Helping Employees Understand their Explanation of Benefits

One of the most common sources of confusion for employees is the Explanation of Benefits (EOB) statement they receive after a medical visit.

It’s not a bill—but it often looks like one. As an employer, helping your team understand what an EOB is and how to read it can reduce stress, cut down on HR questions, and improve employee confidence in their health benefits.

What Is an EOB?

An Explanation of Benefits (EOB) is a statement from the insurance carrier that explains:

The services that were billed by the provider
What the insurance plan paid
Any discounts that were applied (network savings)
What the member may still owe (if anything)
It’s a summary of how the claim was processed—not an invoice.

Why EOBs Matter

EOBs provide transparency and serve as a tool for employees to:

Confirm their provider billed the visit correctly
See how their deductible and out-of-pocket maximum are tracking
Catch billing errors or duplicate charges
Understand the value of their health insurance coverage

Common Misunderstandings

Mistaking it for a bill.  An EOB is informational only. If a balance is due, it will come directly from the provider.
Surprise costs.  If employees don’t understand their deductible or coinsurance, the “amount you may owe” line can be alarming.
Mismatch with provider bills.  Timing differences between provider billing and insurance processing can cause confusion.

How Employers Can Help

Provide short educational sessions or tip sheets during open enrollment.
Walk employees through a sample EOB.
Remind them that they can always contact the carrier or your broker (like me!) for clarification.

EOBs are part of a healthy benefits experience—but only if your team knows how to read them. Helping employees feel informed and empowered leads to better usage of the benefits you work hard to provide.

To learn more, contact the Frost / Beck Insurance Agency.  Call us at 419-592-4476, send an email to frost@frostins.com, or click here  to submit your request today!  Alternatively, stop by and see us at one of our four convenient locations in Archbold, Napoleon, Holgate, or Whitehouse.

Coming next week we will talk about bundling your benefits—what it means and when it makes sense.