Empower Employee Benefits Experience with Personalized Digital Technology

Paul Jelnik: Hello everyone, and welcome to today's session, titled Empowering Employee Benefits Through Experience of Personalized Technology. My name is Paul Jelnik. I'm a VP of Product Management here at TriNet. I'm responsible for our health and welfare benefits offerings. Joining me today, is Guy Benjamin, founder and CEO of Healthee.

He will be our main speaker, but before I turn it over to him, I just wanted to give a little bit of background on how we got to know Guy and his team. So, I personally have been in the benefits industry for about 20 years. I've worked for a lot of varying companies within the HCM space, and one of the things that I've noticed over the years is that the average employee does not understand benefits.

I see a lot of head nodding, so that's good. And, for those of you that are around benefits, you realize what problems that creates, right? So, for employees, I always think of it as one of the most important decisions they make during their lives or on an annual basis, and unfortunately, statistics say that a typical employee spends 15 minutes making a benefits decision, which, of course, is not long enough given the importance of it.

And the worst situation when someone makes wrong benefits decisions is one of two things. One is they choose benefits that are more expensive, more than they need, so they're overpaying for something they don't need. The worst case is they choose a benefit where it doesn't provide enough coverage, they have an event and then suddenly they don't have the insurance to pay for it. So huge problem in the industry that I've seen over the years. So when I joined TriNet early part of last year, I saw the same issue happening over and over. So, working with TriNet and the other members of the team, we finally decided to do something about it.

And that's when we started looking at what companies out there in the industry can help us solve these problems. And after going through a lot of discussions, we came across Guy and his team. And he'll give you all the details in a moment. But one of the things that we really liked about Healthee in particular is that, unlike a lot of companies out there that focus primarily on helping employees pick the right plan during enrollment, I think what Healthee does, which is unique, is that they also help employees leverage the plans that they already have throughout the year.

So, again, to me, that's a really big differentiator. So again, I think very highly of Healthee. I think they're doing a really good job. We've been collaborating with them for a little bit of time here and, you know, we'll be announcing some really exciting news here in the coming days and weeks. So stay tuned. But with that said, I'm going to turn it over to Guy and he's going to walk you through, you know, some of the opportunities they're seeing in the industry and then some of the ways they're solving for those.

Guy Benjamin: Thanks, Paul. Hey, everybody. Hey, I'm Guy Benjamin, CEO and co-founder of Healthee, and what I want to talk about today is a little bit about what are our employees expectations and what can we do more as HR leaders to kind of enhance their benefit experience.

Just a little bit about my background, that's me. You're gonna have to believe it, but it is me. I can send you this picture and you can tell it's you, but for now that's me. I used to be a fighter pilot in the Israeli Air Force. That's my background. I flew F16 for about 13 years. I think there's a happy hour later, so if I drink enough I can tell you about the time I bombed the wrong bridge, but that's for another time. So after 13 years in the Air Force, I came to the U.S., went to Yale, and then worked at McKinsey, the consulting firm.

And while I was working at McKinsey, I realized pretty quickly that I have zero clue about my health benefits. And every time that I have a question, I go to HR. Usually that ends with me calling a call center. And that wasn't really the experience I was hoping to get as an employee. And at first, I thought, well, that's probably me as an immigrant, I don't really know what I'm covered for, but when I was asking my friends and colleagues, nobody knew what they're covered for. And when you think about millennials, Gen Zers, they don't want to call their mom, let alone a call center. So I thought that there could be a really good opportunity to bring AI and technology into the space of health and wellness benefits.

So, I left McKinsey about two and a half years ago. Web of investors kind of laid out the vision of, again, bringing technology into the space, and we raised about $26 million and then started this company, Healthee. I'm going to spend most of the time talking not about what we do, but mostly because of why we do it, right? Why did we decide to go and kind of tackle this super important issue, but that's super complicated and try to bring technology into it? And, you know, why did I make this kind of like my life calling at the moment, right? Feel free to stop me at any time with questions, but I'm going to start just with a few questions.

