What 1,500+ Employees Can Teach Us About Open Enrollment 

Every Open Enrollment season comes with the same big question: What will employees choose? But there may be a more important question to ask first: What did employees learn from living with the plan they chose last year?

Take Command surveyed more than 1,500 employees to understand how they felt about their current health plan and how that experience is shaping their mindset heading into their next enrollment decision. 

The findings point to an important shift for employers, benefits consultants and carriers: getting employees enrolled is only the beginning. The experience that follows can determine whether they stay, switch, or head into Open Enrollment ready to reconsider their options.

Here’s what they told us.

The biggest opportunity is with employees who are undecided 

It’s easy to think about Open Enrollment in two groups: employees who are happy with their coverage and those who are ready for something different. But there’s another group that deserves attention: employees who simply aren’t sure yet. 

Rather than treating Open Enrollment as an administrative exercise, employers and benefits consultants can use it as a moment to help employees reflect on what worked, what didn’t, and consider what they actually need from their coverage next year. 

Uncertainty doesn’t necessarily mean employees are disengaged. It may mean they recognize that their current coverage isn’t a perfect fit but don’t yet know whether another option would serve them better. Open Enrollment gives employers and benefits consultants an opportunity to help those employees turn a general sense of uncertainty into a clearer set of priorities. 

The goal isn’t simply to move employees through enrollment quickly. It’s to help them make more informed decisions. 

Price gets attention, but usable value earns loyalty 

The premium is one of the easiest plan features to compare during enrollment, but it offers only a partial view of affordability. Deductibles, copays, prescription costs, and out-of-network care can all influence what employees ultimately spend, while access and usability shape what they receive in return. 

Can they see the doctors they want? Are their prescriptions covered? Do they understand how their benefits work? Can they access care easily? 

Because employees experience the value of their health plan through access, coverage, and ease of use, any meaningful conversation about affordability must extend beyond the monthly premium. 

A plan’s value depends on provider access 

A plan may look affordable on paper, but its value can feel very different if a preferred doctor isn’t in-network. Employees may have to change providers, travel farther for care, pay out-of-network costs, or navigate a new healthcare system when they expected continuity. 

Because healthcare needs are different for every employee, the lowest-cost plan may not be the best-value option if it doesn’t include the doctors, specialists, facilities, or types of care they expect to use. Maintaining access to trusted providers can therefore be an important part of whether coverage genuinely works for the person using it.

Prescriptions deserve more attention during enrollment 

Prescription coverage can also shape how employees experience their health plan, particularly when they rely on medication to manage an ongoing condition. A medication may be covered under one plan but excluded from another, placed on a different formulary tier, or subject to different cost-sharing requirements. 

That means employees may need to look beyond whether a prescription appears on a formulary. Its tier, expected out-of-pocket cost, pharmacy requirements, and any coverage restrictions can all affect access throughout the year. 

Helping employees consider those details before they enroll can reduce unexpected costs and frustration while giving them greater confidence in the plan they select. 

Open Enrollment shouldn’t start from zero 

Perhaps the biggest takeaway from the research is that every employee enters Open Enrollment with a year’s worth of experience behind them, and that experience is valuable data. Employees may have discovered that they paid for benefits they rarely used, lacked coverage where they needed it most, encountered unexpected costs, or struggled to understand how their plan worked. 

Those experiences can help employees identify what they want to preserve and what they want to change. Employers and benefits consultants can use them to make enrollment guidance more relevant, rather than allowing employees to default to last year’s choice without considering whether it still fits. 

Carriers can use broader patterns in employee satisfaction, uncertainty, and switching behavior to examine how plan design, network strategy, and communication affect the member experience. The value of the research is not limited to predicting what employees will select; it can also help explain why they make those choices. 

A better OE experience starts with understanding the employees

A better Open Enrollment experience begins with understanding that employees aren’t making decisions in a vacuum. Their priorities have been shaped by a year of searching for providers, filling prescriptions, managing costs, and trying to use their coverage. 

That context becomes especially important when employees choose their own individual health insurance through a CHOICE Arrangement (formerly ICHRA). The wider range of available plans creates more opportunities to find a personal fit, but it also gives employees more variables to evaluate. 

Effective decision support helps employees translate their healthcare experience into practical selection criteria. Instead of comparing premiums alone, they can consider which plans include their providers, cover their prescription, align with their expected use of care, and offer costs they understand and can plan for.