Building an employee health insurance benefits plan

This guide breaks down what the ideal health insurance package looks like today, what to include, and how to offer health insurance benefits your employees will actually use. We also uncover some specific options that market-leading companies are using to save millions with preventive care.

5 markers of the best health insurance benefits plans

• Strong and widespread coverage 
• Simple for employees to understand and access
• Preventative care that reduces absenteeism and increases productivity
• Attractive to candidates for new roles and to keep existing employees loyal
• Delivers measurable return on investment

Health insurance benefits are the foundation of an effective employee benefits package. This component of your offering can make or break a hire. The best candidates are actively seeking a strong health insurance plan with robust coverage and a variety of care options. 

For many organizations, benefits plans can be costly on paper, underused in practice, and a point of confusion instead of value. 

However, some inexpensive additions to a standard plan can make a massive difference, both in reducing healthcare costs for the employer, and in increasing usage and attractiveness for employees.

What is the ideal health insurance benefits package for employees?

The best health insurance benefits package offers more than just basic coverage alone. Benefits managers should aim to build a set of health resources that employees can easily access when they need them, in ways that fit their work and life.

This accessibility will increase engagement, improve outcomes, and prevent more costly downstream interventions triggered by a lack of adherence (or not using care services until severe conditions have developed).

Solving problems early and preventing pain altogether is the secret to maximizing ROI for your health insurance benefits spend. The employer will see a supporting reduction in extended sick leave and absenteeism. 

4 high-impact health benefits that employees value and use 

A modern plan recognizes that the true value of benefits lies in usage and outcomes.

High engagement and adherence rates are both critical indicators of success. Benefits managers should be tracking these metrics in collaboration with their partner healthcare providers.

Member health outcomes and ROI are the most important metrics.

1. Comprehensive medical coverage for routine and urgent care
2. Musculoskeletal (MSK) care to address chronic pain and prevent more serious conditions 
3. Outcomes-focused mental health support with clinically-proven effectiveness
4. Accessible, digital-first solutions that eliminate commute and scheduling barriers.

5 key components of a strong health insurance package

A well-designed health insurance package does more than tick compliance boxes. You should strive to take your offering above the baseline and start measuring return and impact.

Your health benefits package can directly impact the health, productivity, and loyalty of your employees.

Here are the five foundations every modern employer should get right, with the detail that separates surface-level perks from real value.

1. Comprehensive medical coverage

Medical coverage remains the bedrock of any employee health plan. But “comprehensive” today means more than a generic HMO option.

Modern plans should include:

• Robust in-network and out-of-network coverage, so employees don’t face surprise bills.
• Transparent cost sharing: Clear co-pays and deductibles that are easy to understand.
• Specialist access without unnecessary hoops, because delays often lead to worsening conditions and higher downstream costs.
• Pharmacy benefits that make prescription drugs affordable — not just technically covered.

Employers who lead in this area also provide navigation support. That could be through dedicated care concierges or simple digital tools to help employees find the right care, the first time.

Employer takeaway: A plan that’s broad but confusing will still go unused. Clarity and access are just as important as breadth of coverage.

2. Virtual-first MSK care

Musculoskeletal (MSK) conditions like back pain, joint issues, and repetitive strain injuries are the single biggest category of employer healthcare spend, costing the U.S. over $10.3 million every hour on unnecessary or low-value care¹.

The best health benefits plans provide smart healthcare offerings, offering recovery and prevention plans for musculoskeletal issues. This helps to lower costly surgical intervention and keep employees healthy. 

Sword Health’s Thrive program provides an easily-accessible digital model with proven results that provide sustained return on investment for employers and health plans alike.

How does Thrive help employees recover faster from MSK pain?

Thrive pairs patients with licensed physical therapists and a physical device to guide their recovery plans with supporting AI technology. Thrive allows members to complete their exercises anywhere, any time. The dedicated Doctor of Physical Therapy ensures their treatment plan is tailored to their specific health goals. 

Sessions can be completed from the comfort of home, using a Thrive-powered tablet (or motion sensors for some conditions) to provide:

• Real-time form correction to improve technique
• Instant feedback to reinforce safe movement
• Progress tracking to keep the patient accountable
• AI-powered updates to inform the PT who adjusts the program accordingly
• 81% program completion means far more people actually finish their care, reducing surgical intent and lowering MSK claim rates².

Employer takeaway: Digital MSK care lowers costs, reduces absenteeism, and protects productivity. That’s why it’s fast becoming a must-have in a modern health benefits plan.

3. Mental health and EAPs

If your mental health benefits are still limited to a dated Employee Assistance Program (EAP) flyer in the break room, you’re falling behind.

