The Trust Gap Around New Benefits Closes When Employees Help Shape The Decision

The credibility gap around benefits changes is not unique to ICHRA, but ICHRA exposes it sharply because the shift asks employees to move from a plan chosen for them to plans they choose themselves. The model can improve cost control, personalization, and long-term sustainability simultaneously, but none of that matters if employees experience the change as something being done to them rather than built with them. The employers who succeed with major benefits transitions are the ones who invest in trust before they invest in enrollment technology.

Eric Fredriksen is the CEO of Fredriksen Health Insurance, a family-owned employee benefits advisory firm. Fredriksen serves as Board Chair of United Benefit Advisors, the largest independent partnership of privately held benefit advisory firms in the country. His recent work guiding an Idaho hospital through a major ICHRA transition, one that more than halved the organization's projected healthcare spend, gave him a direct view of what the trust-building process actually requires on the ground.

"With benefits changes, people immediately wonder, 'What am I losing? What's getting cut?' So before you even talk about the healthcare component, organizations need to address that trust piece," he says. The takeaway from the transition has less to do with the healthcare product itself and much more to do with building the right process around it.

Suspicion is the default

Benefits changes trigger a specific kind of organizational anxiety. Employees know that healthcare is one of the largest costs a company manages, so when leadership announces a shift, the first instinct is to assume the change serves the budget. Fredriksen sees this dynamic play out consistently. Even with a model like ICHRA, which can offer more choice, lower out-of-pocket costs, and better personalization, the initial reaction is fear. "People are afraid they're going to pick the wrong plan. That's why I think employers resist it. They think, 'We're sending our people out to the wolves. How are they actually going to manage this?'"

In such instances, he says the fear isn't actually about the model itself, but about the feeling of being left alone with a decision that matters enormously and that most employees do not feel equipped to make.

Build internal advocates before the rollout

The most effective trust-building mechanism Fredriksen has seen to counteract this uncertainty is the benefits committee model. The hospital he worked with assembled a committee of roughly a dozen people that included decision-makers alongside frontline culture carriers who knew the workforce and represented different departments and stakeholder perspectives. "They picked key influencers in the business, people who run departments or have just been there a long time and really know the culture," he shares. "They all represented different parts of the business."

The committee heard from multiple advisors, evaluated the options together, and voted on the direction. The vote itself was an alignment mechanism. When the committee approved the ICHRA transition, each member became an internal advocate who could explain the change peer to peer, in their own language, grounded in the same concerns their colleagues would raise. "They created a group of disciples inside their organization to go out there and let people know why they were doing this and why it was going to be a good deal for them," Fredriksen says.

The peer-to-peer channel matters because employees trust colleagues differently than they trust HR communications or advisor presentations. A department leader who sat on the committee and can say "I had the same concerns, and here's what I learned" carries more credibility than any enrollment guide.

Communication must be continuous

While the committee is the foundation, the communication cadence is what sustains the trust through the transition. "Communicate, communicate, communicate," Fredriksen instructs. "Make sure you use an advisor who has the tools and expertise to market the change in a positive manner to let people know the benefits."

He emphasizes that one town hall or one email does not constitute communication. Employees need to hear the message repeatedly, in different formats, from different voices, with room to ask questions and surface concerns. The advisor plays a role here too, serving as an accessible resource for employees who have complex situations or who simply need reassurance that someone knowledgeable is available when they need help. "Have someone who can say, 'Hey, if things get squirrely, or if you just need help, you've got people behind you.'"

Technology lowers the decision anxiety

The practical enrollment experience is where trust either holds or collapses. Employees who face a list of unfamiliar plans without guidance will default to fear and frustration. According to Fredriksen, the technology layer has to meet them at the point of decision with tools that match their physicians, medications, and family needs to the plans available in their area. "Having a good advisor and good technology to help these people, that's where the secret sauce is so they can rest assured that the doctors they see and the prescriptions they take are going to be covered."

Fredriksen is direct that without the technology component, ICHRA does not work for any employer of meaningful size. The plan-shopping tools are what turn expanded choice from an abstract benefit into something employees can navigate with confidence.

The broader lesson extends beyond ICHRA

The trust dynamic Fredriksen describes applies to any major benefits transition, whether it involves ICHRA, a move from fully insured to self-funded, a plan redesign, a network change, or a new vendor. Employees experience all of these through the same lens: what am I losing, and does leadership actually care about my coverage? The employers who answer those questions before they're asked are the ones whose transitions hold. Ultimately, Fredriksen says it comes down to making sure employees know they are not alone in the decision. The committee creates advocates. The technology creates confidence. But neither replaces the reassurance that comes from knowing a real person is available when the process feels overwhelming. "We have a team. Reach out to them. They're the experts, and they'll be able to help you find the best situation for what you're trying to accomplish."