Benefits Complexity Is Becoming HR’s Next Healthcare Challenge

Rising healthcare costs aren’t employers’ only benefits problem. Increasingly, benefits experts say employers’ bigger challenge is helping employees navigate a healthcare system that’s become so complicated that even robust benefits packages can fall short if workers don’t understand how to use them. 

That was a recurring theme during a SHRM26 panel discussion in Orlando on balancing benefits cost, care, and the employee experience. As healthcare costs continue to rise and employees shoulder more of the costs, benefits experts said employers are shifting their focus from simply offering more benefits to helping workers make smarter decisions about the coverage they already have. 

“The challenge...is not necessarily cost versus care; it’s how you build a benefits package that’s more affordable and smarter to achieve both without making a complicated experience for your employees,” Amy Mattingly, vice president of group benefits distribution at Nationwide Financial in Louisville, Ky., said during the panel. 

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Benefits Education Is Evolving 

Benefits education has historically centered on open enrollment — a time when employers share information on available plans and encourage enrollment. But that cannot be the only time employers discuss benefits. 

“I feel like we’ve shifted away from that,” said Lindsey Murray, president of Nationwide Group Benefits in Columbus, Ohio. “The healthcare system is so deeply complicated; it’s confusing to use.” 

Employers need to help employees understand how different offerings work together throughout the year, she said. 

“We need to continue to tailor and personalize,” Murray said, noting that many employers are moving away from “off-the-shelf solutions” and instead trying to understand what their workforce actually values. 

That shift extends to voluntary benefits, which panelists said have evolved beyond simply checking a box during enrollment. 

“It’s moved much more toward, ‘What is the right benefit for the right person at the right time?” said Gwen Tormey, president and COO of Corestream Benefits in Tampa. “That shifts over time with their life stage.” 

Rising Costs Demand a Different Strategy 

The discussion came as employers continue to grapple with rising healthcare costs, growing deductibles and increasing financial pressure on employees. According to consulting firm Mercer, health benefit costs are on pace to increase 6.7% in 2026, pushing the average cost above $18,500 per employee. 

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Dave Przesiek, chief revenue officer for Ryan Specialty Benefits in Boston, said during the SHRM26 panel that employers should spend less time thinking about cost-cutting alone and more time managing healthcare spending strategically. 

That starts with understanding where healthcare dollars are actually being spent, he said, encouraging employers to explore self-funded options when appropriate because they provide greater visibility into claims data. Greater visibility, he said, can help employers identify spending patterns and make more informed benefits decisions. 

“If you can see it, you can better manage it,” Przesiek said. “If you can’t see it, you can’t manage it.” 

Making Benefits Easier to Use 

Throughout the discussion, panelists repeatedly returned to one issue: complexity. 

Employees often don’t know which benefits fit their situation, how different plans complement one another, or even when they should file a claim. 

Even professionals who work in benefits can struggle. “I busted up my thumb, tried to file a critical illness claim,” Przesiek said. “It was arduous at best, and I do this for a living.” 

"If I’m confused,” he added, “I guarantee your employees are confused.” 

Panelists said employers can help by pairing benefits with better decision support, simpler communications, and year-round education. Rather than relying on lengthy explanations filled with insurance jargon, panelists encouraged organizations to use straightforward language, visuals, and personalized guidance that help employees make informed decisions. 

AI also surfaced as a potential tool for simplifying benefits selection and navigation. 

As technology becomes more sophisticated, panelists said it could help employees choose benefits based on factors such as age, family situations, and anticipated healthcare needs. 

“The more that we can demystify and create a sense of clarity on what people should do, the better off we’re going to be,” Przesiek said. “Because then it’ll truly be an employee benefit, and not a hassle for them.”