employers invest in health benefits because a healthy workforce is imperative to organizational performance and growth,” the report said. “For maximum ROI, employees and their families must use those benefits effectively. Employee utilization and engagement data can help employers address gaps.”
Cigna found that of those who reported being stressed about their health often or very often:
50% had missed one or more days of work due to physical or mental health,
49% had come to work feeling sick,
50% said they were not mentally present while at work,
34% were unable to perform at an optimum level, and
49% often or very often found work stressful.
On the flip side, the 20% of workers who reported being confident in their health insurance knowledge were also healthier and had fewer medical concerns than those who were less informed, the report states.
The report found that those in the top 20% of health insurance literacy were more likely to positively rate their physical and mental health compared to those with a limited understanding of their benefits. They were also more likely to be more proactive about their health by taking steps to:
Research and compare health plans,
Seek out regular preventive care,
Manage chronic conditions, and
Stick to prescription regimens.
What employers can do
In light of the study’s findings, it’s clear that employers should boost health insurance literacy among all staff, not only for their employees’ health and finances, but also for the firm’s finances, productivity and office morale.
The report recommends that employers focus on three areas:
Educational programs: Hold regular in-person health engagement sessions that give staff the opportunity to ask questions and learn about their benefits. Some employees may benefit more from sessions like these if offered as webinars or online courses that educate them about their health benefits.
Interactive tools: Provide interactive tools that can guide your employees when making plan decisions. These are often available through the insurance company and can include:
Plan comparison tools — These online platforms can be used during open enrollment to help employees and their families compare plans based on premiums, coverage, doctor networks, out-of-pocket expenses and maximum limits.
Cost calculators — These online or app-driven tools allow employees to estimate their out-of-pocket costs for various medical services and treatment options.
Benefit portals — These online or app-driven tools can help your staff make decisions about their health care and how insurance will help pay for it.
Provide support: Create an environment where your workers feel comfortable approaching HR with questions about their health insurance benefits. Designate one or more team members as point persons for these interactions and emphasize to staff that the department has an open-door policy.
Finally, as your broker, we can also help educate your workers and provide resources that help them make better decisions.
The “Big Beautiful” tax bill being debated in Congress has several provisions that would make major changes to rules governing individual coverage health care reimbursement arrangements and tax-advantaged health savings accounts. Many of these changes would benefit both employees and employers.
The legislation has not yet been signed into law and could undergo significant changes in committees in the U.S. Senate. After the Senate makes changes to the bill, which has already passed the House, it may be completely different. However, the changes proposed for ICHRAs and HSAs seem to be noncontroversial, with no opposition reported.
Here’s a look at the proposed changes.
Making changes to HSAs
HSAs, which are tied to qualified high-deductible health plans (HDHPs), allow employees to sock away untaxed income for future medical and health-related expenses. Usually, a set amount is withdrawn from their paychecks before taxes are applied.
Account holders can invest the money in these accounts like they do with 401(k) plans; the accounts can be moved from one employer to the next and kept into retirement. Funds are withdrawn tax free to reimburse for qualified medical and health-related expenses.
The bill would:
Allow working seniors who are 65 and older to continue contributing to an HSA, a change from current law that prohibits this.
Expand HSA eligibility to people with ordinary bronze-level plans and catastrophic major medical coverage. Currently, only individuals in HDHPs have access to HSAs.
Allow an HSA to reimburse for gym memberships and other fitness-related costs. The reimbursement limit would be $500 annually for individuals and $1,000 for families.
Permit workers with access to an employer’s on-site clinic to contribute to HSAs. Under current law, access to an employer health clinic violates the rule that an HSA owner must have an HDHP.
Allow married couples who file taxes jointly to make catch-up contributions to the same HSA. Currently, married couples can only make catch-up contributions to their own accounts. The maximum HSA contribution in 2025 is $4,300 for an individual and $8,550 for a family. Individuals over the age of 55 can make catch-up contributions of up to $1,000 each year.
Allow HSA owners to pay dues for a “direct primary care practice,” a subscription service for primary care. It would limit the reimbursable dues to $150 for an individual and $300 for a family.
Allow workers with health reimbursement or flexible spending arrangements that are terminating to roll some unused funds from those accounts into an HSA. The maximum amount that can be converted is linked to the FSA contribution limit, which is $3,300 in 2025.
Would allow one spouse to contribute to an FSA and the other to an HSA. Under current law, if one spouse has an FSA, the other cannot contribute to an HSA.
Would set the maximum HSA contribution based on earnings. For example, for employees making $75,000, the contribution limit would increase to $8,600 for an individual, compared to $4,300 today. For a couple making $150,000 annually, the amount would jump to $17,100 from the current $8,550.
Tweaking ICHRAs
The legislation would rebrand ICHRAs to individual care expense arrangements (CHOICE arrangements), which would be made available through a cafeteria plan.
This change would also address an issue that has plagued ICHRAs: funds in those accounts are not eligible for tax-free status if used to purchase individual coverage on Healthcare.gov or other Affordable Care Act exchange. By funding them through a cafeteria plan, workers with CHOICE arrangements would be able to pay for individual coverage on the exchange using tax-free dollars.
The bill would also allow employers to give workers the option of enrolling in a CHOICE arrangement or a traditional group health plan.
Further, it would provide employers a monthly tax credit of $100 per employee enrolled in a CHOICE plan when the plan includes major medical coverage that offers at least the same type of benefits that a bronze plan on the government exchange would. Typically, bronze plans cover about 60% of medical costs.
