55% Of Large Commercial Health Plan Members Do Not Understand 'Critical Details' Of Their Health Plans, Online Survey Finds

Main Category: Health Insurance / Medical Insurance
Article Date: 02 May 2008 - 5:00 PDT

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Fifty-five percent of members from 107 commercial health plans nationally said they do not understand "critical details" of their coverage, including prescription drug benefits, finding the proper physician and appealing coverage denials, according to the 2008 National Health Insurance Plan study released Wednesday by J.D. Power and Associates, Bloomberg/Arizona Daily Star reports.

The second annual online survey was conducted in November and December 2007 and received responses from 37,060 members nationwide, J.D. Power officials said (Blum, Bloomberg/Arizona Daily Star, 5/1). The survey asked respondents to rate their satisfaction with their insurance providers in seven areas: coverage and benefits; choice of physicians, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service (Roberson, Dallas Morning News, 5/1).

The survey also found that not-for-profit health plans, such as the regional Blue Cross Blue Shield organizations, rated the highest among the respondents for overall satisfaction more often. Public companies, including United Healthcare Group and Humana, rated best among respondents in certain regions (Bloomberg/Arizona Daily Star, 5/1). In Florida, Blue Cross and Blue Shield of Florida ranked first among customers in the state, while Cigna ranked second (Wessel, Orlando Sentinel, 5/1). Respondents in Texas rated Humana first for customer satisfaction, according to the Dallas Morning News.

Jim Dougherty, executive director of J.D. Power's health care practice, said, "With increasing health care costs and an aging work force that needs additional services, businesses have less and less tolerance for insurers that aren't consistently engaging members and helping them manage their own health care and the associated costs" (Dallas Morning News, 5/1).

The 2008 National Health Insurance Plan Study is available online (.pdf).

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