Coverage and Benefits
page Redesign
Overview
Project Overview: The goal was to redesign the coverage page of a health insurance member portal to enhance user experience and accessibility. The existing page was complex and confusing, leading to frequent user complaints and difficulties in locating essential information about their health insurance coverage.
Problem
Members have difficulty finding information about their coverage on BAM and understanding how their plan works. The lack of insurance literacy and knowledge of plan coverage details from the beginning may contribute to future problems such as unexpected charges, delays in seeking medical help, and general frustration.
From the business model, a lack of members’ understanding of coverage creates a need for higher customer service call center engagement, and a loss of customer retention in the future.
Initial Challenges
The redesign faced several significant challenges:
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Technical Constraints: The legacy system had outdated code and was tightly integrated with other components, making it difficult to implement new design features without risking system stability.
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Lack of Information: There was a scarcity of detailed user feedback and analytics data on how members interacted with the coverage page. This made it challenging to pinpoint specific pain points and user needs.
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Variety of Accounts and Plans: The portal needed to accommodate a vast range of account types, plans, and coverage details. This diversity meant that creating a single, consistent template that could effectively present all types of information was particularly challenging. Each plan had unique features and coverage details, complicating the design process and necessitating a flexible, adaptable solution.
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Balancing Information and Usability: We needed to strike the right balance between showcasing the most important information and making all benefits visible, while avoiding page overload that could lead to excessive scrolling and longer loading times.
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PDF-Based Coverage Details: Initially, all member coverage details were stored in PDF format. PDFs were not easily searchable or accessible, particularly for users with specific needs, such as those relying on screen readers. The technical difficulty of transferring all coverage information from PDFs onto a web portal page required integrating several internal and external APIs and coordinating with multiple teams. Despite the complexity and potential cost of this update, I demonstrated that it would significantly improve user satisfaction and utilization rates.
Solution
Redesign improved user satisfaction with the Coverage and Benefits page and using the members' portal in general by:
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Providing the most important coverage information at a glance, instead of being hidden.
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Offering documents, articles, and other materials educating users about their plans.
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Researching and expanding the number of visible benefits to cater to the most inquired topics.
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Additional descriptions providing more details about the contents of every section.
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Provided links to the pages members mostly interact with after visiting Coverage page to provide a seamless experience throughout the web portal.
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Highlighted additional complimentary services included in members' plans to improve engagement.
By expanding the information available on the Coverage page, we promoted customer interaction with the page and eliminated the need to call customer service. This resulted in improved member satisfaction and members loyalty to the company. From the business perspective, this improvement will result in a significant cost reduction that the enterprise spends on utilization of call centers.
Design Process
Step 1: Empathize, Research
The journey began with a deep dive into understanding the pain points and aspirations of users interacting with the health insurance member portal. Extensive UX research methodologies, including user interviews, surveys, and heatmaps derived from analytics tools, provided valuable insights.
These insights highlighted common frustrations such as complex navigation on the Coverage and Benefits page, difficulty finding information about their coverage on BAM and understanding how their plan works. The lack of insurance literacy and knowledge of plan coverage details from the beginning may contribute to financial troubles such as unexpected charges, delays in seeking medical help and general frustration.
Service blueprint
These insights were aligned with trends found in analytics data from Foresee, Clarabridge, and the Call Center. In conjunction with the data from other sources, the data from the usability study was used to prioritize the most important and actionable opportunities for improvements.
CURRENT SUMMARY NOT VISIBLE BY DEFAULT
Users wondered why the current year’s Summary of Benefits and Coverage was not immediately visible on the page, as many specific benefits information are not readily available in the highlights.
USERS WERE UNSURE WHY OUT OF NETWORK BENEFITS WERE NOT DISPLAYED IN HIGHLIGHTS
Users were unsure why only in network benefits were displayed, when the deductible listed both in network and out of network benefits.
RECOMMENDATIONS
Consider displaying current Summary of Benefits and Coverage by default while past years’ plans are displayed under a dropdown.
Consider adding out of network benefits to relevant lines in benefits highlights.
DEFINITION OF SPECIALIST VISIT NOT CLEAR
Some users were confused by the definition of “specialist visit” and were unsure whether a particular visit was a specialist or if the visit required further consultation of the plan book.
SIMILAR TYPES OF BENEFITS NOT GROUPED
Some users expressed confusion that similar types of benefits were not grouped together. They noted the copay for a specialist visit was noted at the top of the benefits highlights while other copays were listed further down the page.
USERS CONFUSED ABOUT INCLUSION OF BLUE CARD PROGRAM IN BENEFITS HIGHLIGHTS
Since BlueCard was listed with the deductibles and copays, users thought BlueCard was connected to those details but unsure how.
RECOMMENDATIONS
Consider grouping benefits by category, such as deductible, copay, or out of pocket maximum and defining benefits further. Consider more clearly delineating medical and non-medical benefits.
Report with recommendations
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Step 2: Define the insights
Armed with insights collected in a previous stage, the next step involved defining clear problem statement and design goals. The Coverage and Benefits page required simplification of information hierarchy to improve accessibility and clarity.
Problem Statement:
Members happen to have difficulty finding information about their coverage on BAM and understanding how their plan works. The lack of insurance literacy and knowledge of plan coverage details from the beginning may contribute to future frustrations such as unexpected charges, delays in seeking medical help and general frustration. From the business model, lack of members’ understanding of coverage creates a need to higher customer service call centers engagement.
By addressing the problems, we aim to improve overall experience when visiting the page by providing most important information at a glance, educating users about their plan and expanding the amount of visible benefits to cater to a most inquired topics. We hope to promote customer's interaction with the page. This will lead to improved member satisfaction and will build members loyalty to the company.
