Employers are paying for embedded wellness, mental health, and financial tools that most workers never touch
American employers are spending billions on health plans that include mental health resources, employee assistance programs (EAPs), nutrition counseling, digital wellness tools, and financial coaching and in many cases, their workforces have no idea those benefits exist.
"Employers look for solutions outside of what they already have, and strangely enough, a lot of those solutions are embedded in a lot of their plans already," said Kristen Dougherty, Senior Vice President and Employee Benefits Practice Leader at Univest Financial in Philadelphia. "They're not thinking about the fact that there are wellness solutions that they're already paying for in their premium."
According to the US Bureau of Labor Statistics' Employer Costs for Employee Compensation data, benefits represent nearly a third of total employer compensation costs; the single largest expense after wages. When those benefits go unused, that spend produces no return for the employer and no value for the employee.
The utilization gap hiding in plain sight
Dougherty, who has spent 25 years in the group benefits industry, says the problem shows up across every industry and workforce type. Employees routinely present their insurance card, receive a bill, and have no real sense of what their plan covers beyond basic medical claims, let alone what wellness tools or mental health resources sit inside it.
"It never ceases to amaze me that we deal with all types of businesses - blue collar, white collar, gray collar - and most employees don't understand how to use their health plan to the best of their ability," she said.
Employees pay out of pocket for services their plan already covers. Employers absorb premium increases driven partly by poor utilization patterns, while the wellness tools they're funding - tools that could reduce downstream claims - go untouched. Nearly one in four employers reported that fewer than 20 percent of eligible employees participate in wellbeing programs, according to Gallagher's 2026 Workforce Trends Report – Benefits Benchmarks, which surveyed more than 3,700 US organizations. That figure is pushing employers toward integrated, year-round benefits strategies rather than stand-alone initiatives.
Why open enrollment isn't enough
The problem is most visible during open enrollment, when employees make consequential financial decisions about plan design with little preparation and often less interest.
When employers offer both a high-deductible health plan (HDHP) with a health savings account (HSA) and a richer traditional plan, employees routinely choose the higher-premium option assuming it offers better protection without running the numbers for their own situation. The result is higher out-of-pocket costs and an underutilized HSA that could have provided meaningful tax-advantaged savings.
Dougherty's team at Univest runs what they call a "Did You Know" campaign, a quarterly communication strategy that surfaces a different embedded plan benefit each quarter, sent to both employer leadership and the workforce. Q1 covers wellness and activity resources. Q2 focuses on mental health, timed to Mental Health Awareness Month in May. Q3 addresses HDHP fundamentals and plan comparison ahead of renewal. Q4 opens the full range of open enrollment choices.
Content goes out across webinars, lunch-and-learns, and on-demand video on the benefits administration platform, with access extended to spouses and partners, who often drive household healthcare decisions more than the enrolled employee does.
"A spouse who knows what's already covered can prevent an employee from paying out of pocket for something their plan already includes," Dougherty said.
Benefits communication is also a retention strategy
Employees who don't understand or feel connected to their benefits are quicker to leave, sometimes for marginal pay gains elsewhere. SHRM's research on employee benefits consistently shows that perceived benefit value shapes both satisfaction and tenure in ways that compensation alone does not.
Gartner's latest survey of 10,055 employees found that the most-valued total rewards offerings are now dominated by financial stability and protection from unanticipated costs, a direct signal that employees are paying attention to whether their benefits actually deliver when it matters, not just whether they exist on paper.
"When you have programs and educational opportunities and employees are feeling that connection to their employer - that's where the rubber meets the road," Dougherty said. "If they don't feel that connection, they're going to take the first phone call from the competition for a dollar more an hour."
Research bears that out. Gallagher's 2026 Workforce Trends Report found that career growth and benefits quality are now the primary drivers of retention outcomes for US employers navigating costly turnover, with engagement strategies that connect employees to tangible support generating the strongest results.
Before adding new benefits to a plan, Dougherty says the first move should always be an audit of what's already there and whether employees know about it.
"How can we make sure people are taking advantage of those things before we recommend another solution that's going to add to their bottom line?" she said. "That's our fiduciary responsibility as their business partner."
