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Embel Assist
Working-age employee reviewing personal health and benefits options on a smartphone in a sunlit workspace

Challenge 05

Healthier Employees. More Productive Workforces. Lower Healthcare Costs.

Embel Assist partners with self-insured employers, health plans, TPAs and healthcare technology providers to help employees take greater ownership of their health. Through HealthVia℠, we bring these capabilities together to create continuous, personalized conversations that encourage prevention, guide meaningful action and recognize progress.

Our shared objective is to improve employee health, support workforce productivity and reduce avoidable healthcare costs.

Request a conversationOur delivery model

01 - The market

Employer-Sponsored Healthcare at Scale

Employer-sponsored coverage is the primary foundation of working-age healthcare in the United States. Because most covered workers are enrolled in self-funded plans, employers directly fund medical claims as well as preventive, clinical, and navigation benefits intended to support workforce health.

For self-insured employers, improving employee health is more than a benefits initiative. It is an opportunity to support workforce productivity, reduce avoidable medical expenses and create greater value from existing healthcare investments.

KFF estimate (nonelderly population)

~166 million
People under age 65 in the United States with employer-sponsored health coverage, including covered workers and their dependents.

KFF: Long-Term Trends in Employer-Based Coverage(opens in a new tab)

2025 KFF survey (covered workers)

~67%
Percentage of covered workers enrolled in self-funded employer health plans, where the employer funds medical claims directly (worker share, not percent of all covered lives).

KFF: 2025 Employer Health Benefits Survey(opens in a new tab)

Directional extrapolation (estimate)

~110 million
Directional estimate of nonelderly people covered through self-funded employers, extrapolated from the two KFF figures above - not a directly measured enrollment count.

Directional extrapolation from KFF data(opens in a new tab)

Methodological note: The ~166 million figure is a KFF estimate of the nonelderly (under age 65) population with employer-sponsored coverage, including dependents. The 67% figure from the KFF 2025 Employer Health Benefits Survey measures the share of covered workers in self-funded plans and should not be equated directly with dependent percentages; ~110 million is shown only as a directional illustration.

02 - The problem

Healthcare Has a Relationship Problem

"When was the last time you heard someone say they have a great relationship with their health insurance company?"

For many employees and family members, healthcare interactions still center on claims, coverage questions, unexpected bills, or acute health problems. Health plans and TPAs do conduct preventive outreach, but those touchpoints often feel episodic, administrative, and disconnected from a person's day-to-day life.

At the same time, employees frequently do not know about, understand, or use the preventive services, condition-management programs, navigation tools, and support resources their employer already pays to provide.

Key thought

We have organized much of healthcare around financing, administering, and delivering care - not consistently around a positive, ongoing relationship that empowers people to manage their own health.

When employees do not understand available benefits, delay appropriate preventive care or struggle to navigate support for health conditions, opportunities for better health can be missed. For employers, those missed opportunities can contribute to avoidable healthcare spending, health-related absences and reduced productivity.

03 - Four stakeholders

Four Stakeholders. One Opportunity for Shared Accountability.

The individual should own their health - not the health plan, the employer, or the provider. Other stakeholders have an opportunity to support that ownership through accessible benefits, understandable information, appropriate clinical care, and aligned incentives.

Supporting individual ownership does not mean claiming individuals control illness, genetics, or all health outcomes, nor does it assume health plans and providers are universally operating under value-based contracts.

Center of the relationship

Primary health owner

Employee / Individual

Role & accountability
Owns personal health decisions and day-to-day participation; faces real consequences and barriers.
Opportunity
Guidance, access, preventive action, and meaningful incentives for achievable participation.

  • Plan sponsor

    Employer

    Role & accountability
    Sponsors benefits and, if self-insured, funds medical claims.
    Opportunity
    Support workforce health, increase value of funded benefits, and explore verified savings sharing.

