Health plan members who buy their plans individually or who work for small employers are considerably less satisfied with their health plan experience than those who work for larger organizations, says the J.D. Power & Associates 2009 National Health Insurance Plan Study released last month.

Now in its third year, the study measures member satisfaction among 131 health plans in 17 regions throughout the U.S. by examining seven key factors—coverage and benefits, provider choice, information and communication, claims processing, statements, customer service, and approval processes.

The study found that health plan members working for employers with 50 or fewer workers are less likely to be satisfied with their health plan. Satisfaction among members working for small employer groups averaged 692 on a 1,000-point scale, while members of health plans sponsored by large employers, with 500 to 5,000 workers, and jumbo employers, with more than 5,000 employees, had satisfaction levels averaging 717 and 725, respectively.

Health plan members working for larger organizations also were more likely to re-enroll and to recommend their plan to others, compared with members working for small employers.

Satisfaction among individual purchasers, which account for 9 percent of health plan members, is comparable to that among members of plans sponsored by small employers, averaging 694 points. Likewise, among individual purchasers, likelihood to re-enroll, recommend, and buy other products is lower compared with members working for larger organizations.

"As unemployment rates rise across the nation, more members are moving to individual health plans from employer-sponsored plans," says Jim Dougherty, executive director of the health-care practice at J.D. Power & Associates.

"By more effectively managing the member experience for this growing segment of members, health plans could reap considerable financial benefits through increased retention and recommendations, and prepare themselves for the anticipated health-care reform measures facing the industry," Dougherty says. Those measures, he says, "are likely to drive additional enrollment among previously uncovered individuals and small employers."

Health plans ranking highest in their respective regions were (in alphabetical order): Anthem Blue Cross and Blue Shield of Kentucky; BlueCross BlueShield of Alabama (these two plans tie in the East South Central region); BlueCross BlueShield of Arizona; BlueCross BlueShield of Florida; BlueCross BlueShield of Illinois; BlueCross BlueShield of Nebraska; Dean Health Insurance; Harvard Pilgrim Health Care; Health Alliance Plan (HAP); Highmark Blue Cross Blue Shield; HIP Health Plan; Humana (which ranks highest in the South Atlantic and Texas regions); Kaiser Foundation Health Plan (which ranks highest in the California, Colorado, Northwest, and Virginia-Maryland regions); and Medical Mutual of Ohio.

The study also found that while satisfaction levels have increased significantly from 2008 in the New England, South Atlantic, California, Arizona-Utah, and Illinois-Indiana regions, health plan members in the New England, Michigan, Pennsylvania-Delaware, California, and South Atlantic regions are the most satisfied overall.

"Across the industry, satisfaction with health plans remains fairly stable, increasing only slightly compared with 2008," Dougherty says.

"Members still tend to be least satisfied with the information and communications they receive from their health plan—the third-most-important factor in overall satisfaction. Consequently, improving member communications can go a long way in driving higher levels of overall member satisfaction—particularly since only one-third of members say they fully understand how their health plans work."

The 2009 National Health Insurance Plan Study includes responses from more than 33,000 members of commercial health plans. Members were surveyed online in December 2008 and January 2009.

Westlake Village, Calif.-based J.D. Power & Associates is a global marketing information services company operating in key business sectors including market research, forecasting, performance improvement, Web intelligence, and customer satisfaction. The company's quality and satisfaction measurements are based on responses from millions of consumers annually.