We're not going to do a formal survey, but I'm going to think about it. According to McKinsey, what percent of people prefer to manage their health care online, right? When you think about it, is it 30% to 40%, 40 to 50%, 60 to 70, or 70 to 80%? I think the answer, for me, it's pretty obvious, right? But the answer is 70 to 80%. So most people do prefer to manage their health benefits online. Where are they doing it today? They're doing it either on the phone, trying to call a call center. I actually talked to a few employers that they still do handouts where they send letters to someone's house and they have to choose which benefit to choose from and send it back, which for me sounds like 1980, but that is the reality. But that's what our employees are expecting. That's what we expect. We want to be online. We want the Amazon-like experience, the Uber-like experience.

Next question. What percentage of employees would regularly use an app to access their Health benefits information, right? Again, is it 40%? Is it close to half? 63% or even close to 80%?

So think about it for a second. Again, for me the answer is pretty obvious, right? It's almost 80%. 80% of our employees expect to manage and access their benefits online and under fingertips, right where they are. And think about your experience with health benefits, think about if there's any HRs here, what experience are you providing to your employees and does it meet their expectation?

And then last question is—what would you look most likely to achieve or with an optimized benefit experience, right? Do you want to have higher employee retention, lower healthcare overhead, reduction in HR burden, higher benefit engagement, or all of the above? So again, pretty obvious. It's all of the above, right? We want to get an optimized benefit experience for our employees. We want to give them the best experience that we can give them. Think about, my VP people is right here, and things that she talks to me all the time about is how do we make the experience of the employees amazing?

How do we wow them every day, not just on day one, every day? And we try to do it, but then they meet their health benefits and they're the opposite of wowed. So, when you think about people leaders, they're tackled with a lot of different tasks throughout the day. These are just some of them, right? They need to contain healthcare, right? The CFO keeps talking to, I mean, I keep talking to, my VP people are like, "Hey, what about our healthcare costs? Let's reduce it. Why is it so high? Why is it going up year over year by 30, 40%?" They're asked to answer employees questions. And again, none of us here is a healthcare expert, right, let alone HR leaders. They're not healthcare expert, but they're tackled to do that. They need to provide plan guidance.

And it's funny, I just had a call the other day with an HR leader and I asked them—how do you help your employees pick a plan during open enrollment? And I'm not lying, this is what they said. He said, "Well, I just tell them what I picked." And that's it. And that's not how it should be, right? But there's a lot of things that HR leaders are tackled to do. And this is just part of it on healthcare. But it's among all the other critical duties that they have, right, that you may have on your plate: people's strategy, experience, a lot of other stuff that does not have to do with health benefits. Now, what are the biggest challenges that we see for HR leaders today or HR facing companies today? The number one that we're seeing is obviously rising healthcare costs.

Again, I was talking to one of our customers the other day, or I think it was two days ago. This is a company with about 330 employees in Connecticut. They've seen a 40% year over year increase in their premiums, 40%. That's think about as the HR leader that needs to go to the CFO or the CEO and kind of explain why last year we were spending this much and this year we're going to spend 40% more. Now, the rising health care cost is not just a burden on us as employers, it's on us and us as employees, right? This is from the last 10 years. You can see deductibles have more than doubled in the last 10 years. Family premiums, 76% increase in the last 10 years, and you can see the trend, right? You don't have to be a statistician to know the trend, that it just keeps increasing, right?

And you can see the wage. Wage is increasing at 43%. So the burden, and we'll talk about it in a minute, the burden of healthcare is not just on employers, it's on our employees. They think about it. It's part of their life every day.

And the second thing is frustration. There's a lot of frustration for employees around their health benefits, right? So, 45% of our employees, they feel like they're financially burdened by healthcare, by health insurance. 60% of them are not really utilizing their benefits because they're not sure how much it's gonna cost them. Think about an employee that needs to do an MRI, and about 10% of the population every year needs to get an MRI.

Think about what they're thinking. Well, I come from a country where you don't need to think about it because it's socialized healthcare. The first thing they think about is, "How much is it going to cost me,” right? “Am I going to need to spend thousands of dollars on MRI?" Pregnancy. First thing people think about sometimes is, "Okay, what are going to be the bills if I'm going to go to the hospital for a pregnancy?" And 60% of them will not use their benefits because of that, which is crazy. Think about it. Again, how much money we spend as employers on our benefits for our employees, and many of them do not even use it. And then, last one is 63% of them consider leaving their workplace because of the price of health insurance. It's that much of a burden.