  • Plan administrator

    Health Plan / TPA

    Role & accountability
    Administers benefits, claims, networks, navigation, and sometimes care-management programs.
    Opportunity
    Connect members to existing resources and coordinate appropriate services.

  • Clinical care

    Provider

    Role & accountability
    Delivers clinical care, advice, and follow-up.
    Opportunity
    Support prevention, appropriate treatment, quality, and continuity of care.
The Employee / Individual sits at the center of the relationship, supported by the Employer, Health Plan / TPA, and Provider. The employer sponsors benefits and reviews aggregate program performance - never individual medical records.

04 - The opportunity

From Healthcare Coverage to a Positive Healthcare Partnership

Healthcare relationships should start before something goes wrong. Rather than waiting for an acute event or complex claim, a positive, prevention-first approach helps employees understand and use what is already available to them - including preventive care, routine screenings, chronic-condition support, behavioral health resources, benefits navigation, telehealth, and medication support, as applicable to their employer plan.

Employers often already fund valuable benefits that employees do not fully understand or use. The first opportunity is to help employees find and use appropriate existing services - not simply purchase another standalone wellness program.

Relationship -> Ownership -> Action -> Shared Value

  1. 01

    Relationship

    Positive, trusted, ongoing communication, not isolated transactions.

  2. 02

    Ownership

    Understanding, choice, and decisions within the individual's control.

  3. 03

    Action

    Preventive care, earlier intervention, and guided use of available programs.

  4. 04

    Shared Value

    Appropriate participation incentives and potential employee share of independently validated aggregate savings.

Better Health. Better Productivity. Better Healthcare Economics.

Greater Health Ownership -> Better Health Decisions -> Healthier Employees -> Improved Productivity & Lower Avoidable Costs

When individuals take greater ownership of their health, they are better positioned to participate in preventive care, manage existing conditions and make informed healthcare decisions. For employers, those actions can contribute to healthier workforces, improved productivity, more effective use of existing benefits and opportunities to reduce avoidable healthcare costs.

The objective is a positive, ongoing healthcare relationship in which better individual health can create meaningful value for employees and employers alike.

Design principle

Shared-savings incentives represent a design opportunity to explore, not an existing guaranteed program. Program design must always encourage appropriate preventive and clinical care - never avoiding necessary care - while recognizing that prevention supports long-term health and does not always reduce near-term spending.

05 - How Embel Assist makes it operational

Bringing Continuous Employee Health Relationships to Life

Embel Assist partners with self-insured employers, health plans, TPAs and leading healthcare technology providers to help employees take greater ownership of their health. Through HealthVia℠, we design, implement and operate ongoing, personalized conversations that evolve with each individual's needs, connect people with existing healthcare resources and encourage meaningful action.

The goal is to help employers build healthier, more productive workforces while reducing avoidable healthcare costs.

  • Embel Assist

    Strategy, conversation design, implementation and ongoing operations. We work with employers, health plans and TPAs to design and operate dynamic employee health conversations that help people understand their health, take action and celebrate progress.

  • HealthVia℠

    Our adaptive healthcare conversation framework connects relevant information, individual preferences, next best actions and ongoing interactions to support each person's changing health journey.

  • Enterprise Communication Orchestration

    Leverage existing enterprise platforms such as HCL Unica+, Adobe, Salesforce or other compatible technologies to coordinate personalized conversations across channels and journeys.

  • Guided Action

    Use Ushur or other compatible conversational technologies to help employees navigate benefits, address barriers and complete meaningful next steps, such as enrollment, scheduling or follow-through.

  • Prevention & Early Intervention

    Integrate Hibiscus Health and other complementary healthcare technologies to support health awareness, appropriate screening opportunities and earlier intervention through approved clinical pathways.

Deployment

Designed for Employers. Delivered in Partnership with Health Plans and TPAs.

