5 Ways to Improve the Private Health Insurance Exchange Experience


Health insurance is complex and intimidating – the introduction of private exchanges means more choice for consumers, but is that a good thing?  

With 70% of employers preferring to offer benefits through private exchange, employees will soon have both the opportunity and the burden of choosing their own insurance package after navigating through the sea of information available. A good user experience can help employees to make sense of all the complex data and feel empowered, not discouraged, by the process and results.

Insurance plans have dozens of different attributes from various co-pays and deductibles, to policies surrounding in-network vs. out-of-network coverage, which can make comparing plans difficult for employees. Beyond the confusion and anxiety that may arise, when people are confronted with too many options, they are less likely to be satisfied with the choice they’ve made. Members are more likely to regret their decision because they easily imagine a scenario where they had chosen a different plan with better coverage or a lower price tag. Great member experience and robust exchanges can live in harmony, however. Here are five ways to simplify the insurance exchange experience for new members.

1.  Apply the Decision Complexity Matrix to understand users

Fortunately, with a strong understanding of our users we can help to reduce confusion and empower consumers in their decision making.  One tool we can use is a Decision Complexity Matrix, which helps us to pinpoint where complexity resides with the particular user population we’re designing for.  Complexity can arise because users who are new to exchanges have little prior knowledge or expertise choosing plans. The complexity of the decision itself depends on how many plans are available to choose from, how many facets there are to each plan, and the similarities between plans.


Complexity is determined by the ability of decision maker and simplicity of options.

2.  Employ visual design to educate user on what’s important

When complexity arises from the consumers’ lack of experience, we need to design solutions that help them to construct preferences around their health coverage.  One fundamental way to achieve this is through the visual design of plan information. Greater visual emphasis on the information that matters most will increase its importance in the decision maker’s mind By identifying and emphasizing key plan facets that are likely to increase satisfaction, we can nudge those who are unfamiliar towards weighing the appropriate attributes in their choice.



Plan summaries should highlight the most important data

3. Utilize informative content and visual guides

Another way to help consumers construct preferences is by educating them about the domain of insurance. Avoid throwing users in head first into industry terminology, rather, assume that they need things spelled out for them. Informative content and visuals should guide users through concepts that industry insiders take for granted like deductibles, co-insurance, and max out-of-pocket. Illustrate the impact that particular choices will have on actual members’ lives.

4. Focus on a few meaningful options for coverage

Regardless of the level of expertise that consumers have, choosing insurance is simply a complex task. Confronted with the dozens of plans, people are likely to look for shortcuts to eliminate as many plans as they can because the work of evaluating them is tedious and confusing. The first thing exchange designers can do is to pair down the number of plans offered. Focus offerings on a few meaningful choices of plan rather than offering every possible configuration of benefit.


Oscar health does a great job of restricting option to a meaningful range of price points.

5. Enable recommendation agents to do the hard work

One way to pair down plans while retaining a vast base of offerings is to employ recommendation agents. These interactive guides can help to tailor offerings to the particular needs of each user. Good recommendation agents help the system understand user’s preferences by asking questions in plain language, as well as, employing data gathered through other means like customer’s historical utilization or purchases from members like them. With this data in hand, the system can do the tedious work of evaluating plans nearly instantly.  It is important to note that users will have greater trust in recommendations that display a level of transparency about why plans are recommended.


Recommendation agents combine user and consumer data to deliver tailored recommendations

Empowered customers mean happy customers

Insurance exchanges offer great potential for customers, however, developers of  these exchanges need to remember that more isn’t always better. By understanding users, offering decision support tools, and designing information so it easy to comprehend we can create better experiences for customers and increase their satisfaction with their decisions.

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