The benefits priorities employees held a decade ago aren’t the same ones they hold now. The shift has been quiet but real: mental health has moved to center stage, responsive service has gained weight relative to plan features, and flexibility (especially for distributed workforces) has become a differentiator. Employers operating on outdated assumptions about what employees want are often surprised by feedback they receive in current surveys.
Here’s what the major published research consistently identifies about what employees want from their health benefits today: what’s at the top, what’s shifted, and how small and mid-sized employers can respond.
What the major surveys consistently find
Several major surveys publish recurring research on this topic:
- The Society for Human Resource Management Employee Benefits Survey ranks benefits importance from the employer side
- MetLife’s Employee Benefit Trends Study captures both employer and employee perspectives
- Willis Towers Watson’s Global Benefits Attitudes Survey is a major recurring multi-country employee survey
- The Kaiser Family Foundation Employer Health Benefits Survey is the most-cited public source on plan design and cost trends
Across these, the recurring findings:
- Affordability is consistently the top concern. Employees prioritize predictable, manageable cost over almost everything else.
- Mental health is a rising priority. Especially among younger employees.
- Service experience matters increasingly. Employees evaluate the experience of using benefits, not just the benefits on paper.
- Flexibility is gaining weight. Multiple plan options and design that fits distributed workforces.
The recurring top-ranked benefits
Across the major surveys, the benefits employees consistently identify as important (the order varies by source and year):
| Priority | Description |
|---|---|
| Affordable premium and out-of-pocket | Cost predictability above plan breadth |
| Comprehensive mental health coverage | Increasingly central |
| Responsive claims and billing support | Often weighted heavily |
| Provider network strength | Especially for employees with established care relationships |
| Prescription drug coverage | Specialty drugs particularly important |
| Dental and vision | Used frequently; visible if weak |
| Telemedicine access | Now expected as baseline |
| Tax-advantaged accounts (HSA, FSA) | Higher-income employees particularly value |
| Maternity and parental leave | Heavily weighted by family-stage employees |
The first three are universally high. Items 4–9 vary more by demographics.
What’s shifted in recent years
Mental health moved from peripheral to essential
In employee survey data over the past decade, mental health has risen steadily up the priority list. The drivers: post-pandemic stress visibility, generational openness about seeking care, and the practical access challenges (long wait times, narrow networks) that employees increasingly notice.
Employers with strong mental health coverage (short wait times, broad in-network therapist access, generous EAP programs) increasingly have a recruiting and retention edge.
Service experience gained relative weight
Surveys increasingly capture that the experience of using benefits (finding a provider, resolving a billing issue, getting questions answered) competes with incremental plan design improvements as a satisfaction lever.
Concierge-supported plans receive higher satisfaction scores than equivalent plans with traditional carrier-only support, even when underlying coverage is identical.
Tax-advantaged accounts gained credibility
HSA familiarity has risen. A growing share of employees, especially higher-income ones, actively seek HDHP/HSA combinations for the tax advantages and long-term savings potential. Employers who fund HSA contributions well are increasingly rewarded for it. See How HDHP + HSA Saves Money.
Flexibility moved up the list
Remote and hybrid workforces have made benefits flexibility more visible. Structures benefiting from this shift: ICHRAs (which let employees shop individual-market coverage), multi-option plans, and carriers with strong national networks.
What’s stayed consistent
Some baseline expectations haven’t shifted:
- Low barrier to preventive care — employees expect $0 copay preventive visits
- Coverage for common procedures — surgery, maternity, ER visits without surprises
- Out-of-pocket maximum that actually caps exposure
- Reasonable access to urgent care
- Honest, clear communication about the plan
What’s moved is what employees want beyond the baseline.
What employees say they dislike
The consistent top complaints across employee surveys:
- Difficulty understanding what’s covered. Summary documents are dense; employees often don’t know what they have until they try to use it.
- Frustrating carrier customer service. Phone trees, transferred calls, scripted responses.
- Surprise bills. Out-of-network charges, unexpected denials, unclear deductible accumulation.
- Narrow networks or network disruption.
- Slow claims resolution.
Most of these are experience issues rather than plan-design issues. Addressing them usually means better administrative partners (TPAs, concierges) rather than richer benefits.
How small and mid-sized employers can respond
Practical actions:
1. Add concierge / care navigation. The single highest-impact change for most groups; pays for itself through reduced HR workload and better employee experience. Concierge vs. Call Center covers the mechanics.
2. Benchmark mental health access. Check whether your current carrier’s mental health network has reasonable wait times in your geography. If access is poor, consider supplementing with an EAP or digital mental health benefit.
3. Improve HSA funding if on HDHP. Token contributions don’t move perception. Meaningful contributions shift employee experience.
4. Communicate plan decisions clearly. Most employees respond well to honest explanations of why benefits are structured the way they are.
5. Offer plan choice where feasible. For groups large enough to support multiple options, letting employees self-select fits the design to the situation.
6. Re-evaluate the broker/advisor. Year-round partners deliver better employee experience than transactional brokers, and frequently for similar or lower total cost. Transactional vs. Year-Round Partner covers the differences.
The gap between what employers think employees want and what employees actually want is bigger than expected. Running even a simple 10-question benefits satisfaction survey produces insights that make the next plan design decision significantly better.
What to do next
What employees want from health benefits today isn’t wildly different from a decade ago. The categories haven’t changed. But priorities within those categories have shifted. Mental health matters more. Experience matters more. Flexibility matters more. The old “rich PPO + low deductible” formula increasingly misses what employees actually value.
For employers willing to listen to their workforce (even through simple surveys) and respond with the specific adjustments that move satisfaction, the payoff is real: better retention, easier recruiting, and an HR team that spends less time mediating benefits frustration.
Want to survey your workforce and benchmark your benefits against what employees actually want? We can help structure the survey, interpret the data, and turn it into a practical benefits plan. Talk to us.