Embel Assist works with self-insured employers and their health plan or TPA partners to help employees take greater ownership of their health. An initiative may begin with an employer seeking healthier employees, greater workforce productivity and lower avoidable healthcare costs, or with a plan or TPA seeking to offer a differentiated capability to its employer clients. In either case, HealthVia℠ is delivered within the plan's or TPA's approved environment, building on existing data, programs and technology investments.

Deployed Within the Health Plan or TPA Environment

HealthVia℠ is implemented within the health plan's or TPA's approved technology and data environment, leveraging authorized healthcare information, existing benefits and programs, and established communication infrastructure.

Embel Assist works with the plan or TPA to integrate approved data signals, establish next best action decisioning and implement personalized conversations that encourage prevention, guide meaningful action, recognize achievements and connect employees with available employer-sponsored incentives.

Individual health information remains governed by the plan or TPA and its authorized healthcare partners. Employers receive appropriate aggregate reporting to assess participation, outcomes and potential financial value, without unrestricted access to employees' identifiable health information.

06 - Practical example

Every Health Journey Is Different. Every Conversation Should Reflect That.

Health is not a straight line. Individual needs, priorities, motivations and circumstances evolve. Through HealthVia℠, Embel Assist helps employers and their healthcare partners create continuous, adaptive conversations that respond to where people are in their health journeys.

Sometimes the right conversation helps someone understand their health. Sometimes it encourages a meaningful next step. Other times it celebrates a win, recognizes progress or explains an incentive offered by the employer. The objective is not more messages; it is more meaningful conversations that support healthier employees, greater productivity and lower avoidable healthcare costs.

These examples are not sequential steps. A person may move among them as their health and circumstances change, and the relationship continues after an action is completed.

Discover & Understand

Employee situation

An employee feels healthy but has not completed recommended preventive care and is unsure which services are available.

Illustrative conversation

  1. Open

    "Staying healthy starts with understanding your health. Would you like to explore preventive services available through your benefits?"

  2. Respond

    Learn what matters to the individual and present appropriate screening or assessment options based on authorized information.

  3. Guide

    Help connect the employee to scheduling, benefit information or clinical resources; where appropriate, eligible biomarker tools may provide additional insights for clinical follow-up.

  4. Continue

    Follow up based on the individual's preferences, acknowledge completed steps and suggest an appropriate next conversation.

Employee value
Better health awareness, confidence and access to preventive care.
Why it matters to employers
Greater preventive participation and opportunities for earlier intervention may help avoid more costly care later.

Motivation Matters. So Does Recognition.

Healthcare ownership grows when people understand why an action matters, have support to follow through and feel their efforts are recognized. Through HealthVia, Embel Assist helps organizations connect individual motivations to meaningful actions, positive recognition and available employer-sponsored incentives.

Employers create and fund the incentives. Embel Assist helps make them meaningful.

Employers establish incentive goals, eligibility, funding and program rules. Their health plan or TPA may administer rewards on their behalf. Embel Assist designs, implements and operates the communication experiences that explain opportunities, guide eligible actions and celebrate progress. Financial rewards are not required for positive recognition to be valuable.

Employers may also explore appropriately structured ways to share verified aggregate healthcare savings with employees over time. This is a potential future program design, not an existing Embel Assist product or a promised savings outcome. Incentives must be equitable, support reasonable alternatives when applicable, and comply with relevant wellness-program, benefit-plan, privacy and accessibility requirements. Do not reward favorable medical status or penalize illness.

Start a conversation

Better Health Is Good for People. And Good for Business.

When employees are empowered to take greater ownership of their health, employers and employees both have an opportunity to benefit. Employees gain the information, guidance, encouragement and recognition to make progress in their own health journeys. Employers gain a path toward healthier workforces, stronger productivity and lower avoidable healthcare spending.

Embel Assist works in partnership with employers, their health plans and TPAs, and our technology partners to bring these relationships to life through HealthVia℠, strategy, implementation and ongoing operational support.

Let's explore how healthier employees can create healthier businesses.

Talk with us612.293.9805
Employee Health Ownership & Shared Value - Embel Assist