Are benefits advisors ready for the digital future?

In the health care administration space, organizations are deeply invested in lowering benefit costs. They often prioritize offering new service solutions over investing in the technology and integration needed to connect these solutions and improve the benefits experience for members. This focus is understandable—their primary goal is to ensure the groups receive the best coverage and benefits. They’re not tech companies with resources to build, support, and iterate on a tech solution.

Technology is the future to deliver solutions and engage members, and organizations that fail to prioritize tech will risk becoming obsolete. The landscape is evolving rapidly, and outdated technologies simply don’t meet member expectations in a world shaped by Netflix, Apple, and Amazon experiences. AI and seamless integration of member experiences is where health care is heading. To truly succeed and grow, benefit administrators and consultants need to have a roadmap for investing in the right technology that can streamline future operations, enhance member engagement, and deliver a connected benefits experience that sets their services apart.

While this may sound daunting, the good news is they don’t need to hire an entire team of engineers and in-house developers to do this. Affordable technology already exists that brings the benefit experience—and solutions—together.

Here’s what you should consider when choosing a technology partner to help you lead in health care’s new digital era:

Truly configurable tech is key

Essentially every tech tool in the benefit space will claim that it is customizable. But, as they say, the devil is in the details. Brokers and TPAs are wise to investigate exactly what can be configured and in what ways. In the complex benefit space, one-size-fits-all solutions are a myth — real customization is essential.

For instance, what is the member experience? Can the solution be branded dynamically to carry either your brand or the brand of the client company itself? Does that go beyond just swapping a logo? Are the colors and fonts customizable as well to reinforce brand recognition for the user with the organization providing the benefit?

Beyond the appearance and feel, is it easy for administrators to turn features on and off or rearrange the menu? Tools should be seamless and intuitive based on the specific benefits offered — the last thing anyone wants is for members to give up on the tool because they’re confused by features that don’t work with their plan or unable to find a feature they need.

Your tech should combat point solution fatigue: Think seamless integration

Point solution fatigue is a growing concern in the health care industry, where members are overwhelmed by the need to manage multiple logins and disjointed apps. An integrated solution brings the benefits experience together—under one roof—providing a streamlined experience that eliminates the frustration and inefficiency of juggling various platforms and making it easier for members to be active, informed and engaged in their benefits. Many members are unaware of the benefits included in their plan. A good tech solution places these benefits front and center, all in one place, so members can easily access and use them without having to dig to find them, ultimately reducing costs.

By seamlessly integrating multiple benefits into one platform, benefit administrators reduce complexity, improve the user experience and create a system that health care consumers want to use. This not only fosters higher member engagement but also drives better health outcomes, cost efficiencies for groups and a more enjoyable experience for everyone involved.

Elevating member experience with advanced virtual assistance

Everyone has experienced the annoyance of chatbots that fail to understand questions or provide useful guidance. However, those frustrating experiences are becoming increasingly rare. Advances in generative AI have transformed the chatbot from a nuisance into a valuable virtual assistant in just a few short years.

In fact, some of today’s virtual assistants are far more than automated response systems—and they can be a powerful extension of your service team—allowing you to operate at peak efficiency. For example, they can be preloaded with group benefit plans, allowing them to answer member questions about coverage instantly.

Related: Transforming coordination of benefits: Challenges, technology, and the path forward

Consider how many hours your team spends answering “easy” questions: Is it covered? What’s my copay? These questions, while simple, consume a significant amount of time that could be better spent on more complex issues. By implementing advanced virtual assistants preloaded with group benefit plans and accumulator information, these questions can be answered instantly and accurately. This not only saves valuable time for administrative teams but also ensures that users receive prompt, reliable information when they need it most. And the best part? These virtual assistants can intelligently evaluate a member’s needs, connecting them to human guidance and benefit navigation tools when necessary.

The build vs. buy dilemma

As benefit administrators evaluate whether to build or buy a tech platform, there are several considerations to keep in mind. The decision to develop an in-house solution versus leveraging existing technology can significantly impact both short-term efficiency and long-term growth.

While building a custom platform offers tailored solutions, it often requires substantial investment in time, resources, and ongoing maintenance. Conversely, buying a proven tech platform provides immediate access to advanced features, continuous updates, and support without the need for a dedicated engineering team. But is it the tech you need?

Brokers and TPAs who want to win the future must help their groups leverage technology effectively. By choosing the right tech solutions, they can enhance member engagement, streamline operations, and ultimately deliver a benefits experience that meets—and exceeds—member expectations. It’s about creating a cohesive, efficient, and enjoyable journey for members, ensuring that the benefits experience is as seamless and satisfying as possible.

Markus Waite is president of Empara, a developer of health care technology focused on making health care accessible, affordable and seamless. Empara is part of the Goodroot community of companies where Markus also serves as CIO.