Clearing up healthcare law confusion

September 15, 2010

Though the debate and eventual passage of the Patient Protection and Affordable Care Act (PPACA) filled news cycles for months, the bill ? and healthcare in general ? are so complex that plans have been working overtime to explain the many provisions of the new law.

Though the debate and eventual passage of the Patient Protection and Affordable Care Act (PPACA) filled news cycles for months, the bill - and healthcare in general - are so complex that plans have been working overtime to explain the many provisions of the new law. People are still sorting out the rhetoric of the political process from the realities of the bill that was passed.

At CIGNA, for instance, they have already created a site on healthcare reform that provides information on the new law and it's impact on brokers, consultants and customers. They're also creating a "Let's Be Clear" website that will provide information on the law's immediate impact on customers' plans, as well as tips for getting the most from your plans. The site will also include an "Insurance Speak-to-English" guide to facilitate better understanding of health plan products and services.

CIGNA is also keeping its customer service staff updated and prepared to address questions on the new law and its impact on plans. It does the same with clients and brokers by sending letters and hosting webinars to help them update customers on the law. The most recent webinars drew more than 3,000 attendees, according to CIGNA's Joe Mondy.

According to recent surveys, they have their work cut out for them.

The J.D. Power and Associates 2010 U.S. Member Health Insurance Plan Study, shows overall member satisfaction averages 701 on a 1,000-point scale, declining from 712 in 2009 and falling below 2008 levels. Member satisfaction has declined in all factors except customer service, where satisfaction has remained flat, with notable decreases in coverage and benefits and information and communication.

"This significant decline in overall satisfaction is partially driven by a lack of members' understanding of their plan's coverage and benefits and how to successfully access them," said Jim Dougherty, director of the healthcare practice at J.D. Power and Associates, in a press statement. "Understanding alone does not explain member satisfaction, although it may help to mitigate other problems with the member experience. While satisfaction with many plans has declined this year, satisfaction decreases are less severe for those plans able to substantially increase member understanding."

According to some findings of a recent HealthDay/Harris Poll, most respondents (about 58%) know that the reform package will prohibit insurers from denying coverage to people because they are already sick; 55% know the law  permits children to stay on their parents' insurance plan until age 26; and 52% realize that people who don't have insurance will be subject to  financial penalties. Additionally, half are aware that employers with more than 50 employees will have to offer their workers affordable insurance.

Among other findings: 63% of those polled either aren't sure or don't know if the new law will increase the number of people eligible for Medicaid; 79% don't know or aren't sure if drug companies will pay an annual fee; 73% don't know the law establishes a new tax on the sale of  medical devices; 66% don't know or aren't sure if the legislation will result  in insurance exchanges where people can shop for insurance; and about 82% think the bill will result in rationing of health care, or aren't sure if it will.

According to Dougherty, health plans can create a foundation for a more satisfying member experience by providing new and existing members with a better understanding of their coverage, and by proactively communicating with subscribers about impending changes in benefits, physician or hospital networks or costs. Overall, members with higher levels of understanding tend to be more loyal and are better advocates for the health plan.

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