AI helps select employee benefits — and saves organizations money

As the research and development into AI grows, so does its ability to support more industries, including the benefits space.  

This month, software company Avante launched their AI-powered benefits platform. Designed to help organizations manage their healthcare costs, the AI's goal is to align a company's benefits investments with employee needs, driving cost savings, stronger utilization and improved health outcomes. With the roll out of its new product, Avante also hopes to cement AI's role as a necessary tool to improving the enrollment process. 

"Our thesis has always been that if we can increase or improve the utilization of benefits that companies spend hundreds and millions of dollars to put together, we can have a positive impact on trends," says Rohan D'Souza, Avante's CEO. "So we started building out the AI capabilities to help employers figure out where their gaps, their blind spots and their opportunities are." 

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In 2025, U.S. employer-sponsored healthcare costs are projected to increase by approximately 9%, reaching an average of over $16,000 per employee, according to a report by professional services company Aon, which marks the highest surge in over a decade. Beyond core health coverage, companies are also investing a significant amount of money into additional benefits, like mental health support, fertility care and fitness programs. 

The problem is that many employees are still either unaware of these benefits, have no use for them or, in worse cases, are enrolled in plans that they don't need. As a result, companies end up wasting their benefit budget, as well as the valuable opportunity to meet their workforce's needs. 

But early intervention and education are critical to solving the issue, according to D'Souza, and Avante's AI can handle both simultaneously. For example, informing an employee of the difference between an HSA with a high deductible health plan and a triple tax benefit can put money back in their pocket that they're putting towards really high cost plans they don't need. The employer is then given a clearer understanding of just where their benefit dollars are going. 

 "For the employer, it measures what they're spending on a per employee, per month basis for these point solutions, against how many people are either inquiring about them and using them," he says.

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Accessibility and personalization

The AI delivers personalized, around the clock and on-demand benefits guidance in 50 languages to help employees optimize coverage by giving them access to high-impact programs that may be underutilized. It can also make recommendations for telehealth services, mental health resources and wellness programs based on the kind of benefits they're interested in. This cuts down on the hours HR and benefit leaders spend navigating benefits administration.

"Previous chat bots failed us in delivering because they did not understand us as individuals — their sole job was to deterministically answer questions because it was programmed in key value pairs," D'Souza says. "Our AI understands context."

For example, if an employee started at the company recently, it already knows they're seeking plan recommendations. If an employee is complaining about back pain, it can make benefit suggestions that mention musculoskeletal issues specifically. In the same vein, if an employee is worried about feeling stressed at work, the AI won't stop at just recommending a company's EAP — it'll explain what that EAP does, who the vendor is and begin the process of getting them a consult. 

Benefit leaders already have these skills; they just lack the bandwidth, according to D'Souza. Sometimes organizations have HR teams of three to four people serving employee bases of over 7,000, making personalized assistance difficult. In comparison, organizations that came to Avante with utilization rates as low as 12% or 14% are now reporting numbers closer to 40% or 50%.

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"We wanted to go beyond the standard of AI accuracy," D'Souza says. "This means that our AI is always providing citations and links to the actual reference. It also means that it's always providing the ability to quickly escalate the conversation to an actual human being when it has completed its task." 

Managing AI expectations

While the sentiment around AI has come a long way from where it once was, a little hesitation from benefit leaders is expected. But d'Souza urges them to consider that with the right tool, AI has the ability to support both sides of the aisle in the benefit selection process and continue to build on the progress the industry has already made.

"People can go through the process of selection, consumption, utilization and even off-boarding with a seamless experience because of what we have today," he says. "That pushes the journey of personalized benefits we're on that much further."