Brokers face a new reality in voluntary benefits

Employer expectations around voluntary benefits are changing. Tight budgets, increased legal scrutiny on these products and evolving product designs are causing employers to raise new questions about voluntary benefits — challenging the long-held belief that these plans carry minimal risk because employees fund the premiums.

At the center of this heightened scrutiny is a simple but important issue: Are employees paying for benefits they don’t fully use — or don’t fully understand?

While the legal outcomes are still evolving, the broader implications for brokers are already clear. The standard for recommending voluntary benefits is changing. It’s no longer enough to offer competitive pricing or a wide range of options. Today, brokers must be prepared to prove value.

A shift from price to utilization

For many employers, it’s easy to “push the easy button” on voluntary benefits. These benefits don’t get the attention that core medical and other ancillary lines do. They often end up evaluated on a spreadsheet, looking at price, coverage breadth and plan design. But those factors don’t always reflect what matters most — whether employees actually use the benefits.

That’s where the conversation is shifting.

Value is increasingly being defined by utilization: how often benefits are used, how easily employees can access them, and whether they deliver meaningful support in real-life situations. A benefit that looks strong on paper but goes unused, or doesn’t align with current medical treatments, or proves difficult to access at claim time, quickly loses its value.

Why utilization is the new proof point

Several forces are accelerating this shift.

Today’s employees have access to more benefits than ever but also have fewer resources to educate themselves on their benefits. Expectations can vary widely, but one value they undoubtedly understand is getting paid.

Employees don’t just need access to benefits—they need benefits that are easy to understand, easy to use and designed around real-life health events.

In practice, that means evaluating:

• How simple is the claims process? And how quickly are claims paid? Do the benefits align with today’s medical practices?
• Do employees clearly understand when and how to use the benefit?
• Do the benefits align with a modern workforce?

These are quickly becoming the new proof points of value.

What utilization-driven design looks like

This shift is also influencing how benefits are structured. Instead of competing on the longest list of covered conditions or the lowest price point — approaches that often fail to translate into real usage — leading solutions are being designed with utilization in mind.

That includes:

• Focusing on common, high-impact conditions rather than overly broad coverage
• Paying benefits earlier in the care journey, not just at the most severe stages
• Considering more, forward-thinking plan designs emphasizing things such as mental health or rewarding policyholders for being claim-free
• Reducing barriers to claims, so employees can access what they’ve paid for

For example, some critical illness coverage structures payouts in stages — providing partial benefits at early identification and increasing support as conditions progress. This approach not only aligns better with how care unfolds but also increases the likelihood that employees will receive and recognize the value of the benefit.

Similarly, hospital indemnity products are evolving to reflect how care is delivered today, such as recognizing observation stays as eligible events or simplifying how benefits are triggered — making them more usable in real-world scenarios.

The rise of human-centered coverage in voluntary benefits

Another important evolution is the growing emphasis on human-centered design. Employees increasingly expect benefits that reflect the realities of modern life. Not just catastrophic events, but everyday challenges.

That includes areas like:

• Mental health support
• Family caregiving and guidance for care support
• Early-stage diagnosis and intervention

Benefits that integrate these elements, and treat them as core, not optional, are more likely to resonate with employees and drive engagement. Just as important, they help ensure benefits are relevant to a broader segment of the workforce.

A more accountable role for brokers

For brokers, all of these point to a more active and accountable role. Recommending voluntary benefits is no longer just about assembling a competitive package. It’s about validating that those benefits will deliver real value once employees need them.

That requires:

• Asking deeper questions about the claims experience and utilization
• Evaluating the employee journey — not only plan features
• Aligning recommendations with workforce demographics and real-world needs
• Getting away from the spreadsheet and the “race to zero” on price

It also means helping employers rethink how they define value and providing much-needed education to ensure employees understand their benefits and how they work.

A changing employer mindset, along with recent legal activity, may be driving the change, but the underlying shift is much broader. The voluntary benefits market is moving toward a more utilization-driven standard. And in that environment, the most important question is no longer “How much does this benefit cost?” It will be “Will employees actually use it — and will it deliver when they do?”

For brokers, the ability to answer the latter question clearly — and confidently — will define success in the years ahead.

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Christin Kuretich is the vice president of product at Trustmark Voluntary Benefits. Contact her at [email protected].