Leading employers are considering the following options to help attract and retain good talent:

• On-demand access to licensed therapists or counselors, not weeks of waiting for an appointment.
• Multiple channels for care and support including telehealth, video sessions, text or live-chat, and self-guided digital solutions
• Integration with physical health programs because MSK pain and mental health struggles often go hand in hand.

Sword’s own data shows that treating MSK pain can reduce depression symptoms by 64% and anxiety by 50%³. That’s a powerful reminder of the connection between mental and physical health. A strong health benefits plan provides options for both .

Employer takeaway: When mental health is easy to access and normalized in company culture, you’ll see improvements in absenteeism, productivity, and retention. You should also start measuring the impact that physical health programs can have on improving mental health outcomes.

4. Preventive care and screenings

Preventive care is often the most impactful lever employers have to contain rising costs. Yet it’s often the least used.

A strong plan:

• Covers annual physicals, vaccinations, and screenings with no out-of-pocket cost, removing barriers to care
• Considers incentives (whether financial rewards or lower premiums) for completing screenings or wellness milestones
• Partners with digital solutions that make scheduling, reminders, and education seamless

Employer takeaway: Up to 36% of MSK surgeries are unnecessary and 80% of these costs could be avoided⁴ with earlier, proactive physical therapy treatment. Every condition caught early is a condition that costs less and causes less disruption to your workforce.

5. Digital access and ease-of-use

One reason so many health benefits go unused? 

Some benefits are really difficult to use, particularly with traditional healthcare models. Scheduling appointments, securing referrals, commuting to busy clinics during working hours – all of these challenges becomes barriers to accessing care.

Top employers are solving this by:

• Choosing vendors with consumer-grade digital experiences with app-based scheduling, reminders, and real-time progress tracking
• Even more accessible self-serve digital solutions like Sword allow the employee to complete sessions from home at any time of the day or night
• Offering care that works for remote workers, shift employees, and working parents, who can’t take hours off for an appointment.
• Looking for solutions that fit modern schedules: Sword Health’s virtual PT shows that 42% of sessions happen after traditional work hours, and 23% on weekends⁵

Employer takeaway: When healthcare benefits plans usage climbs, ROI follows. Make sure your plan includes care programs that are flexible and easy-to-use. Track engagement and adherance rates with your care partners and hold them accountable to delivering on real health outcomes. 

Create a health insurance benefits package employees will actually use

Survey employees to learn what barriers exist. 

• Are appointments too hard to get? 
• Is coverage confusing? 
• Do members feel supported for chronic pain or mental health issues? 
• Do people know about their options? 
• Is accessing a clinic too difficult?

Benchmark your current plan

Compare usage rates to industry averages. For example, if your physical therapy plan completion rates are under a 50% average, there’s room to improve. 

Work with your care providers to track engagement and adherence and strive for improvements.

Choose vendors who deliver outcomes 

Demand more than glossy presentations. Look for partners with proven results. 

You should expect each partner to provide performance reporting on real healthcare outcomes. Sword’s 81% program completion rate far outpaces traditional models⁶ and our 3.2:1 ROI is the highest independently-validated ratio in the industry.

Align incentives with results 

Look for providers that match payments to healthcare results. Sword’s outcome-based pricing is a good example. Our clients pay when people improve clinically, not just when they sign up.

Why preventive care matters for cost control

Many employers underestimate just how much unused preventive care drains their budgets. Chronic pain, for example, is a gateway to unnecessary surgeries, long-term disability claims, and opioid dependency.

Sword’s data shows:

• 36% of MSK surgeries are unnecessary or unsupported by evidence⁷
• Proactive care delivered early can save an average of $3,177 per member per year⁸

Virtual-first programs close this gap. Sword’s Predict identifies high-risk employees up to 6–8 months before they’d otherwise face costly surgery or leave . That’s money back in your budget — and healthier people at work.

Usage rates drives healthcare ROI 

Enrollment means nothing if your people don’t use what you provide.

Employers with the best health insurance benefits for employees track:

• Session completion rates
• Access timelines (days to start care)
• Cost savings per member per year
• Productivity recovery

Sword clients report 81% program completion⁹, 68% productivity recovery, and up to 4.4x ROI when using predictive engagement tools . That’s the difference between passive coverage and an active, cost-saving solution¹⁰.

Modernize your health insurance benefits program with accessible digital care

The next generation of health insurance benefits for employees will:

• Offer care anytime, anywhere.
• Predict problems before they become costly.
• Prove their value with clear outcomes.
• Address equity gaps so all employees benefit.

Sword Health’s digital MSK solution is built for this shift: virtual-first, outcome-based, and personalized. When you increase program engagement and adherence rates, more people get better, and employers reduce their healthcare costs.