3 Tips for Helping Your Members Navigate Complex Benefits Designs

Health care is messy and, for most people, it’s difficult to understand. As health benefits information becomes increasingly complex, educating health plan members and helping them successfully navigate through their benefits is critical. Working with a variety of large and small health plans across the country, I’ve observed several ways health plans can effectively communicate with and educate their members.

Below are three tips to consider as you develop your member education programs related to complex benefits information.

  1. Put everything in their terms. Too often, health plans get stuck using their own jargon to communicate to plan members. Terms like “imbedded coinsurance” and “out of pocket max” make sense to those of us in the industry, but are you aware of the percentage of people who actually understand the verbiage typically used within payer organizations? This study from policy genius shows that only 4% of Americans could correctly define the following four terms: deductible, coinsurance, co-pay and out of pocket maximum. In order to make information stick with your members and help them comprehend these terms, put everything into language that makes sense to them. A good way to practice is to try explaining the basic tenants of the previous four terms to your family members. When you have simplified them enough for your parents, spouse or even children to understand, make that language universal to your members. You will find that you have created more meaningful and authentic communication as a result.
  2. Help members connect the dots with visuals. The effort of attempting to untangle the complexity of health care combined with the structure of benefits often leads to an overwhelming sense of frustration for members. Help them see how all of these insurance terms come together in a meaningful way by including visual elements to simplify ideas and concepts. Providing visual representations allows for a simplified version of complex ideas to be communicated in a format that is more consumable for many people. The use of visualization has been leveraged in many industries, including software development and engineering, where tools like concept maps and mind maps are often used.
  3. Keep it consistent. Through the use of consistent terminology and definitions across all your health plan communication, members feel a level of comfort that leads to trust and understanding. The continuity of terms, tone and tenor provides familiarity and acceptance while eliminating confusion and frustration for members. I recommend a full audit of your communications to ensure consistency. You’d be surprised how often health plans confuse their members through the use of different terms for the same concepts.

If you are seeking to educate members about complex benefit designs, leverage these three best practices to help navigate them to a better understanding of the complete picture.