Now, employees are looking for a better, less costly benefit experience, and they want to meet it, meet them where they are, and where are they? It's on their phone, but not on their phone calling. They're looking for that digital experience. They're looking for, again, that Amazon-like experience, that Uber-like experience. And it's not something we're providing today, yet. Now what are the current gaps in the employee benefit space? There's many of them, but let's talk about a few. First one is underwhelming apps, right? So, a really poor platform we send them to, either the carrier website, which is okay, but not great.

We either send them to multiple sources. This is what I call single use case apps. An app for, to choose a plan during open enrollment, an app to find doctors, an app to maybe book appointments, and then another app to know what you're covered for, and then, three different call centers or phone numbers to access your medical, dental, and vision. Right, so they're really underwhelmed by what we're providing them today, and it causes confusion and frustration, right? Think about if you had to use Uber and it wouldn't really work, right, how frustrated you were. Or if on Amazon, you wouldn't see prices, you gotta buy without seeing prices, right?

That's like the equivalent of what our employees are feeling every day. And, again, 93 million Americans are looking for health benefits online. They're looking for that experience. 80% of Americans spend on their phone at least three hours a day, right? 25% of them only have a phone; they don't even have a computer, they just have their smartphone. And then 77% of employees would regularly use an app to access their benefits.

The next one is kind of like that PCM experience. We talked about it. People love apps, but they hate redundant apps, right? How many apps do you think on an average phone each person has? If you're gonna throw out a number. Five, like 10, 20, 30, 100? Okay, it's about 80 apps that we have on our phone, on average, right? If you take out your phone now, there's about 80 apps there, but we only use nine of them on a daily basis. That's it. So, 10% more or less, right? 60% of them, we don't even use on a monthly basis; they're just there.

And again, when you think about that experience that our employees are looking for, they want something that they can use, maybe not on a daily basis, but they can use for more than one thing, for more than just a single use case, right? They want, and Paul talked about it, not just during open enrollment, and that's it. They want something, and that's why we created Healthee. They want something that's there all across the year, all year long. And then, one last thing is that they don't want generic answers. And sometimes when you go to HR, you kind of get answers that are like the HR that I mentioned.

Okay, this is the plan I picked. They want something personalized. They want a personalized experience. They want something that can give them an answer for what they need at their specific time that's going to meet their care needs. And again, sometimes when you call a call center, that's not the experience that you're getting. And I think when you look at your demographics and your employee's demographics, that's what they're looking for. Now, you can see these stats, but 70 to 80% want to manage their healthcare digitally. We talked about it. 72% already engaged in looking for benefits online. And then 88% want to access expert guidance and information to make informed decisions.

And if we're looking to create that experience, there's a lot of things that we can do, a lot of technologies out there that we can leverage, but what we cannot do is just keep going as is, right? A lot of the things that I talk about is the cost of doing nothing. If we don't do anything about it, if we don't create healthcare that is more accessible, if we don't help our employees know how much things are going to cost, if we don't make them smart consumers, we're just going to keep that line that we saw on deductible, the line that we saw on premiums, it's just going to keep increasing, because if we don't help our employees be smarter consumers, they're not going to be smart consumers.

And the cost is going to be on them and on us as an employer. And that's exactly, when we started the company, what we said we wanted to try and change. And if we don't meet the employees where they are, it's going to mean lower employee satisfaction, it's going to be decreased retention rates. And again, when you think about what HR leaders are looking to do, it's exactly it. It's employee satisfaction. You want higher retention. Now, what I mentioned so far is what employees are looking for, what's the expectations, where they are. But there are things that we can do that sometimes are like a mix between technology and non-technology solutions.

And what we like to talk about is three kind of pillars that can really help lower healthcare costs for employees and employers. And it's like on three pillars of cost transparency, behavior steering, and accessibility. And each one of them is probably a whole, we can talk for a while on each one of them, but I just want to touch on each one just to talk about what can we do as employers to help our employees lower their costs, which in return will lower our costs as employers.

