What to measure
Evidence before assumptions.
- Navigation utilization
- Member satisfaction
- Resolution time
- Avoided billing friction
← The Framework
Component 08
Navigation & Employee Experience
Can employees actually figure out how to use the health plan?
Clear definition
Navigation and employee experience give members practical support to find high-quality care, understand benefits and resolve administrative friction during stressful healthcare decisions.
Common mistakes
What weakens performance.
- Expecting employees to become healthcare economists
- Offering support that is difficult to find or use
- Measuring engagement only at open enrollment
High-performance practices
Build a deliberate approach.
01
Provide advocacy, concierge and claim-support pathways
02
Make price, quality and provider information easier to act on
03
Design communication around real employee care moments
Definitive employer guide
Navigation turns a benefit design into a usable employee experience by helping people make confident decisions at the moments that matter.
This guide gives plan leaders an operating model for making the component measurable, accountable and connected to the rest of the health-plan strategy. It is educational guidance and should be applied with appropriate legal, financial and clinical advisers.
Identify high-friction moments
Map the points where employees face unfamiliar choices: a new diagnosis, a specialist referral, an expensive procedure, a leave event or a pharmacy change. These are the moments when a generic benefits portal is least likely to be enough.
Use call themes, complaints, utilization patterns and employee feedback to prioritize improvements.
Make the preferred path simple
Give employees one recognizable starting point and explain what happens next. Navigation should coordinate benefits, care options and practical support without making the employee learn the vendor ecosystem.
Communications should be timely, plainspoken and available through the channels employees actually use.
Connect navigation to strategy
Navigation is most valuable when it is tied to the plan’s quality, access and affordability priorities. Build defined connections to primary care, centers of excellence, pharmacy support and complex-case resources.
Protect privacy while creating aggregate insight about where the plan experience is difficult to use.
Measure resolution, not activity
Track completed referrals, time to support, successful scheduling, avoided friction and employee confidence in addition to calls or logins. Review unresolved cases and repeated handoffs as design signals.
Accountability belongs with both the navigation partner and the employer’s internal benefits owner.
Five metrics every employer should monitor
Access and experience
Can employees and leaders use the intended path without avoidable friction?
Cost and utilization
What patterns show whether the strategy is changing the relevant drivers?
Vendor performance
Are partners meeting contracted commitments with usable reporting?
Decision cadence
Are results reviewed early enough to guide a decision?
Documented outcomes
What changed, what was learned and what action follows?
Maturity progression
Crawl. Walk. Run. Sprint.
Crawl
Basic information is available, but decisions remain largely renewal-driven.
Walk
Leaders have a defined owner, baseline measures and recurring review.
Run
Strategy, contracts and employee experience are connected through active governance.
Sprint
The organization tests assumptions, shares learning and continuously improves.
Ten questions to ask
- 01What decision are we trying to improve?
- 02Who is accountable for the result?
- 03Which baseline measures will guide us?
- 04What assumptions are we treating as facts?
- 05What data rights do we need?
- 06How does this connect to other plan components?
- 07What employee friction could undermine the strategy?
- 08What does the vendor contract require?
- 09What will we review in the next 90 days?
- 10How will we document progress and adjust?
What good looks like
Managed, not merely renewed.
A high-performing approach is transparent, actively governed and connected to employee experience. It gives leaders a repeatable way to test assumptions, make tradeoffs and improve outcomes over time.
Related 
- Health Plan Score: identify the current gap
- Three-Year Health Plan Roadmap: sequence the work
- Framework component workbook: assign evidence and owners
Frequently asked questions
Where should an employer begin?
Begin with a clear decision, an accountable owner and a baseline that makes improvement visible.
How often should leaders review this component?
Review the operating measures at least quarterly, with more frequent attention when a material decision or risk requires it.
Is this component separate from the rest of the Framework?
No. Each component affects the others, so priorities and vendor actions should be coordinated rather than managed in isolation.
Sources & references
Evidence that supports the work.
This guide combines the Framework methodology with primary government guidance and independent health-policy research. Sources are included for further review and are not legal, tax or clinical advice.
- Reviewed / updated
- Framework component
- Navigation & Employee Experience
- Book connection
- Chapters 22–23
- Author
- Corry Hull, REBC®, CSFS® — Vice President of Employee Benefits, BHC Insurance; Health Rosetta Advanced Advisor; author of The High Performance Health Plan.
U.S. Department of Labor — Employee Benefits Security Administration↗Centers for Medicare & Medicaid Services — Transparency in Coverage↗U.S. Department of Health & Human Services — No Surprises Act↗Internal Revenue Service — Publication 15-B↗KFF — Employer Health Benefits Survey↗RAND — Hospital Prices Paid by Private Health Plans↗
Book connection
Chapters 22–23: Making the plan usable
Chapters 22–23
The book connects navigation to the real decisions employees make when care becomes complicated.
Explore the bookHealth Plan Score connection
Navigation & Employee Experience
Can employees find and use practical support for benefits, claims, provider choice and care decisions?
A lower score means the plan should map common employee friction points and simplify the route to help.
Take the Health Plan ScoreDecision-support documents
Put the strategy to work.
resourceNavigation Program Evaluation
A printable Employer Benefits IQ worksheet for defining the decision, evidence, accountable owner and review cadence.
Author perspective
Corry Hull, REBC®, CSFS® — Vice President of Employee Benefits Consulting at BHC Insurance, Health Rosetta Advanced Advisor, author of The High Performance Health Plan, founder of Employer Benefits IQ, 2026 Health Rosetta Rosie Award recipient, public speaker and employee benefits strategist.
Explore the Health Plan ScorePut the methodology to work
Apply the HPHP methodology with .
Employer Benefits IQ is the practical application platform for employers who want to use education, tools, data, vendor intelligence and decision support in real-world benefits decisions.
tools and decision support