AI in Benefits 101: Moving HR from Benefits Help Desk to Strategic Partner

Human Resources teams are facing a massive disconnect. They are hired to be strategic partners, improve retention, and shape culture—all while executing workforce planning. Yet, they spend far too much of their time operating as a “benefits help desk,” buried in a never-ending pile of administrative work.

From fielding constant benefits questions, to employees not understanding when and how to use their benefits efficiently, to the reactive nature of handling employee requests, the current system is full of friction. 

HR teams are looking for resources and tools that can help lighten the load—AI tools being an example. As Justin Holland, HealthJoy CEO and Co-Founder states, “Current systems in HR are PDF-paper education based, AI can help improve those.”

As we covered in part 2 of our AI in Benefits 101 series, AI is an amazing asset for HR. The challenge isn't that we can't trust AI; it's that we need to point it at the right source of truth to ensure it’s helpful and factually accurate.

Now in part 3 of this series, we’ll walk through some of the administrative challenges HR teams face, how AI can help, and how to ensure the AI you’re using is trustworthy for healthcare. 

Problem 1: The Constant Benefits Questions

HR teams are drowning in the same questions most days: “What’s my deductible?” “Is my doctor in-network?” “How do I use my FSA?” While these questions are important, they aren’t the best use of an HR professional’s time. In fact, these types of routine inquiries have become a huge barrier to strategic work.

Generative AI is the solution, but it must be built on a Retrieval-Augmented Generation (RAG) framework. RAG ensures the AI doesn't just "guess"; it retrieves information exclusively from authorized, verified documents—like your company's plan documents, provider networks, and program details—before generating an answer. 

This specialization is key to providing accurate, trustworthy information, giving employees a 24/7/365 benefits expert and making the solution viable for handling sensitive health information (PHI) within a compliant platform.

This immediately deflects the high volume of questions from the HR team and gives employees the instant, consumer-grade experience they need and expect. Meanwhile, the HR team can be confident in the answers employees are receiving. 

Problem 2: Low Benefits Utilization = Wasted Spend

The healthcare ecosystem is confusing to say the least. When members are confused, they either don't use their benefits or they use them inefficiently—such as going to an expensive emergency room for an issue that urgent care could handle. This results in wasted healthcare spend and poor employee health outcomes.

Generative AI that’s built on an RAG framework steps in to act as a sophisticated “navigation system.” It doesn’t just answer questions; it proactively steers members to the right programs at the right time—so they know where to go for care—before they actually need it. 

This type of AI can guide a member to a virtual MSK provider, identify a high-quality, low-cost imaging center, or even recommend a mental health solution—dramatically increasing engagement with your programs and lowering overall costs.

Problem 3: HR is Stuck in "Reactive" Mode

It’s impossible for an HR team to focus on "big picture" strategic initiatives when their day is spent reacting to the immediate needs of the "benefits help desk."

Generative AI enhanced by RAG helps by handling the day-to-day administrative burden. It fundamentally changes the paradigm. Holland says it best: AI can "enhance and improve a big problem in HR." Let AI handle the "transactional," freeing your human experts to focus on the "transformational."

Instead of answering deductible questions, HR can use their time to analyze AI-backed utilization data to design a better benefits strategy for next year. Instead of manually pointing employees to providers, they can focus on building a culture of well-being in the workplace. This fundamental shift is how HR reclaims its time and solidifies its role as a strategic partner to the entire business.

At HealthJoy, we use this very technology to power JOY, our virtual benefits assistant. Want to learn more about how the right generative AI tool can lighten the load for HR teams? Reach out to a HealthJoy expert.