Concerns about not having enough health coverage is driving down plan member satisfaction with health plans, according to a survey released this week by J.D. Power.

While health insurance companies are introducing themselves to customers in new markets through new channels, 41% of existing health plan members feel they do not have enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics and drug coverage. These concerns negatively affect overall satisfaction more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan Study.

“With this new world of private exchanges, public exchanges and more and more people — whether by employer choice to move people to high-deductible plans or whether employees are making that choice themselves — there’s a huge challenge with employees who are either completely uninformed because they’ve never had health insurance before or because they’re switching plans,” says Rick Johnson, senior director of the health care practice at J.D. Power. “There’s a tremendous need for digestible information. It really came through in a number of ways in the study.”

For example, he says, “people want to get information that is going to help them manage chronic conditions. That’s definitely an area of improvement. We also saw a drop in the usefulness of information people reported seeing.”

Johnson recommends employers and health plans ensure information is layered. “If they’re predominantly using email or driving people to a website and they have a question, those might not be the best ways to convey the information,” he says. “But layering those methods of communication with knowledgeable call centers to answer questions in plain language and help someone understand what their coverage is and how the process works is absolutely critical.”

Additionally, when rolling out a new initiative, use real people to test key messages as much as possible “to hear that language and then tell you ‘what does this mean?’” says Johnson. “It’s a great test to see if you’re conveying what you really think you’re conveying.”

The study measures satisfaction among members of 136 health plans in 18 regions throughout the U.S. It asks questions in six areas: coverage and benefits, provider choice, information and communication, claims processing, cost and customer service. In 2014, overall member satisfaction averages 669 on a 1,000-point scale.

New this year were questions about cost, which makes comparing 2014’s member satisfaction with last year’s numbers a bit like comparing apples and oranges, says Johnson. “That had a tremendous impact on our satisfaction model,” he says. “It changes the model.”

Other key findings from the survey include:

  • Fifty-five percent of members indicate having experienced an increase in costs in 2013, which negatively impacts cost satisfaction.
  • More than one-third (35%) of members say they received a notice of changes in their coverage, networks or rates from their health plan in the past 12 months.
  • In the 2013 plan year, 74% of health plan members maintained their preferred physician and 83% retained their same hospital network.
  • Seventy-five percent of members indicate having submitted a claim in the past 12 months.
  • The average monthly premium paid in 2013 is $285.

Satisfaction is highest among health plan members in the California and Michigan regions (in a tie); the Indiana-Illinois and Mid-Atlantic regions (in a tie); and the East South Central and South Atlantic regions (in a tie). Satisfaction is lowest in the New England, New York-New Jersey and Southwest regions.

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