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Health insurance plans need to make customers happier

A new company sits atop the J.D. Power and Associates annual survey of customer satisfaction with employer-sponsored health insurance plans.

Health Care Service Corp. (HCSC), which operates four Blue Cross and Blue Shield plans, was ranked the highest among fully insured employer-sponsored health plans in the J.D. Power 2013 Employer Health Plan Study. Cigna ranked highest among self-funded employers in the fourth annual survey.

health insurance customer satisfactionIn the past, Kaiser ranked the highest in employer satisfaction among fully insured commercial health plans while Aetna ranked highest among self-funded commercial health plans.

Scott Hawkins, director of health care for J.D. Power, says HCSC was able to "upset" Kaiser, a perennial favorite, by making significant improvements to its customer service.

HCSC customer service improvements

Lauren Perlstein, spokesperson for HCSC, says HCSC expanded technologies and programs that measure performance and wellness initiatives to better serve its customers. She says that "93 percent of member inquiries are resolved in the first call and an estimated 93 percent of claims are paid in the first 14 days."

Hawkins says that HCSC is on the right track and that if other health insurance plans don't aim to please employer groups they could risk losing business to competitors, especially with Affordable Care Act deadlines looming.

Earlier in July, the Obama administration extended the deadline to 2015 for businesses with 50 or more employees to provide coverage for all its full-time employees. The start date had been Jan. 1, 2014.

Other provisions of health care reform, including insurance marketplaces, still are set to take effect. Marketplaces are websites where consumers can compare health plan prices and benefits. They are supposed to be operational by October.

Health insurance marketplaces make it easier to shop

Hawkins says the marketplaces, also called exchanges, will make it easier for dissatisfied customers -- whether employer groups or individuals -- to shop for a better plan for their needs.

"We believe that employers who aren't happy with their health insurance [companies] are more likely to stop working with them and consider alternative health plans or give their employees vouchers to purchase health insurance on their own online through the exchanges," Hawkins says.

If employers give their employees vouchers to buy their health insurance, the market will be even more competitive, Hawkins says. "Anytime you put more control in the hands of the consumer, you become more competitive," he explains. Also, he says, if employers send their employees to the exchanges for their health insurance, the employees can shop for the best plan for their needs - not be stuck with the plan their employer picked.

The survey also found that 15 percent of employers say they "definitely will not" or "probably will not" continue sponsoring coverage for their employees in five years.

Susan Pisano, spokesperson for America's Health Insurance Plans, a trade group, says health reform or not, health insurance companies know they have to please subscribers and will continue to do so to retain business.

"Irrespective of Obamacare, health plans have always known that there are other carriers eager for employers' business," she says. "And they have been very focused on the customer, whether it's an employer group or an individual consumer."

Pisano doesn't believe that focus will change, no matter what health insurance reforms are in place.

Perlstein says HCSC is preparing to offer an array of competitively priced products both on and off the exchanges in the four states where it operates Blues plans.

"HCSC works closely with our employer group customers to understand what is required by the Affordable Care Act and what options are available to them," she says.

HCSC is the largest customer-owned health insurance company in the U.S. It operates four Blues plans: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas.

The survey used a 1,000-point scale. In it, HCSC received the most points among fully insured employers: 741. Cigna and Kaiser tied for second with 737 and Aetna came in third at 724. Others on the top of the list were WellPoint/Anthem with 707, United Healthcare with 703, and Humana with 693.

The average for the fully insured segment was 709.

Cigna scores highest for self-funded employers

Among self-funded employers, Cigna had the highest score at 707. Aetna was second at 694. Others on the top of the list were WellPoint/Anthem with 692 and United Healthcare with 669. Under self-funded plans, the employer pays claims costs while the insurer administers the plan benefits.

The self-funded segment average was 696.


To measure customer satisfaction, J.D. Power surveyed employers on how they felt about their plans' service experience, account servicing, program offerings, benefit design, problem resolution, and cost.

The annual survey included responses from 5,857 employers. Measures were in place to assure that the companies studied were well distributed among small, medium and large employers. Customers were surveyed in April and May.

More from Beth Orenstein here

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