Designing a Consumer-Friendly Exchange
CALPIRG Education Fund
The exchange is a store where consumers can buy health insurance products – and anyone who’s worked retail knows that however much work has gone into crafting strong policies and building an efficient back-office, if customers can’t understand, compare and choose the products that are right for them, it just won’t work. It’s the same with exchange – the consumer experience is an important prerequisite for success.
Simple, Streamlined, and Accessible: The exchange’s web-portal must be well-designed, ensuring that the language used is straightforward, avoiding jargon as much as possible and addressing the diverse language needs of enrollees. The exchange must also help those without high-speed internet to find coverage, providing a toll-free hotline and face to face assistance through its navigator program.
Empowering Consumer Choice: Without the right tools, consumers on the exchange could face the same incomprehensible menu of poor-quality insurance plans they find today on the individual market. The exchange can take five steps to help consumers make informed choices:
First, the exchange must help consumers make apples to apples comparisons of plans.
Second, the exchange should make it easy to search for and find products that meet a consumer’s particular needs.
Third, the exchange should develop ratings and rankings to allow consumers to understand the strengths and weaknesses of their coverage options.
Fourth, easy-to-use search tools should integrated into the exchange web portal to allow consumers to know whether changing their coverage will also mean changing their doctor.
Fifth, the exchange must clearly explain the cost of each product, including premiums and cost sharing.
Privacy Protections: The exchange must develop and implement a plan to ensure that identifiable personal information is not shared, internally or externally, with those who do not have an immediate, legitimate need for it.
Consumer Assistance: Even the best designed exchange will not function perfectly in all cases. So consumers will need help from consumer assistance programs and navigators to make sense of their options, as well as a place to register their complaints-such as a strong, well-funded ombudsman or consumer protection agency.