Employers spend an average of $16,501 per employee on health benefits annually. Despite this investment, one in four employees value their benefits at $1,000 or less. This represents a massive gap between employer spending and perceived value.
According to Mercer’s 2025 National Survey of Employer-Sponsored Health Plans, benefits costs are expected to rise, on average, 6.5% in 2026, making this the fourth consecutive year of elevated benefits costs growth. For benefits leaders, this cost trend puts pressure to find measures to drive improved ROI and amplify utilization of health benefits.
Low engagement with benefits creates a sinkhole for hidden costs that expands far beyond the immediate waste of unused programs. Understanding the root cause of low engagement requires benefits leaders to evaluate two critical factors: accessibility and value.
When the answer to either question is “no,” employees may default to more expensive care pathways, which can erode ROI.
The U.S. benefits system is under strain from inefficiency, waste, and misaligned incentives. According to a report from Nayya, employers spend more than $3 trillion annually on benefits, yet 74% of employees do not understand what those benefits are worth, leading to billions in lost value for both workers and companies. And the financial impact extends across several dimensions:
Modern employers reportedly manage as many as 20 point solutions. While these are meant to offer employees comprehensive benefits, employers have to determine how to properly communicate them, what channels to use, and the appropriate timing. Adopting a modern front door to healthcare, especially one that leverages AI, offers a new paradigm, one that amplifies the existing ecosystem of health benefits.
Counsel’s medical AI has opened new possibilities for benefit exploration by fundamentally changing how employees interact with their health benefits. Rather than requiring employees to self-diagnose which program they need, medical AI can analyze their concerns in real time and surface relevant resources automatically.
Solutions like Counsel can ingest an employer’s benefits design, effectively supporting care navigation. Counsel provides personalized care via a messaging-based interface, giving employees instant personalized guidance via its medical AI and the ability to chat with an in-house physician in minutes.
When further support is needed, an employee further describes symptoms so the platform can identify patterns, consider their health story, and adapt to their needs to determine which existing benefit is most appropriate.
Unlike traditional virtual healthcare models, AI-enabled solutions, like Counsel, differ in several ways:
Instead of measuring success based solely on enrollment numbers, organizations leveraging medical AI as a front door to healthcare can track how often employees receive timely, appropriate guidance that prevents unnecessary escalations. The platform becomes a true front door, a single entry point that automatically routes workers to the full spectrum of benefits they already have access to.
This approach also generates data that can help refine benefits strategies over time. Employers can see which programs get recommended most frequently and which remain underutilized.
Counsel takes this concept further by integrating directly with your existing benefits ecosystem. Rather than replacing current solutions, our platform amplifies them through context-based recommendations delivered at the point of care.
Consider an employee who messages their doctor about persistent back pain. Through Counsel's physician-led care model, AI evaluates the concern, asks relevant questions, and determines the nature of the problem. If the diagnosis suggests a muscular issue rather than one requiring immediate specialist attention, the patient is then matched with their employer's musculoskeletal solution within the conversation.
This occurs without the employee needing to be aware of the program beforehand. Care navigation becomes part of the medical guidance itself, removing the burden of research and decision-making from the employee while maximizing the ROI for employee benefits that the organization has already purchased.
The same principle applies across other benefits:
By embedding benefit navigation within medical conversations, Counsel removes barriers to benefits program engagement. Employees do not need to remember their benefits, search through confusing portals, or figure out which program exactly addresses their concerns because Counsel does it for them.
By implementing Counsel's solution, employers can create a connected care experience that enables employees to receive timely, cost-effective guidance, while driving higher utilization across their entire workforce. Our care model effectively manages care for workers, expanding access for employees through a convenient, messaging-based platform.
The improved employee benefits ROI can be measured through the following metrics:
For organizations seeking to slow the cost curve while enhancing the employee experience, Counsel represents a new frontier in benefits strategy: one where technology and human expertise enable every employee to navigate their health confidently while receiving the highest-quality care imaginable.
The Counsel Health editorial team is a multidisciplinary group of writers and editors dedicated to delivering clinically grounded, evidence-based health information. Their work is informed by real-world care delivery and guided by physician expertise, ensuring content is accurate, accessible, and trustworthy. By translating complex medical topics into clear, practical guidance, the team helps readers understand their health, explore care options, and make informed decisions in a rapidly evolving healthcare landscape.
Our content is created for informational purposes and should not replace professional medical care. For personalized guidance, talk to a licensed physician. Learn more about our editorial standards and review process.
