Decision Guide 01 5 minutes

The benefit exists. Why aren't people using it?

Measure how many employees your EAP or mental health benefit reaches, what each engaged employee costs, and what to ask next.

What you'll get: reach and cost-per-engaged-employee figures, questions for your team and vendor, and a brief you can share.

Start with your numbers View all Decision Guides

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About this guide

What it looks at: Whether your mental health benefit reaches the employees who need it, when they need it.
The question it answers: Is the cost of your benefit spread across real engagement, or a small fraction of your workforce?
What you'll get: A read on your cost per engaged employee, how your reach compares, and a brief you can take into a benefits conversation.
What it uses: Your headcount, utilization, and program cost, plus Spring Health's 2026 national EAP utilization research. Your answers stay in your browser.

Your numbers

How many employees are your current numbers actually reaching?

Enter these once. Your reach, cost per engaged employee, and brief all update from the same answers. Enter your annual program cost directly, or estimate it from PEPM × eligible employees × 12.

Eligible employeesCurrent benefit utilization rate (%)

Annual program cost

When is support available?

View updated results

Reach

At this rate, approximately 125 employees are engaging with the benefit.

2,375 employees are not represented by utilization data.

Not every employee outside the utilization figure needs care. But widespread reported burnout alongside 3–5% national EAP utilization means low use should not be read as low demand. The gap is a reason to ask which employees the current benefit is not reaching.

Cost of reach

$960

Annual cost per engaged employee

At your price and your utilization, your cost is about $960 per person helped.

Cost per engaged employee gives you a clearer read on how effectively your spend translates into access. A low PEPM can look efficient while still producing a high cost per person reached when utilization is low. If that number is high, your current vendor may not be taking the investment very far, and it still does not tell you whether people improve once they enter care.

Your conversation brief

Questions for your team. Questions for your vendor.

Built from your answers above: the internal questions to settle first, then the questions to bring to your next QBR or renewal conversation.

Editable brief · generated from your inputs

Questions for your team

Settle these before your vendor meeting.

What would success look like a year from now?
Why it matters: A utilization rate, fewer leaves, better retention, less strain on managers? Most teams have never named it, which is why EAPs rarely get held to anything.
What utilization would make your current spend feel worth it?
Why it matters: At your price, reaching 10% of employees would bring your cost to $480 per engaged employee, a 50% reduction from your current cost per engaged employee.
Which employees do you most need this to reach?
Why it matters: Burnout, mental health needs, and barriers to care do not look the same across a workforce. Examine reach by role, location, shift, age range, caregiving status, and any other demographic breakdowns your data can responsibly support. Even without a complete breakdown, the known gap between reported distress and EAP use makes it likely that people who could benefit are not getting into care. You're currently reaching about 5% of your workforce.
Would anyone notice if your EAP disappeared tomorrow?
Why it matters: If only a small share of employees use the benefit, ask whether it has enough presence, trust, and day-to-day relevance to be missed. The question is not whether the EAP has zero value; it is whether it has become a meaningful path to support beyond the few employees who find it.

Questions for your vendor

Bring these to your next QBR or renewal conversation.

How do you define utilization, and what's our rate for clinical care specifically?
Why you're asking
You're seeing about 5% utilization. It matters what's being counted.
A good answer sounds like
Clinical engagement reported separately from other interactions.
Red flag
A single blended number that counts app logins or webinar views.
Which employee groups are using the service, and which aren't?
Why you're asking
About 2,375 of your employees aren't using support.
A good answer sounds like
A breakdown by location, role, shift, and age range.
Red flag
They can't break down their own data.
What outcomes do you measure beyond usage, like symptom improvement or recovery, and can you show them for our employees?
Why you're asking
Usage alone doesn't tell you whether anyone is getting better.
A good answer sounds like
Clinical outcomes for your population, reported regularly.
Red flag
Usage counts or satisfaction scores only.
Can we see our program data in real time, or only in periodic reports?
Why you're asking
Without frequent data, there's no way to act on problems while they're happening.
A good answer sounds like
A live dashboard you can check anytime.
Red flag
Quarterly or annual reports only.
What's our effective cost per employee who actually used the service last year?
Why you're asking
At your current price and utilization, it's about $960 per person a year.
A good answer sounds like
A clear number, and a plan to bring it down by reaching more people.
Red flag
They won't or can't calculate it.
What happens when someone reaches out at 10pm on a Tuesday?
Why you're asking
Your support is available during business hours only.
A good answer sounds like
A licensed professional, live.
Red flag
Voicemail or a next-business-day callback.

