Satisfaction With Health Plans Lower Among Individual Purchasers, Says J.D. Power

Health plan members who individually purchase their plans or work for small employers are considerably less satisfied with their health plan experience, compared with health plan members who work for larger organizations, according to the J.D. Power and Associates 2009 National Health Insurance Plan Study.

Now in its third year, the study measures member satisfaction among 131 health plans in 17 regions throughout the United States by examining seven key factors: coverage and benefits; provider choice; information and communication; claims processing; statements; customer service; and approval processes.

The study finds that health plan members working for small employers (50 employees or fewer) are less likely to be satisfied with their health plan than those working for larger organizations.

Satisfaction among members working for small employer groups averages 692 on a 1,000-point scale, while members of health plans sponsored by large employers (501-5,000 employees) and jumbo employers (more than 5,000 employees) have satisfaction levels averaging 717 and 725, respectively. Health plan members working for larger organizations are also more likely to re-enroll and recommend their plan to others, compared with members working for small employers.

Satisfaction among individual purchasers, which account for 9 percent of health plan members, is comparable to that among members of plans sponsored by small employers, averaging 694 points.

Likewise, among individual purchasers, likelihood to re-enroll, recommend and purchase other products is lower compared with members working for larger organizations.

"As unemployment rates rise across the nation, more members are moving to individual health plans from employer-sponsored plans," said Jim Dougherty, executive director of the healthcare practice at J.D. Power and Associates. "By more effectively managing the member experience for this growing segment of members, health plans could reap considerable financial benefits through increased retention and recommendations, and prepare themselves for the anticipated healthcare reform measures facing the industry, which are likely to drive additional enrollment among previously uncovered individuals and small employers."

Health plans ranking highest in their respective regions are (in alphabetical order):

• Anthem Blue Cross and Blue Shield of Kentucky;
• BlueCross and BlueShield of Alabama (these two plans tie in the East South Central region);
• BlueCross BlueShield of Arizona;
• BlueCross BlueShield of Florida;
• BlueCross BlueShield of Illinois;
• BlueCross BlueShield of Nebraska;
• Dean Health Insurance;
• Harvard Pilgrim Health Care;
• Health Alliance Plan;
• Highmark Blue Cross Blue Shield;
• HIP Health Plan of New York;
• Humana (which ranks highest in the South Atlantic and Texas regions);
• Kaiser Foundation Health Plan (which ranks highest in the California, Colorado, Northwest and Virginia-Maryland regions); and
• Medical Mutual of Ohio.

The study also finds that — while satisfaction levels have increased significantly from 2008 in the New England, South Atlantic, California, Arizona-Utah and Illinois-Indiana regions — health plan members in the New England, Michigan, Pennsylvania-Delaware, California and South Atlantic regions are the most satisfied overall.

"Across the industry, satisfaction with health plans remains fairly stable, increasing only slightly compared to 2008," said Dougherty. "Members still tend to be least satisfied with the information and communications they receive from their health plan — the third-most-important factor in overall satisfaction. Consequently, improving member communications can go a long way in driving higher levels of overall member satisfaction — particularly since only one-third of members say they fully understand how their health plans work."

The 2009 National Health Insurance Plan Study includes responses from more than 33,000 members of commercial health plans. Members were surveyed online in December 2008 and January 2009.

Address: J.D. Power and Associates, 2625 Townsgate Road, Suite 100, Westlake Village, CA 91361; (805) 418-8000, www.jdpower.com.