The takeaway
Much can change between now and when the tax bill is signed into law. If the above provisions make it into the final version, they could greatly expand the use of HSAs and ICHRAs. One analysis of the bill predicts it would expand the pool of people eligible for HSAs by 20 million.
The IRS has announced slightly higher health savings account contribution limits for 2026, with the amount increasing 2.3% for individual HSA plans.
The IRS updates this amount annually, along with minimum deductibles and out-of-pocket maximums for high-deductible health plans. HSAs, which help employees save for medical expenses, are only available to those enrolled in qualified HDHPs.
Understanding these amounts now can help you get an early start on human resources planning for next year.
Here are the changes coming in 2026:
HSA annual contribution limit
Self-only plan: $4,400, up from $4,300 in 2025
Family plan: $8,750, up from $8,550 in 2025
Catch-up contribution (for those aged 55 and older): $1,000 (unchanged)
HDHP minimum annual deductible
Individual plan: $1,700, up from $1,650 in 2025
Family plan: $3,400, up from $3,300 in 2025
HDHP annual out-of-pocket maximum
Individual plan: $8,500, up from $8,300 in 2025
Family plan: $17,000, up from $16,600 in 2025
Maximum employer excepted-benefit HRA contribution
$2,200, up from $2,150
What to do
If you sponsor an HDHP for your staff, review the plan’s minimum deductible and maximum out-of-pocket limit when preparing for the 2026 plan year.
If you allow employees to make pre-tax contributions to an HSA, you should also update your plan communications to reflect the new amounts.
The many benefits of HSAs
An HSA is a special bank account for your employees’ eligible health care costs. They can put money into their HSA through pre-tax payroll deductions, deposits or transfers. As the amount grows over time, they can continue to save it or spend it on eligible medical and medical-related expenses.
Employers can also contribute to the accounts, but the annual contribution maximum applies to all contributions in total (from the employee and the employer).
The money in the HSA belongs to the employee and is theirs to keep, even if they switch jobs. If they go to a new employer that offers qualified HDHPs, they can continue to fund the account in their new job.
Funds roll over from year to year and can earn interest. Many plans also have investment options to help savers further grow the account.
There are several benefits for employees who have an HSA:
The money an employee contributes to an HSA is not subject to income taxes, which reduces their overall taxable income.
They are not taxed on withdrawals.
If employees contribute to their HSA with after-tax money, they can deduct their contributions at tax time on Form 1040.
Employees can tap the funds for any approved out-of-pocket medical expenses.
They can also grow the account tax-free by investing the funds in the account, like a nest egg for medical expenses in retirement.
HSA-eligible expenses:
Payments for services or medicine that count towards health plan deductibles, copayments or coinsurance.
Dental or vision care (including orthodontics, eye exams and corrective lenses).
Medical devices.
Certain over-the-counter medicines, such as pain relievers, allergy medication, cold and flu medicine and menstrual products.
Vitamins and health supplements, if recommended by a medical or health professional for the treatment or prevention of a specific disease or condition.
If you are offering high-deductible health plans to your staff to reduce overall premium outlays, you know that this type of insurance has one major drawback: higher out-of-pocket expenses that some may struggle to afford if they experience a sudden illness or accident. Fortunately, you can offer a product that can help them cope with unexpected out-of-pocket costs for their health care: gap insurance, otherwise known as supplemental medical expense coverage. Supplemental insurance is an extra layer of coverage designed to help with expenses primary health insurance may not fully cover, including copays, coinsurance, deductibles and even living expenses.
With more Americans going into serious debt due to medical expenses, supplemental insurance can provide a financial lifeline when someone needs it most.
Group supplemental insurance is a voluntary benefit that is usually less expensive than if someone purchases it on their own. There is typically no underwriting or health exams for group policies, which is not always the case with individual policies.
This voluntary benefit can be structured in different ways, but they usually cover deductibles, copays, coinsurance costs, prescription drug costs and other health care-related expenses.
Gap insurance may also cover nonmedical expenses, including living expenses during a hospital stay or while recovering at home from an illness or accident. Other gap plans might include income replacement for periods when individuals can’t work due to an illness, accident or after a medical procedure.
Types of gap insurance
There are a few types of gap insurance, each covering something a bit different:
Hospital indemnity insurance — This can help cover the costs associated with a hospital stay, including the cost of childcare or if a patient needs to travel far from home to receive medical care. Depending on the plan, hospital indemnity insurance gives you cash payments to help pay for added expenses that may come while you recover. Typically, plans pay based on the number of days of hospitalization.
Critical illness insurance — This provides a benefit if a policyholder becomes very ill or suffers a serious medical problem, like a heart attack or stroke. This plan supplements existing health insurance coverage with extra funds when a policyholder incurs extra expenses due to an illness and when they can’t work. They may receive a lump sum to cover these added expenses or monthly payments depending on the plan.
Accident insurance — This can help the policyholder cover medical costs or living expenses if the policyholder is injured in an accident. Policies pay out a preset number of times over a specific time or in a lump sum.
Cancer insurance — This can cover radiation, chemotherapy, immunotherapy, surgery, hospitalization and possibly screening benefits — all related to a cancer diagnosis and treatment. It can pay out in different ways:
Expense incurred policy, which pays a specific percentage of treatment costs up to a set limit.
Indemnity policy, which covers expenses for approved treatments up to a predefined limit.
Lump-sum policy, which pays a fixed amount after a cancer diagnosis.
Benefit to employees
The cost of gap coverage is reasonable, ranging from $10 to $50 a month depending on the coverage. Employers can offer to pay all or part of the premium.
If you offer HDHPs to your staff, supplemental insurance can help your employees weather a serious illness or accident by providing much-needed funds to help them get buy during a difficult period.
