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Open Enrollment: What Employees Want and How They Make Decisions

Open Enrollment: What Employees Want and How They Make Decisions

Open Enrollment PhotoWhen open enrollment begins this year, employees and health plan subscribers across the country will have a lot of choices to make. Are people willing to sacrifice doctor choice or pay high deductibles to save on monthly premiums? Are they happy with the plans they have? And what should employers look for when they decide which plans to offer employees?

We worked with the healthcare experts at Becker’s Hospital Review to survey 415 people using SurveyMonkey Audienceso that we could learn how consumers view the choices they’re likely to face during open enrollment. Our sample included people from 18 to 64, who either receive health insurance from their employer or pay for their own health insurance.

Are subscribers happy with the status quo?

Overall, the health insurance subscribers we surveyed seem reasonably satisfied with the insurance they receive. 57% rate their insurance plan “very good” or better, and only 2% think their plan is “poor.”

hc like itWhen it comes to premiums, expenses, and choices associated with their existing health plans, a large majority of subscribers are at least “moderately satisfied” with everything we asked them about. Here’s the breakdown:

• Monthly premiums: 73% were at least moderately satisfied
• Annual deductibles: 72% were at least moderately satisfied
• Copayments for doctor visits: 76% were at least moderately satisfied
• Out-of-pocket prescription costs: 77% were at least moderately satisfied
• Choice of primary care doctors: 89% were at least moderately satisfied
• Choice of specialists: 88% were at least moderately satisfied
• Choice of hospitals: 93% were at least moderately satisfied

In most cases, health plan subscribers seem to be more satisfied with the choices their plans afford than the expenses associated with them. For example, only 19% have ever had problems finding doctors or providers willing to accept their plans, but 30% feel their plans offer a “fair” or “poor” value.

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These differences are exacerbated when the health of subscribers is taken into account. Those who describe themselves to be in “fair” or “poor” health tend to be less satisfied with the choices available to them. As an example, here’s how subscribers feel about the choice of hospitals, broken down by how healthy they are:


satisfaction by health type

On the flip side, the older people get, the more satisfied they tend to be with primary care choices, specialists, and hospitals available under their plans. Here’s the same question, comparing responses by age:

hc satisfaction by age

Making open enrollment decisions

So when it comes time to choose their health plans, what matters most? When asked how important they consider different costs and benefits, it appears subscribers want it all. They say all the different facets we asked them about are “very” or “extremely” important, though range of coverage and costs matter a little more than choice of doctors:

• 87% say the range of benefits or a specific benefit is very important
• 86% say the cost of deductibles and copays is very important
• 86% say the cost of monthly premiums is very important
• 79% say the choice of available doctors and hospitals is very important

Choosing between savings and benefits

hc Wellness

Picking a plan during open enrollment requires finding the right balance of cost, choice, and coverage. We also looked at what tradeoffs subscribers would be willing to make to get the things they want. Here’s what subscribers would be willing to do to lower their monthly premiums:

• 87% would be willing to participate in wellness programs (like weight loss, blood pressure, or cholesterol control)
• 44% would be willing to pay more for brand name prescription drugs
• 42% would be willing to change their primary care physician
• 30% would be willing to accept a more restricted list of providers
• 16% would be willing to pay “significantly higher” deductibles

What does it take for someone to change their doctor?

We also asked subscribers how much they would have to save on premiums to choose a plan that forces them to change their primary care physician. The median response was a savings of $100 a month, but some people would ask for a lot more, including 28% who would want to save at least $200 a month to choose a plan requiring them change doctors.

Bottom line, open enrollment poses a lot of tough questions for both employees and employers. If you have employees and you want to understand what they really want, a survey is a great way to make sure you meet everyone’s needs. Here are more ideas for how to run healthcare surveys.


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