By Sally Poblete
In the process of assisting several individual consumers and small groups in finding coverage, I visited and used many insurance company websites, in addition to the State and Federal marketplaces. It was a very humbling and gratifying experience to service consumers who were confused and frustrated by their health insurance search experience. Here’s what I found:
Terminology and Network Very Confusing to Consumers
Consumers were confused by common insurance terminology and how it could impact them. They did not know the names of the networks needed to determine which doctors and hospitals were included in their network. For example, a consumer may have had an in-network doctor from a prior plan with their employer, but that same doctor may be out-of-network in an individual plan of the same carrier. A consumer needs to know the name of the network and how to search the right provider directory in order to access accurate information. Without that information, they may purchase a plan that does not cover their current doctors or provide the benefits they need. The carrier website network searches were cumbersome, and the State and Federal marketplaces also did not offer adequate support in this area.
Carrier Websites Far From Intuitive
Carrier websites offered helpful summaries of the plans. However, they did not always include SBCs (summary of benefits and coverage), which is necessary to drill into the details. In addition, a consumer would have to research each carrier’s website individually to determine what the plan would actually cover. It was challenging to find both the prices and the level of detail on the same site.
The bottom line is that the user needs to understand that the carriers, networks, and products can differ drastically. Consumers could easily purchase a plan that doesn’t cover them appropriately or include a network that doesn’t meet their needs. Consumers need the information in an easy-to-digest format that explains the nuances of the various plan options in a way they can understand.
I understand the aggravation and headache that people feel when trying to navigate such an important buying decision. It is not surprising that Aflac found that just over 40% of employees surveyed would rather be subjected to some form of discomfort, like doing three hours of hot yoga or cleaning up dog poop, than research their insurance benefits during open enrollment.
Part of the reason why I started Wellthie was to simplify the way that people learn about and choose insurance. I always knew that this was a significant goal, and working with consumers first hand reinforces our mission.