Nayya, the AI-powered benefits experience platform, has released a national research report titled "Confident and Wrong: The Benefits Accuracy Crisis Hiding in Plain Sight," documenting the financial consequences employees face when they rely on general-purpose AI for health and benefits guidance. The report finds that among employees who followed AI advice that turned out to be incorrect, more than one in four faced unexpected out-of-pocket costs of $100 or more, with some reporting losses exceeding $2,500. The findings are drawn from two independent surveys conducted in April 2026, covering 995 full-time, benefits-eligible U.S. employees and 126 HR and benefits professionals, nationally representative across age, gender, household income, and region.
Quick Intel
General AI Has Become the Default for Benefits Navigation
The central finding of Nayya's research is not that employees occasionally consult AI about their benefits. It is that AI has become the default first stop, ahead of HR departments, plan documents, and carrier portals. Nine in ten employees report already using AI for health or financial questions, and 98% say AI is easier to understand than their official plan materials.
This behavioral shift has taken hold regardless of whether the AI tools employees are turning to are equipped to answer accurately. General-purpose AI tools have no visibility into employer-specific plan documents, provider networks, formularies, or benefits structures. They generate responses based on how insurance generally works, not how a specific employer's plan actually operates. The result is guidance that can feel clear and authoritative while being factually inapplicable to the employee's actual coverage situation.
The Financial Cost of Inaccurate AI Guidance
The gap between AI confidence and AI accuracy carries a measurable financial cost for employees. Among those who followed AI guidance that turned out to be incorrect, more than one in four reported unexpected out-of-pocket costs of $100 or more. Some reported losses exceeding $2,500, representing a significant personal financial consequence for decisions that employees reasonably believed were informed.
With 51% of employees reporting that the guidance they received from general AI tools was not completely accurate, the scale of exposure across a national workforce is substantial. The report frames this not as an edge case but as a systemic risk embedded in the way employees are currently navigating health and financial decisions at scale.
A Responsibility Gap Between Employees and Employers
What makes the problem structurally difficult to address is the disconnect between how employees and employers perceive accountability. Employees hold their employers responsible for the accuracy of the AI guidance they encounter when making benefits decisions. Employers, meanwhile, assume that employees will independently verify the information they receive before acting on it. Neither assumption has ever been explicitly communicated to the other party.
With Open Enrollment approaching, this unresolved accountability gap creates conditions for a direct collision between employee expectations and employer preparedness. The report identifies this misalignment as a significant and underappreciated liability for HR and benefits teams heading into one of the most consequential decision-making periods of the year.
"Employees have decided that AI is how they navigate their benefits. That's not going to change. What employers can control is whether the version their people are relying on was actually built for this." said Sarah Liebel, CEO of Nayya.
What Purpose-Built Benefits AI Actually Requires
The report's findings implicitly draw a line between general-purpose AI, which answers based on broadly available information, and purpose-built benefits AI, which is designed with access to the specific plan data, network details, and benefits structures that make guidance accurate for a given employee in a given plan year.
For employers, the practical takeaway is that deploying or endorsing AI for benefits navigation without ensuring it is grounded in actual plan data introduces meaningful financial and reputational risk. For HR and benefits professionals, the report offers a framework for evaluating what purpose-built benefits AI requires, alongside a detailed look at how inaccurate guidance affects employees across the full benefits lifecycle.
The Nayya research adds quantitative weight to a concern that has been building quietly as AI tools become embedded in everyday decision-making. Employees are not waiting to be told how to use AI; they are already using it for some of the most financially consequential decisions they make each year. The question for employers is no longer whether AI will play a role in benefits navigation, but whether the version employees are relying on is accurate enough to be trusted with that role. As Open Enrollment nears, the window to close that gap is narrowing.
About Nayya
Founded in 2019, Nayya is on a mission to connect people's most important information, so they can thrive in their health and wealth. Nayya's platform is the first of its kind: agentic AI that doesn't just advise, it acts—transforming benefits from a once-a-year decision into an always-on advantage for every employee. As a trusted platform to leading employers, Nayya unlocks long-term value through helping employees live more resilient lives.
TechIntelPro empowers B2B technology decision-makers with the latest industry trends, deep insights, leadership perspectives and actionable intelligence to drive both organizational and professional milestones—and thrive on the tech pulse.