Reducing Errors
Reducing Participant Errors in Benefits Administration
When it comes to benefits, participants often make avoidable mistakes. This isn’t because they don’t care, but because the complex systems guiding these plans often confuse more than they clarify. By analyzing common errors, benefits teams can take proactive steps to simplify experiences, reduce confusion, and ultimately improve plan utilization.
The Problem: Misunderstandings That Lead to Escalations
In a recent internal review, I analyzed hundreds of participant support logs and case escalations. The goal? To identify the most frequent mistakes that caused claim denials, lost funds, and frustration for both the participant and support teams.
Here’s what the data revealed:
As shown, the most frequent errors included:
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Missing claim deadlines (often due to unclear communication on cut-off dates)
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Incorrect or missing documentation (frequently tied to digital uploads or lack of clear examples)
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Submissions for ineligible expenses, particularly in flexible spending accounts (FSAs)
The Approach: Education-First, Data-Supported
I partnered with the Customer Service and Education teams to develop targeted educational materials, including:
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Pre-enrollment guides outlining common claim errors
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Visual one-pagers for eligible vs. ineligible expenses
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Email templates tailored to specific account types and deadlines
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A proposal to host regular internal training meetings based on trending support issues
The Results: Better Outcomes for Everyone
These interventions reduced escalations and repeated participant inquiries, while boosting confidence and participation in benefit programs.
Key outcomes:
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Fewer resubmissions of claims
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Decrease in support call volume during peak seasons
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Higher participant satisfaction and confidence in using their benefits
Takeaway: The Value of Listening to the Data
Often, the loudest problems in benefits aren’t technical; they’re human. But technical tools using data analysis help us understand those problems clearly and build scalable, human-centered solutions.