More than one in five people in the United States speak a language other than English at home, and that share continues to grow.¹ When employees cannot easily read, hear, or ask questions about their coverage, health equity suffers — and so do care outcomes.
The federal government’s 2024 update to Section 1557 of the Affordable Care Act makes that point clear: covered entities must ensure meaningful access for people with limited English proficiency. That includes providing language assistance and clear notices of availability.2,3
This is not just a compliance box to check. It’s a strategic imperative. Providing bilingual benefits support improves understanding, reduces unnecessary spending, and strengthens trust across a multilingual workforce.
Language barriers in healthcare are well-documented and costly. Studies show that patients with limited English proficiency often experience lower-quality care, longer hospital stays, and higher readmission rates.
Spanish-speaking employees, in particular, report challenges finding providers who speak their language, even in large networks. Many prefer to receive care in their primary language when it’s available.⁴
The equity issue is simple but profound: if your workforce can’t easily understand or navigate a benefits portal, they’re more likely to avoid care altogether or miss covered services they’re entitled to. Over time, that leads to delayed diagnoses, preventable hospital visits, and a widening gap in health outcomes.⁴
Benefits confusion is a major expense for businesses. Low health insurance literacy directly correlates with delayed or foregone care — even for preventive services that carry no out-of-pocket cost.⁵
For employers, this translates into real dollars. Missed screenings and untreated chronic conditions eventually drive higher claims, increased absenteeism, and productivity losses.
Recent studies show that when professional interpreters or language-concordant providers are used, hospitals see fewer readmissions and shorter stays.6,7,8 That means better outcomes for employees — and lower total healthcare spend for the business.
Bilingual benefits support turns equity from aspiration into action. Inside Healthee, employees can get immediate, accurate answers to cost and coverage questions from the platform in English or Spanish. But with Zoe, our multi-agent conversational AI, every employee can speak directly to her in over 50 languages.
This eliminates the need for employees to rely on HR or struggle through confusing plan documents. When more complex questions arise, Healthee seamlessly connects them with human support — ensuring accuracy and empathy at every step.
With Healthee actively serving over 3 million households, you can bet that includes a lot of languages. And our platform is ready to take on that challenge and deliver equitable access to benefits.
From a compliance standpoint, bilingual benefits platforms align directly with Section 1557 expectations for “meaningful access.”² But the benefits extend far beyond avoiding penalties.
A bilingual platform:
Spanish remains the most common non-English language spoken in U.S. households — and multilingual communities are expanding nationwide.¹ Employers that design benefits experiences to meet employees where they not only comply with the law but also gain a competitive advantage in attracting and retaining diverse talent.
A bilingual platform is simply a smart financial strategy; it would be hard to argue otherwise.
Research shows that language-concordant care and interpreter use lead to tangible improvements in clinical outcomes, such as shorter hospital stays and lower readmission rates.6,7,8
At the same time, clearer benefits communication helps employees make more cost-effective choices:
Every one of those shifts contributes to lower claims and higher satisfaction. The pattern is clear: better understanding leads to better utilization — and better utilization leads to fewer high-cost events.⁵
Employers ready to improve access and equity can start with three proven steps:
These steps not only improve compliance readiness — they elevate benefits communication into a genuine engagement driver.
The workforce is becoming more diverse, and so are its needs. Employers that embrace bilingual benefits platforms are doing more than meeting regulatory requirements — they’re reshaping the employee experience around inclusivity and empowerment.
By bridging language gaps, HR teams can help employees make confident health decisions, avoid unnecessary costs, and feel valued by their organization.
Compliance may set the floor — but it shouldn’t define your ceiling. When employees can understand their benefits in the language they trust, everything improves: confidence, care choices, and cost control. That’s the promise of bilingual benefits done right.
At Healthee, we turn that promise into practice. With Zoe’s bilingual support, a clear, self-service experience, and on-demand human help, we help employers deliver equitable access that’s measurable, repeatable, and scalable. The outcome is simple: healthier employees, lighter HR workloads, and a benefits program that finally feels built for everyone.
1. U.S. Census Bureau. Language Use in the United States: 2023. https://www.census.gov
2. U.S. Department of Health and Human Services (HHS). Nondiscrimination in Health Programs and Activities, Section 1557 of the Affordable Care Act (Final Rule, 2024). https://www.hhs.gov
3. Centers for Medicare & Medicaid Services (CMS). Section 1557: Language Access Requirements. https://www.cms.gov
4. Parker MM, et al. Language Concordance and Health Care Outcomes Among Patients with Limited English Proficiency. JAMA Network Open, 2020.
5. Kim H, et al. Health Insurance Literacy and Healthcare Utilization. Journal of Health Economics, 2021.
6. López L, et al. Impact of Interpreter Use on Hospital Outcomes in Patients with Limited English Proficiency. Patient Education and Counseling, 2016.
7. Lindholm M, et al. Professional Language Interpretation and Adverse Events. Journal of General Internal Medicine, 2016.
8. Flores G, et al. Errors in Medical Interpretation and Their Potential Clinical Consequences. Pediatrics, 2016.
Learn how to communicate benefit changes thoughtfully, reduce backlash and uphold equity across your workforce.
Employer healthcare costs are rising. But what's driving these cost increases? We dive into the behind-the-scenes of U.S. healthcare.
Learn what public sector procurement and HR teams must know when onboarding employee health benefits software.
