Key takeaways:
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Artificial Intelligence (AI) may soon handle time-consuming tasks like claims processing and employee self-service so your team can focus on strategy and high-impact work.
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Three areas stand to benefit most: instant claims processing, AI-powered self-service for employees, and deeper analysis of benefits performance.
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Better data insights from AI can help you spot gaps, personalize benefits packages, and improve employee retention.
Across all industries and job roles, artificial intelligence (AI) is reshaping working life. In the employee benefits space, leaders are excited but cautious, a survey from HealthEquity revealed that while nearly three-quarters of benefits professionals feel AI will have a positive impact, many questions remain.
One prominent concern is how AI will alter the roles of benefits teams. Some benefits leaders feel anxiety over job security, while others are uncertain how AI can support a role where trust and human touch can be so vital to success.
The implementation of AI in benefits administration is still in its early stages, but we have some insights on how these concerns may be addressed. The benefits professional of the future is unlikely to be replaced by AI, but will instead be supported by tools that streamline technical aspects of the job and provide insights into overall benefits performance. AI tools will give teams more time to focus on what they do best:
- Plan high-level strategy
- Choose and manage benefits programs that improve employee wellbeing
- Provide human-led, high-quality employee experiences.
How could AI help claims be processed instantly?
One of the most labor-intensive aspects of benefits administration is claims processing. Employees filing a claim under their Health Savings Account (HSA), Flexible Spending Account (FSA), Lifestyle Spending Account (LSA), or other benefit must often fill out forms detailing their expense.
It can be a lengthy, detailed process:
- Claims are reviewed before a final decision is made
- Employees may need to be contacted if information is missing or incorrect.
- If a claim is denied, the benefits team may get involved to provide more context.
- It can take days between an employee filing a claim and receiving their reimbursement.
It’s unsurprising, then, that streamlining claims processing and reimbursement is one of the top opportunities benefits leaders see for AI.
With a well-chosen AI tool, benefits professionals could free up much of the time they spend helping employees navigate claims processing. Employees could take a photograph of their receipt and upload it to their benefits platform, while AI auto-fills claims data, alerts employees to any errors or missing information, and delivers a real-time claim approval.
That’s a better experience for employees and frees up time spent on any confusion or delay that crops up in claims processing.
Could AI-powered self-service improve employee experience?
Another frequent use of time, and occasional source of friction, for benefits professionals is handling simple employee service questions.
Although a survey revealed that 81% of consumers would like more self-service options, many are not satisfied with existing options. In employee benefits, that can result in many conversations between employees and benefits team members over technical or task-related queries that could potentially have been solved with better technical support.
AI is a promising solution for this mismatch between preference and reality. The right AI tool can be accessed across several channels according to employee choice, and can answer basic and sometimes even complex service queries. Employees will be able to gather information, ask questions, and resolve issues on their own time without needing to appeal to a live benefits team member.
A good AI tool can even reveal trends in employee queries, helping benefits team members spot issues at the macro level and focus more of their time on addressing them.
How could AI help with benefits analytics?
Benefits professionals are most impactful when they’re engaging with high-level strategy, analyzing the results of specific benefits, and planning new campaigns to drive better health or financial outcomes.
With the right AI tool, benefits professionals will be able to access deeper insights on performance with less time and effort.
AI can analyze:
- Plan performance for the organization on a macro level
- Specific employee demographics and groups
- Benchmarking against industry peers
- Gaps in programs, care, or inequities
- Employee preferences
- How benefits changes may impact the organization
Plus, better insights from AI may help benefits professionals design benefits packages to improve retention and morale.
For example, a benefits team focused on helping employees save enough money to cover a medical emergency could utilize AI to identify the average account balance of employees and average contribution activity during the plan year, both on an organizational level and across different employee population segments. The tool could potentially predict changes to these metrics based on updates made to the plan, such as implementing a seed or match, and it could track changes over time as benefits teams launch new initiatives.
Integration with generative AI, which can produce written or image-based content, could help teams implement these changes. Providing initial drafts of email campaigns that draw from storylines identified in employee data would save time and help develop storylines that resonate with employees.
What will benefits professionals spend their time on?
AI is poised to save benefits teams times by handling easily automated tasks and generating valuable data-based insights. That gives the benefits professional of the future significantly more bandwidth to focus on the areas of the job that require human touch, empathy, and ingenuity.
- Setting strategy that reflects real-world context, like organizational goals, employee morale, and ethical considerations
- Delivering human-led support in sensitive moments that self-service tools can’t resolve
- Designing and improving employee experiences with empathy, nuance, and creativity
- Turning insights into action, such as targeted campaigns that improve health and financial outcomes
How can you start preparing to implement AI at your organization?
Benefits teams should start preparing now to successfully integrate AI into their operations.
- Assess your current state. Map the workflows your team uses today, and note where time and effort concentrate.
- Define the outcomes you want. Identify the top goals you want AI to support, such as faster reimbursements, fewer employee tickets, or stronger reporting.
- Pinpoint the best-fit use cases. Look for gaps or inefficiencies in your processes that AI seems poised to solve.
- Build practical AI literacy. Seek training through professional organizations, webinars, and peer networking, then vet partners with reliable reputations.
- Create internal ownership. Consider appointing an AI committee with designated subject matter experts who champion training, adoption, and alignment to organizational standards.
With diligence and a strategic mindset, your team will be prepared to use AI well, to support processes like the ones outlined here, while allowing benefits professionals to focus on the aspects of their job that deliver the best results for the employees they serve.
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How AI could change benefits work at a glance
| Area AI impacts | What could change | What it could enable | Why it matters to your team |
|---|---|---|---|
| Claims processing | AI could help process claims faster and reduce back-and-forth for missing info | Receipt photo upload, auto-filled claim fields, real-time error checks, and faster approvals | Less manual review, fewer escalations, and a smoother employee experience |
| Employee self-service | AI could help answer common questions across channels | Always-on support for routine issues, and trend reporting on recurring questions | Fewer repetitive tickets, better insights into friction points, and more time for strategic work |
| Benefits performance analysis | AI could make reporting faster, deeper, and more targeted | Macro and segment-level analysis, peer benchmarking, and scenario modeling for plan changes | Easier identification of gaps, opportunities, and program changes that support retention and morale |
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References and disclosures
HealthEquity does not provide legal, tax or financial advice.
