Can benefits summaries make insurers more trustworthy?


I'm a glass-half-full kind of gal. Although many people would consider that an annoying trait, I think it's the best way to make an otherwise maddening situation bearable and maybe even pleasant.

Staying positive doesn't have to stop at individuals; companies can choose to take that perspective too. Take, for example, health insurers and the summary of benefits and coverage (SBC). As of last week, the U.S. Department of Health & Human Services requires insurers to provide the four-page document, which has been likened to the Nutrition Facts labels on packaged foods, to new and existing members.

For consumers, this means they can make apple-to-apple comparisons of health plans. But since the requirement was proposed last year, insurers have been complaining it's yet another onerous burden with little to no benefits.

Many insurers say the reform law-mandated SBC is duplicative of benefits descriptions they already provide. Others are concerned the new requirement places an unnecessary financial and administrative burden on them. These are valid points.

But instead of griping about the SBC, I would recommend insurers take the sunny side--and there's always a way to positively spin any undesirable predicament. Lynn Quincy, senior policy analyst for Consumers Union, says insurers can indeed benefit from this newly effective regulation. "Studies have shown that better consumer understanding of their policy lowers costs" for insurers by, for example, dealing with fewer calls to customer service, she told FierceHealthPayer.

Plus, she added, the SBC "may help with trust of insurers, which ranks very low" among consumers. By providing clear, concise and consistent messages about health plans, insurers appear more open and transparent, thereby boosting consumers' confidence that they provide a product worth buying, even at slightly more expensive costs. "Transparency is good for the bottom line and helps with good will," Quincy said.

What insurance company doesn't want to lower costs? You've got to tackle those growing expenses any way you can, including through seemingly small steps like promoting the SBC. And improving trustworthiness could quite possibly underline almost every big-picture problem facing health insurers today.

That may be incentive enough for insurers to put forth the effort to create and market these documents, particularly since the HHS said it wouldn't fine or penalize insurers for failing to comply with the benefits summary in the first year.

Given the work that goes into creating the benefits summaries, many insurers will want to ensure that consumers actually read the new documents. Even if you have a positive attitude and focus on the rosy side of an unappealing situation, you still want to know you didn't waste time and money. The most important step to that goal, Quincy said, is to "make it easy to find," including placing the SBC in front of all marketing materials and asking members if they've read the SBC when they enroll. "That alone will go pretty far," Quincy added.

As insurers change their perspective on this SBC issue, my hope is they will begin applying it to other unwelcome reform-related requirements. Maybe then we can all pause to enjoy a feel-good moment, singing along to Monty Python's famous song, "Always look on the bright side of life." One can dream, right? - Dina (@HealthPayer)