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Jennifer Benz August 4, 2008 1 min read

Health plan notice falls short

Mystery letter from “Utilization Management Department”

Would you open a letter in a plain white envelope from the “Utilization Management Dept”? I’m guessing that piece of mail would have gone right to the recycle bin for most people. But, knowing that “utilization” is a favorite word of health plans, I decided to open it.

And, I’m glad I did because this was actually a really important communication from my health plan—with good news even! It included a notice that a screening I consistently have problems getting covered is certified as “medically necessary.” Hooray! But, why hide that news in a practically unmarked envelope from an address I’ve never seen before? Why not use this as an opportunity to create a good user experience (for a change)? This is just one of countless examples of the poor and inconsistent communication that comes right from health plans to their members—and to your employees.

If you dare, request all of the standard notifications that your health plans send out to your employees and see where improvements can be made. EOBs are frustrating, claims denial letters are confusing (and often infuriating!) and “good news” like this is often hidden in insurance jargon that you’d need an actuary to decipher.

As the needs of Spanish speakers place more demands on health plans, I’ve seen some lazy and ineffective approaches to bi-lingual communication as well. This letter had an extra page in it with this notice about requesting assistance in Spanish. While the plan was collecting every medical record of mine for the past 10 years, it would have been pretty easy for them to request my language preference as well. If your employees are not receiving health plan communications in a language they understand (the first time, not on request), the opportunity for that piece to have meaning is lost.

Simple simple improvements in health plan communication could go far in terms of helping members understand and use the plans correctly. If you’re not asking your health plans to upgrade their member notifications, please start!

Jennifer Benz

Jennifer Benz, SVP Communications Leader, has been on the leading edge of employee benefits for more than 20 years and is an influential voice in the employee benefits industry.