How are we all feeling about AI in benefits administration?

Even before ChatGPT came into your dinner conversations last year, AI had been a long-discussed topic in the benefits sphere. Since the mid 2010s, the term has been making ripples in plan selection, approval processes, and various other HR pain points.

But none of that compares to what we’ve seen in the past 36 months, since GPT-3 launched publicly. Now, with consumer interest and familiarity, a survey commissioned by my organization found that 73% of benefits leaders believe AI will have a positive effect on employees’ health and financial security.

But that interest doesn’t change the fact that only a small number of these leaders feel that they know enough about AI and current business options to make an informed decision about using it in their organization. That knowledge gap means that those AI hopes are still stars in the sky for many organizations.

Based on my own experiences building and refining viable, AI-based systems in customer service and benefits, I recommend looking at some key areas.

Why the knowledge gap?

AI is new and we operate in an industry that is both highly regulated and naturally reserved about change. It’s understandable that leaders would feel overwhelmed by the sudden deluge of options and even unenthused about navigating the privacy and data safety considerations that are always a part of the calculus of evaluating new technology.

Some of the responsibility falls on organizations to scout the market and inform themselves about AI pros and cons. This and regular discussion and planning internally are how I and many others have discovered and run with early iterations of AI-enabled customer support in particular.

Even so, more than any other technology evolution since mobile computing, it falls on vendors and AI-builders to provide transparent information about their products that skips uber technical jargon and fills a genuine, educational gap. Decision makers are clearly in the market for answers, and the folks creating AI solutions are in a unique position to provide expert guidance and comfort.

If it’s an option, benefits leaders might also consider hiring a technology broker or adding an AI expert to the team to help navigate choices and examine strategy.

Is it just knowledge that is lacking, or is it caution?

Like the public at large, benefits leaders certainly have concerns about AI — most notably overall security, maintaining privacy, and losing the sense of ‘human touch.’

Organizations that are implementing and using AI tools are aware of these concerns and answering them. While building AI software in my organization, for example, our developers are very cognizant about ensuring that what they’re building only uses relevant information to service the member’s needs without compromising personal security or privacy.

Our data shows a strong positive correlation between feeling knowledgeable about AI and the likelihood of implementing it in a benefits administration program — meaning it is in conducting due diligence that benefits leaders can gain confidence in the technology as it relates to their strategies and workflows.

Likewise, leading with alignment on security and privacy issues is the place most teams should start as they look for ways to bring AI to bear. Vendors are largely aware of those concerns and are proactively creating safeguards, but our data indicates that we’re in an adoptive stage. This means less established best practice and more custom tooling for different applications and workflows.

How can we leverage AI without losing touch?

Let’s face it — people use technology all the time, but some still yearn for the human touchpoint to give them a sense of resolution. AI builders are also working to address the human touch issue — often in ways which augment employees’ abilities rather than shifting responsibilities away from them. The most effective efforts I have seen are those that leverage AI to gain macro-level insights that lead to micro-level improvements. At my company, for example, we are using AI to help us keep track of the trends on key business and customer metrics at a macro level. That helps us seasonally to better understand and address how and where to adjust our approach to make processes that can be naturally complex or intimidating, more approachable and friendly. And, because we aren’t dedicating resources to sorting these nuances, it is allowing us to spend more time on our clients.

Here’s the crux: AI is not a replacement for the human touch. AI simply reinforces and sharpens those touchpoints.

I sometimes liken this to how I operate when I’m powerlifting — a sport I’ve participated in for many years. I use my belt to support my back and core, which helps me lift more effectively and safely so I can focus on my main task. But the belt doesn’t do the lifting for me. I still have to do the work, rely on my strength, and use proper technique.

Like a weight belt, AI in HR provides support by handling repetitive tasks, analyzing data, and offering insights. But human interaction remains essential for making nuanced decisions, understanding employee emotions, and fostering a supportive workplace culture, and it still requires human judgement to recognize trends, actions, or possible errors. What it does allow us to do is spend more time being the human touch and less time performing menial tasks, like spreadsheets, claims processing, and other jobs that take us away from human interactions.

Related: Study finds AI’s health advice still faces trust issues

Where should I start?

In our survey, benefits leaders shared what AI features they’re most excited to see. Each of the top uses have a commonality: benefits leaders want AI to power better experiences. These include:

1. Recommending health plans to employees. Enrollment is hard; AI can help make plan selection and understanding the nuances easier.
2. Automating eligibility checks. Probably the biggest pain point for benefits admin, employees, and medical billers is the repetitive processes to determine an employee’s eligibility. Automation would bring relief to the sick and weary—literally.
3. Streamlining claims. Like eligibility checks, this is a repetitive and frustrating process for all involved, and all too often, claims get stuck along the way. Streamlining the process and ensuring that claims go through smoothly would reduce the strain on all involved.

Additionally, AI can help move our organizations from reactivity to proactivity. We can leverage thoughtfully built applications and programs to more effectively predict our customers’ or employees’ needs and interests, allowing us to provide services as soon as the need arises.

AI is abuzz because it is a big deal, and that can be intimidating. However, just like the development of mobile computing, tap to pay, and dozens of other innovations in benefits and financial services, it will become the norm sooner rather than later. The best thing we can do is make it work for us. Fortunately, we have plenty of resources to help us keep informed and help us all make educated decisions on how to best implement it in our own organizations.

Jess Cloud is an accomplished IT transformation leader known for her expertise in driving member satisfaction and company growth. Jess and her team work to steer the company towards numerous efficiencies and innovations. Jess resides in Tennessee.