So the first one is cost transparency, which seems like when you talk about health care, there's nothing transparent there. It's mostly the opposite, right? But I think there are ways to create cost transparency when you talk about health care. The first one is what Paul mentioned, when you pick a plan. So when you pick a plan, not only mention to your employee, "This is what's going to come out of your paycheck every other week," but talk to them. "What does it mean if you're going to go to the hospital, what is it going to cost you? If you're going to have a baby next year, what is it going to cost you?"

Make sure they understand for each plan that they look at, not only the cost for them, but the cost that could be, if they need to go to the hospital, they need to see a doctor. That's the main one and we don't do that enough. So one thing that we can do is just educate employees on each plan, what does it actually mean.

The second one is in versus out-of-network usage. We see way too much usage of out-of-network doctors. Sometimes it could be 20 to 30%. I don't know if anybody here is looking at their claims, but there's a lot of claims that are just out-of-network. And it's mostly because of employees that are just not aware that they need to find in-network providers.

I can tell you about myself. When I just moved to the U.S. for the first year, I didn't even know there was a thing called in and out-of-network. I didn't know. I was told to go to a doctor and I just asked a friend, "Okay, who do you usually go to?" And that's where I went to. And again, I'm a kind of an example of somebody who migrated to this country, but I can promise you that you have employees that are the 26-year-old who just came out of their parents’ plan, who never heard the word deductible or in-network and have no clue. So helping them understand what does it mean in and out-of-network, what do those terms mean, and steering them towards that in-network can save a lot of money to you as employers and to the employees.

The third one is procedure cost. I don't know if many know, but today, because there's a new act that came out a couple of years ago called Transparency Act, you're supposed to know when you go to a hospital, the hospital is supposed to tell you how much things are going to cost before you get it done, how much a procedure will cost before you get it done, which, until now, never happened, right? You would go, get a bill. By the way, there's a book called 'Never Pay the First Bill'.

It's about healthcare bills and it's correct. It's right. But helping them understand there's procedure costs, and there, they can find out, they can find about it. They can ask the hospital, "Okay, how much is it gonna cost me? What are the costs associated with this?" And then even if they need to, they can compare notes and compare kind of prices between hospitals. And you don't have to use, there are technology tools out there that can help with that. Healthee is one of them and I'll show you in a minute. But there are many tools out there that you can use to help employees guide them through that. The second one is probably one of the toughest one, is behavior steering. Right. How do we steer employees to those lower cost but still high-quality options? So ER, anybody has an idea of how many ER, what percentage of ER visits a year are unnecessary?

Fifty. Yeah, 50%. 50% of ER visits are unnecessary. It's somebody that goes to the ER when it's not a life-threatening event. They have many other options that they could have taken. So think about how much money that is that they waste because they are not steered to the right behavior of checking out urgent care or using telemedicine or telehealth, right?

There's many options here that we can steer employees to have better behavior that is lower cost for them and for us as an employer. And then we talked about the in-network guidance, which is also steerage, right, reminding them. One thing that I'm seeing a lot is employers will have like, they're in open enrollment a session, we'll teach employees about in-network, out-of-network, we'll try to, and then half an hour later if people actually attend, they completely forget about it, right? So steerage and educational is not just once a year; it has to happen throughout the year. And then one last thing is accessibility. I talked to a lot of HR leaders, well, CFOs as well, and they will say we provide the best benefits and we have the best benefits and it's the best benefit that an employee can find.

But employees are not aware of it. Why? Because it's not accessible. Providing health care doesn't mean you provide access to health care. So finding ways to make healthcare more easy to navigate, right? And easy to navigate is definitely not an employee handbook that has 600 pages. It's definitely not a plan, sending somebody to look at their plan for, you know, medical and try to find out what page 400 talks about a medication that there may be covered.

And I would argue that it's not even calling a call center because they're just not gonna call it. And some of our employees, when they have time to call, those call centers are not open. So finding ways to help them navigate, and it could be again, using technology, it could be an intranet, it could be just having some kind of resource that is available, again, where they are, which is on their phone, is a really good way to find accessibility.

The other thing is making healthcare easier to understand, which is easier to say, much harder to do. But again, there are ways where we can create benefits that are much easier than, "Hey, if you met your deductible, then it's a 50% copay out of." No, we gotta explain it to them in a way where, you know, like somebody who's again, 26 and it's their first time on their health plan, even if they're not 26, right? Many people just don't understand their benefits.