After your brief

What you discovered

At your utilization rate, about 125 of 2,500 employees are engaging with the benefit, and 2,375 aren't represented by utilization data. That works out to about $960 a year per engaged employee.

Why it matters

Reach and cost per engaged employee show how effectively your current spend translates into access. A low PEPM can still produce a high cost per person reached when utilization is low, and neither figure establishes what happens once someone enters care.

Put the finding to work

Use it yourself

Use reach and cost per engaged employee to examine how far your current investment goes in your next benefits review.

Saves a Word copy of your brief, or copies it as text.

Bring in an advisor

A broker or consultant can compare these figures with your contract, benefit design and other available evidence.

1. Download the brief.
2. Open an email draft in your own email app. Open an email draft
3. Attach the brief yourself and send it.

You send this yourself and attach the downloaded brief. Thoughtful does not contact anyone on your behalf.

Work through it with Thoughtful

Want help putting this into context?

Explore what may be limiting benefit reach and what to ask your current vendor.

A member of the Thoughtful team can help you interpret what you found, identify questions to bring into your next conversation and explore what may be worth looking at more closely.

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The page asks for a few details about you and your organization, work email, name, job title, organization and company size, and a member of the team follows up within two business days.
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Talk it through with Thoughtful

Next guide

Want to see what low use may already be costing you?

Reach shows how far the benefit goes. The financial case guide turns your workforce size and spend into illustrative cost estimates you can take to finance.

Make the business caseYour workforce size, spend and utilization carry over.

This brief is generated from your own inputs. Edit it freely before sharing. No figure here is a projection of your organization's own finances or outcomes.

Supporting material

Why utilization alone can mislead

The gap, in one minute

Utilization is a signal. It is not the whole story.

Low use can mean employees do not know a benefit exists. It can also mean they know about it but the path feels too slow, too visible, too difficult, or poorly matched to the moment they need support. A utilization figure alone cannot distinguish those explanations.

Read the number carefully

What utilization cannot tell you alone.

A low figure can reflect awareness, access, trust, timing, stigma, benefit design, or a mismatch between the care model and what employees actually need. Those are different problems with different remedies, and a single percentage cannot separate them.

It is tempting to put a dollar figure on the employees a program never reaches. We don't, because any such estimate would be invented. What can be examined is the experience behind the number: when employees look for help, what stops them, and whether the first interaction is worth returning to.

The research below covers stress and manager pressure, who existing benefits miss, when employees actually reach for support, and how to measure early rather than after a claim.

Questions to explore with your team

What to examine

Three questions that change the conversation.

01
When can someone get value?
If support only begins after an intake, a phone call, or an appointment days away, the benefit may be missing the moment employees actually reach for help.
02
Who is missing from the data?
Look beyond average utilization. Are high-performing employees, managers, global employees, caregivers, or people under early pressure finding a path into care?
03
What happens after the first interaction?
Activation is not enough. A useful benefit should create an experience people trust, return to, and can continue without starting from zero.

What good benefit design looks like

What good looks like

A benefit designed for the moment people actually have.

01
Immediate, private support when pressure first appears
02
A low-friction path to provider care when it is needed
03
Continuity across sessions, rather than repeated restarts
04
Evidence that distinguishes benefit use from member experience and meaningful progress

See the supporting research

Explore the evidence behind this brief

No. 02 · Report