How to Help Your Employees Avoid the 6 Most Common Health Insurance Selection Mistakes

Helping Your Team Get the Most Out of Their Benefits

Open enrollment is one of the most important, and most misunderstood, moments in your employees' year. Most employees spend less than 30 minutes reviewing their options before making a decision that affects their health and finances for the next 12 months. The result? Many end up in plans that don't fit their needs, face unexpected medical bills, and grow frustrated with benefits they don't fully understand.

As an employer, you can't make the decision for them, but you can make sure they have the information and support they need to choose wisely. Here are six of the most common mistakes employees make during open enrollment, and how you can help them avoid each one.

1. Choosing a Plan Based Only on the Monthly Premium

The lowest-premium plan is almost always the first thing employees gravitate toward. It's easy to understand why, because that number shows up on every paycheck. But premium is only one piece of the cost picture.

A plan with a lower monthly contribution may carry a significantly higher deductible, higher copays, and a higher out-of-pocket maximum. For an employee who needs regular care, that lower-premium plan can end up costing considerably more over the course of the year.

How you can help: During open enrollment communications, show employees the total cost picture, not just the premium. Side-by-side plan comparisons that include deductibles, copays, and out-of-pocket maximums give employees a much clearer basis for decision-making. Real-world examples (e.g. "if you have a $5,000 medical event, here's what you'd pay under each plan") can be especially effective.

2. Not Checking Whether Their Doctors Are In-Network

Employees often assume their current doctors are covered under any plan you offer. That assumption can be costly. If a preferred physician, specialist, or hospital is out-of-network, employees may face significantly higher bills or, in some cases, no coverage at all.

How you can help: Remind employees to verify their providers before enrolling, not after. Include clear instructions on how to use each carrier's provider search tool, and encourage them to check not just their primary care physician but also any specialists they see regularly.

3. Overlooking Prescription Drug Coverage

For employees who take ongoing medications, prescription drug coverage can be just as important as medical coverage, and sometimes more so. A drug that's covered affordably under one plan may fall into a much higher cost tier under another.

How you can help: Encourage employees to look up their specific medications in each plan's formulary before making a selection. If you have employees with chronic conditions or ongoing prescriptions, this step alone can save them hundreds of dollars over the course of the year. Consider including a brief "how to check your formulary" guide in your open enrollment materials.

4. Picking the Wrong Deductible for Their Situation

Some employees automatically choose the lowest deductible plan regardless of their health needs. Others choose a high-deductible plan to save on premiums without fully understanding what that means if they need care. Neither approach is right for everyone.

A high-deductible health plan paired with a Health Savings Account (HSA) can be an excellent option for younger, healthier employees who want to manage costs and build savings. For employees who visit doctors frequently, take ongoing medications, or have chronic conditions, a lower deductible plan may offer better overall value.

How you can help: Provide employees with a simple self-assessment, something as straightforward as "how often did you use your health insurance last year?" that helps them think through which plan structure fits their actual healthcare habits. If you offer an HSA-eligible plan, make sure employees understand the tax advantages and how to use it.

5. Not Understanding the Out-of-Pocket Maximum

The out-of-pocket maximum is arguably the most important number in a health insurance plan, and one of the least understood. For employees facing a serious illness, surgery, or unexpected medical event, this number is the difference between a manageable financial situation and a devastating one.

How you can help: Make the out-of-pocket maximum a centerpiece of your open enrollment education, not an afterthought. Help employees understand that a plan with a slightly higher premium but a lower out-of-pocket maximum may offer far greater financial protection in a worst-case scenario. Frame it simply: "This is the most you would ever pay in a single year."

6. Not Taking Advantage of Their Insurance Advocate

Many employees don't realize that when they enroll in a health insurance plan, they have access to an advocate, typically your broker or benefits team, whose job is to help them understand and use their coverage. Instead of asking for help, employees often struggle through confusing situations on their own, leading to unnecessary stress, claim errors, underutilized benefits, and unresolved billing issues.

How you can help: Make it clear during open enrollment and throughout the year that your employees have a resource available to them. Let them know your broker or benefits team can help explain how coverage works, assist with prior authorizations, help resolve claim issues, and answer questions about medical bills. A simple reminder at the start of the plan year can make a significant difference in how confidently your employees engage with their benefits.

Open Enrollment as an Employee Communications Opportunity

A well-chosen health insurance plan is one of the most valuable things an employee has access to, but only if they understand it. Employers who invest in clear, accessible open enrollment education don't just help their employees make better decisions. Employers who follow these guidelines can reduce frustration, build trust, increase positive benefits utilization, and demonstrate that the benefits they offer are genuinely designed to help.