Nayya counts unfiled claims among one in four supplemental-plan enrollees

Most supplemental health products pay cash when a qualifying event happens, but in most cases only after the employee files ^[5]. To file, an employee has to link a hospital stay or diagnosis to a policy chosen months before during open enrollment, figure out what it covers, collect the paperwork and send in a claim, frequently while dealing with a medical crisis ^[5]. When that step is skipped, claims activity looks low and the coverage can look underused at renewal, even when employees are having the hospital stays and diagnoses it was built to cover, hcamag.com reported ^[9].

"People buy this coverage precisely so they're protected when the worst happens," said Sarah Liebel, CEO of Nayya ^[6]. "What's heartbreaking is that the system asks people to remember a policy, decode what it covers, and chase down paperwork in the exact moment they have the least strength to do any of it." ^[6] The products with the largest payouts and the most complex claims, hospital indemnity and critical illness, are also among the least understood by enrolled employees, Nayya said ^[7].

The worker bears the cost first. Employees typically pay for this cover themselves ^[15]. The average unfiled hospital admission payout in Nayya's data, $1,080 ^[2], is $80 more than the $1,000 medical bill that Employee Benefit Research Institute research found most workers are unprepared to meet ^[8][17].

A skeptic would say the company reporting the unclaimed money sells the software that claims it, and that the figures come from its own platform ^[3]. That objection holds. The outside research from NFP and EBRI measures usage and understanding of supplemental benefits ^[4][8]. Both point the same way without testing the one-in-four rate. Nayya's own counts are also hard to square with each other. Roughly 300,000 people out of 611,000 members is about 49 percent ^[16], close to double the one-in-four rate in the headline finding ^[18].

The evidence supports a distortion in renewal data. The hcamag.com account says low filing weakens the case for keeping or expanding a benefit ^[9], but it does not document an employer that dropped a plan for that reason. Budget pressure makes the case easier to press. In my view a supplemental line with thin claims is easier to question in a year when the core medical premium is climbing. New Mexico regulators approved a 19.8 percent average rise in small group health premiums for 2027, above the national median for a second year ^[10], and expiring Affordable Care Act subsidies are pushing workers toward employer plans, HRD has reported ^[14].

Carriers are starting to take the filing step away from employees ^[11]. Among Securian Financial clients using medical claims integration, 49 percent of claims were initiated by the system, based on its 2025 and 2026 client data ^[12]. Nayya's platform works the same way, linking a member's medical claims to supplemental coverage and flagging a filing opportunity after a qualifying event ^[13].

The trade-off for an employer reviewing a supplemental line this cycle is between the claims count it has and the one it could get. The file shows what employees filed; a carrier with claims integration can show more of what they were owed. If the employer asks for that second figure, or switches the integration on, I'd expect filings to rise in the following plan year, going by Securian's share ^[12]. The next renewal would then be argued on a larger claims count.