And then last one is convenient to use, right? For example, do we provide them telehealth that is, again, very available all the time or do they have to go on their intranet and find it somewhere in a folder? Finding ways to make healthcare much more convenient can also help with providing much better accessibility to healthcare.

Cool, so those are the kind of things to think about. Now I want to show you what we created. So we created Healthee and it really empowers employees to make the best choices possible. It kind of streamlines the benefit experience. When we just started the company about two and a half years ago, the first thing we did was research.

We wanted to know what our employees' needs are. Because at first, we said, "Okay, they just need to know what they're covered for." But there's so much more, right? You need to pick a plan during open enrollment. You need to know what you're covered for, you need to book appointments with doctors, find who is in-network, know your deductible, ID cards, how much things are going to cost before you get it done.

There's so many things that they need to do when it has to do with healthcare. And again, we send them to all these point solutions and they get lost. So what we said is we want to build a platform that it's like a one-stop shop, and I'll show it to you in a second, but a one-stop shop where employees can come and pick the best plan during open enrollment, can figure out if they're covered for something based on their specific plan, can know which doctor is available and which doctor is in-network, book appointments, no deductibles, ID cards, all in one place. And then on top of everything, we created this here. Her name is Zoe and she's like a personal health assistant.

So think about, like a Siri or an Alexa, but for health benefits. And the way Zoe works is that, it's again, easy to say but harder to do, is she uses AI to take any type of health benefit, any type of health plan, medical, dental, vision, any type of point solution, any benefit that you provide to your employees, and she knows how to convert them from an unstructured data, which is just a nicer way to say PDF, to a structured and mapped database.

And once that conversion happens, that's when Zoe becomes your personal health assistant. Because you can go to Zoe and say, for example, "Hey Zoe, my daughter needs a speech therapist." And she'll tell you, first of all, if you're covered for it, based on your plan. She'll tell you where you can get it done, based on your network. She'll tell you how much it's gonna cost, based on your deductible, and how much each location charges. And then she'll book you an appointment, all without talking to a single person, which sounds like heaven. And, the other thing she'll do, is she'll also help you during open enrollment, to pick the best plan for you and your family.

So I'm gonna try to show it to you, show Zoe to you. We'll see if the technology works. I didn't create this technology. So let's see, can we show it? Yeah, wow, okay. I'm even surprised. Cool, so it's working. So, this is basically my phone right here. Again, meeting employees where they are. So what you can see here, this is the platform. This is Zoe. Everything is in one place. So, if I have a coverage question, if I need to find a doctor, immediate care, telehealth is right here, I can see my deductible, ID cards, benefits, they're all in one place. Now if I do have a coverage question, I can click here on the bottom, and I can access Zoe, and I can ask her any question about my health benefits.

And the cool thing here is that I don't need to speak insurance language or medical language. And let me try, let's see again. But again, I don't need to speak insurance language or medical language, I can just ask her, "I have back pains," and she'll tell me immediately if I'm covered for it or not. Let's see if it works. As I thought, the technology sometimes not working, but try one more time. Let's go back to the deck for a second. We'll see if it comes up. Yeah, but when I ask a question, she'll tell me if I'm covered for it based on my plan and then she'll tell me the cost. So I can see exactly for each location how much they charge me for that specific MRI.

So for example, I live in New Jersey. She'll tell me, for example, if I have an MRI, if I can get an MRI for $200 or $2,000 or $500. And again, think about that information for an employee. It makes their life much different, right? It makes them smarter consumers, which they're not until now, right?

So, before I open up for questions, like, this is our vision, right? Our vision is to really create a world where people really understand their health care options. They take advantage of them, that's our mission, really, to make employees healthier and really reduce the burden of health care costs. Cool. I'll open it up to questions. Yes?

Audience member #1: Do you have a letter you can use in Spanish?

Guy: So we have English and Spanish, but we're working on more. Cool. Yes?

Audience member #2: Does the platform have the ability to take into account pre-tax benefits like an FSA or HSA?

Guy: Yep. Yep.

Audience member #2: And steer in that direction?

