Why Health Insurers Make People Ill

Recounting an open enrollment experience that was, in a word, cringeworthy.

[Editor’s note:  This article was originally published by National Underwriter Life & Health magazine on December 18, 2014.]

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‘Tis the season for health insurance open enrollment, which can mean only one thing…  My blood pressure’s going up.

Health insurers talk a lot about how they’re my “wellness partner,” helping me “live a healthier life” and “empowering me to make good decisions.”  But I find all they do is make me ill…  sick with aggravation and annoyance.

That’s perhaps best evidenced by the annual health insurance open enrollment process, when insurers put on a master class in exactly how not to treat your customers.

My open enrollment journey began with a letter from my insurer, indicating that my current health plan would no longer be available next year.  However, the letter explained, they had already selected a replacement plan that would best meet my needs.

Of course, they neglected to tell me what that plan was.  Perhaps they felt adding an element of mystery and suspense to the process would make it more exciting?

A few weeks later, they graciously revealed their plan selection in a second notice.  They picked a coverage option that was nearly twice as expensive as my current one – with a narrower provider network, to boot.  It seemed like a selection that best met their needs, instead of mine.

So off to the Internet I went to research my alternatives.  That alone was an adventure, given how many insurers’ health plan websites appear to have been designed by crazed, blind hermits.

My personal favorite was one major insurer’s site where about half the links to their health plan details yielded the dreaded “404 Web Page Unavailable” error.  I guess they really weren’t interested in getting my business (or anyone else’s).

After evaluating other offerings, it was time to figure out what my options were with my current insurer.  Naturally, their online plan descriptions triggered more questions than they answered – which meant I’d have to contact the insurer’s 800-line service center (also known as Dante’s 9th Circle of Hell).

All I wanted was to speak with someone who could help me.  But that was clearly setting the bar too high.

Once I navigated the labyrinth that was the 800-line menu, I was subjected to a series of pre-recorded messages, including one that felt less like a call center greeting and more like an oral history of the Affordable Care Act.

Then there was the twenty-minute wait until a representative was available, with the on-hold music periodically interrupted by an ironic recorded assurance that the company “values my time.”

They valued my time so much that they made sure to consume a lot of it.  That first call lasted more than two hours and included ten transfers, because nobody seemed to be the “right person” to help me.  You’d think I was asking about some arcane plan feature, but all I had were some straightforward questions comparing networks and benefits across two of the company’s plans.

Each service representative I spoke with began the conversation using the same scripted phrase:  “What would you like to accomplish today on this call?”

“I’d like to not get transferred,” was the reply I started using about an hour into the odyssey.  “That’s my goal on this call.”  The vast majority of the people I spoke with were unable to satisfy even that simple request.

Oftentimes, I found I knew more about these plans than the enrollment representatives themselves.  I even resorted to walking one of them, step-by-step, through the company’s own website materials, when they insisted the plan I was considering had no out-of-network coverage.  (It did, and they finally concurred.)

Even after this first marathon call ended, I was compelled to call again…  and again and again.

In some cases, it was to follow-up on information that enrollment representatives had promised to send me, but never did.

In other cases, it was just to ask the exact same questions of another person, because I had absolutely no confidence in the responses I was getting.  I would pose the same question to three representatives and get three different answers.  That’s how my insurer empowers me to make a good decision?

My experience is not uncommon; health insurers routinely bring up the rear in cross-industry customer satisfaction rankings.  It begs the question, though, how much unnecessary expense are these companies incurring as a result of all this incompetence?

If health insurers simplified their products a bit, if they made their information materials a little clearer, if they trained and equipped their staff better – how much consumer confusion would they mitigate?  How many incoming calls, e-mails and tirades would they preempt?  How much operational savings could they pass on in the form of more affordable coverage?

In a health insurance marketplace that’s becoming increasingly consumer-directed, many insurers have taken to the airwaves to highlight how they enrich our lives and improve our well-being.

But you can’t advertise your way to a good customer experience.  If health insurers are serious about improving my well-being, they can start by creating an open enrollment process that’s more satisfying than it is sickening.

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Jon Picoult is Founder & Principal of Watermark Consulting, a customer experience advisory firm that helps companies impress their customers and inspire their employees.  As a consultant and keynote speaker, he has advised thousands of executives across some of the world’s foremost brands.  Learn more at www.watermarkconsult.net, follow Jon on Twitter @JonPicoult, or subscribe to Watermark’s eNewsletter.