How Employees Are Using AI Benefits Tools to Model Real-Life Scenarios During Open Enrollment
As open enrollment gets underway across employers, we’re seeing new patterns emerge in how employees use AI to understand and choose their benefits. The data reveals a deeper kind of engagement: one that’s unfolding right now, as employees move beyond quick answers to real, personalized decision-making.
Employees aren’t just using Carly, our AI benefits assistant, to get transactional answers to tier-one questions like “What’s the deductible for the HDHP?” or “Tell me about the vision plans.” They’re using it to model scenarios that affect them personally. Scenarios like:
“If my spouse and two kids and I are enrolled on the PPO and each child needs four primary care visits and one specialist visit, what will my out-of-pocket costs be? Okay, now show me that same scenario on the other plan.”
“Run me through a sample scenario for a dermatology visit on each plan offered.”
“My cat has hyperthyroidism—will he be covered by MetLife?”
“I have 2 active boys who go to the ED at least once a year with fractures. Show me how my out-of-pocket changes if I enroll in the accident plan.”
“If I retire in March but fully vest my 401k in January, will my employer’s match be complete?”
These aren’t abstract questions. They’re practical, thoughtful, and deeply human explorations of what coverage means in real life.
What’s emerging through these interactions is a clear signal: employees have a deep hunger to understand and model their benefits. For years, we’ve known that benefits education often stops at “what’s offered,” leaving employees to translate complexity into personal meaning on their own. What Carly is making visible is that, when given the right kind of support, employees want to engage, test scenarios, and see how benefits map to their circumstances. They’re no longer passively clicking through plan documents; they’re actively simulating their families’ real-world needs and financial tradeoffs. And this is happening at scale, across diverse populations and employers. On average, 14% of conversations included a benefits modeling question, but for some of our customers it was as high as 33%.
Why AI-Driven Benefits Guidance Is a Win for Both Employers and Employees
For employers, this is more than a nice-to-have. This use of AI to model specific scenarios heralds a transformation of benefits engagement. Employees who use Avante’s AI are not only getting answers faster, they’re developing a deeper understanding of their benefits and how to use them. That translates into fewer escalations and less confusion during open enrollment, and also into a more confident, better-equipped employee base throughout the year. As employees make more informed plan choices and understand their coverage in context, we can expect stronger utilization of preventive care, smarter financial decisions, and a greater sense of trust in the employer’s investment in their wellbeing.
A New Era of Benefits Literacy is Empowering Employees at Scale
In short, the OE this year demonstrates a shift beyond mere perfunctory use of AI applications. What we’re seeing emerge is a new kind of benefits literacy. Employees are bringing their whole lives to the conversation, and Carly is meeting them there, in real time. For employers, this represents an inflection point: an opportunity to move beyond one-size-fits-all communication toward benefits experiences that feel personal and empowering. It’s happening now, and it’s providing employees with the tools to improve their health and their financial security.