Guy: Exactly. So I didn't show you the plan comparison tool, which is really cool. But the plan comparison tool, what it does is it will ask you, for example, "Are you planning any pregnancy next year or any surgery next year?" And it will help you find the best plan for you. And also we recommend how much to put in your HSA based on your expected kind of usage.

Audience member #3: Just thinking of the main session we were just in, and worrying about sort of hallucinations and how do you help Zoe and the info behind her to be accurate? What's the process you have to do that?

Guy: Yeah. So first thing, just back to that session, another thing that Zoe is really cool about is being private, right? Sometimes when you're dealing with mental health issues, you don't want to go to HR and say, “Hey, what are our mental health benefits?" You can always go to Zoe. But just to your question, what we use is, we're first of all connected to many different data sources just for doctors to see if they're in and out-of-network, your deductible, your coverage. But we take your health plan, as is the 600-page document where that's like the Bible for us and we convert that to structured data and that's how we keep it accurate. Yes.

Audience member #4: Is your technology accessible to non TriNet customers? And then, are you a brokerage firm to allow for plans for other individuals that don't have or are not TriNet customers?

Guy: So we're not a broker firm, we work with any customers. Obviously our TriNet customers are our favorite, but we work with other customers as well. So yeah, the platform is available in other platforms as well. But I will say that what's cool about Zoe is that she also can connect you to a free telehealth, like psychiatrists and psychologists and doctors. And you don't have to be enrolled in a health plan for that. Like you can just access Zoe, and she'll provide... So if you have employees that are not enrolled in health plan, you can still provide them telehealth, free telehealth. Yes.

Audience member #5: Thanks so much for this. Similar to the question previously, are you connected with the carrier websites? Just because the plans generally change once a year, but the providers, who's in-network, who's out-of-network, those can be changing.

Guy: Daily.

Audience member #5: Yeah, like, yeah, daily. Yeah. I feel like I've had people who have gone somewhere they thought was in-network and then it was out-of-network and it's been not a great experience.

Guy: Yeah, so first of all, we're connected to the carrier because we need the deductible data. So we get that through a live feed. But I will tell you maybe something that's going to surprise you. The carrier, they don't have the most accurate data on in and out-of-network. They're probably 60% accurate. We use other data sources and we kind of triangulate from different types of data sources to make sure that whatever we provide on the in and out-of-network is the most accurate one that we can bring.

Audience member #6: How do you ensure that the cost is accurate? So I'm just wondering, you go to New York, different doctors, and they charge a completely different thing for the same.

Guy: That's a really good question. So what we do is we have access to about 22 billion claims. So in the last five, and what we do is we'll look at each location. So let's say, for example, you want to get an MRI and you want to get it somewhere in New York. So we'll look at that location and we'll see what did they charge for somebody on the same insurance as yours in the last five years for an MRI. And we'll tell you, on average, this is what they charge. But if you go two blocks south, you can get the same MRI for a fraction of the cost, based on what they actually charge. So it means, like, we're not just going based on what they're telling you they're going to charge, we're actually looking at what they charged in the last five years, which makes it very accurate.

Audience member #7: How do you handle relationships with ACA and Medicaid and Medicare, which is not necessarily employer based?

Guy: Right, so today we're not doing anything yet with Medicare and Medicaid, but it's in our roadmap. So, we've only been around for two and a half years, we're still a startup, so we have to be super-focused. Obviously, there's many things that we can try to fix in the healthcare system. We gotta start somewhere, so we started with kind of like employer provided healthcare, but it is something that is in our roadmap for the future.

Audience member #8: Coming back to the accuracy of the in-network and out-network providers, you mentioned that these providers could be updating themselves every single day. What kind of guarantees or in terms of recency of information that you provide in your app?

Guy: Yeah, so because we use multiple data sources and third parties, that will make it as accurate as it can be. We've yet to have any issues with a doctor that was mentioned as a network and was eventually out. Maybe one last question if there's one or no, no more questions. So there are no more questions. If anybody wants to see, so my Wi-Fi is out, which is why it didn't work, so if anybody wants to see an actual demo, you can find anybody from our team or myself and we can show you a live demo. Thank you so much for the time. I really appreciate it.