Improvements:
As part of redesign of Coverage landing page, we strive to create a one stop platform where members can effortlessly find the most important information about their coverage. With this round of improvements, we target several areas on the page:
• Improve informational architecture of the data that is currently available on the page to improve its visibility
• Help members find benefits more easily by providing helpful hints
• Addition of most inquired benefits and coverage topics to the page to help eliminate customer service calls.
• Provide educational materials and features that would help with plan comprehension and usability (Plan Progress feature, informational tooltips next to each benefit, linking to other relevant BAM pages)
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Step 3: Ideate
Ideation sessions were conducted to generate creative solutions aligned with the defined goals. Collaborative brainstorming ensured that each page's redesign not only met functional requirements but also exceeded user expectations for usability and aesthetic appeal.
In the first round of iterations, I addressed the feedback we received from the initial user interviews (quick solutions).
SIMILAR TYPES OF BENEFITS GROUPED TOGETHER
TOOLTIPS WITH DEFINITIONS ADDED TO EACH BENEFIT
Benefit Booklet PDFs made more visible
Made sure to always show both In and Out of Network values
Following rounds of iteration explored different information layouts and created one unified layout that would support most types of medical plans with various benefits available.
To fill up the gap between members' understanding of their benefits and how they contribute to yearly spending, I came up with the Plan progress feature.
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Step 4: Validate through testing and Iteration
Prototypes were subjected to 4 rounds of usability testing sessions provided actionable insights into navigation preferences, comprehension of content, and overall user satisfaction. Iterative improvements based on user feedback were implemented iteratively.
First Iteration:
Design Adjustments: In the first round of iterations, I addressed the feedback we received from the initial user interviews (quick solutions) to test the initial hypothesis. The revised prototypes were tested with a select group of users.
Most users preferred the new version of the Coverage & Benefits page
When asked which version of the page they preferred, most users chose the new prototype. The major reasons listed for preferring the prototype included:
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Conciseness
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Ease of reading
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Clear organization
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Modern look
RECOMMENDATIONS
Consider blending the designs by incorporating the chart for Benefit Highlights, but maintaining the tabs structure for PCP, BVA, and Find Provider.
Second Iteration:
Design Adjustments: added Plan Progress, section descriptions, included selector of member to show plan info and dunitization, Plan details shown on the top of the page, Benefit Highlights section was divided into 3 tabs to group. logical and most commonly utilized information together.
The second iteration of the prototype received only positive feedback from participants. They highlighted improved clarity and findability of the most important information on the page such as plan details and Plan Progress.
Plan Progress feature based on a feedback was very helpful in understanding how plan works.
When asked which version of the page they preferred, most users chose the new prototype. The major reasons listed for preferring the prototype included:
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Conciseness
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Ease of reading
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Clear organization
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Modern look
Things to consider after testing:
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When asked to locate information that was in the side tabs, it was not intuitive for members to look there. 1 user mentioned that it was hard to find because they did not think it would be there.
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Mobile layout would would only show one tab at a time and would make other tabs possible overseen.
RECOMMENDATIONS
Consider how to show most of the information on one page, without exposing too much information right away.
Additional research was conducted to specify which information should be showcased on the portal page (since the initial plan coverage information is very text heavy and due to amount of benefits is impossible to show). We were able to identify main groups of benefits our members were inquiring about the most. We addressed the challenge by transferring PDF-based data including most frequently inquired services and procedures, by extracting information from PDFs and integrating it into the web portal.
Most Inquired benefits were:
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Emergency Care coverage,
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X-Rays and Imaging,
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Maternity Services,
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Oncology Care
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Labs and Dialysys
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Behavioral Health.
Validation Phase
A/B testing was used to compare the redesigned page with the old one and measure improvements in usability and performance.
Final round, we validated
1. Using the format of a one-pager instead of a side tabs (mobile friendlier option)
2. Adding more benefits to Benefit Highlights section (Maternity Services, Oncology Care) and more educational articles.
3. After performing a tree test, it was decided to move the highly rated during user testing Plan Progress feature to the Spending page and add contextual links to other pages on the portal.
Most users preferred the new version of the Coverage & Benefits page
When asked which version of the page they preferred, most users chose the new prototype. The major reasons listed for preferring the prototype included:
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Conciseness
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Ease of reading
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Clear organization
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Modern look
Descriptions of the current page were mixed:
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Clean
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Calm
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Plain
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Simple
A few users mentioned preferring the tab structure for PCP, BVA, and Find Provider information
RECOMMENDATIONS
Consider blending the designs by incorporating the chart for Benefit Highlights, but maintaining the tabs structure for PCP, BVA, and Find Provider.
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Step 5: Final solution. Outcomes
The iterative redesign process resulted in several positive outcomes:
1. Improved User Experience:The redesigned coverage page offered a clearer, more organized layout that made it easier for users to find and understand their coverage details.
2. Enhanced Accessibility: By transitioning from PDFs to a web-based format, the page became more accessible and searchable, significantly improving the experience for users relying on assistive technologies.
3. Increased Performance: The use of modular components, collapsible sections, and lazy loading techniques successfully balanced content visibility with page performance, reducing scrolling and improving loading times.
4. Positive Feedback: User satisfaction increased significantly, with many users noting the improved clarity, accessibility, and responsiveness of the redesigned page (add percentage).
Things to consider (wide variety of accounts and amount of coverage categories provided )
technical constrains (system that sources benefits for every member would need to implement new algorytm) and that was not achieved.
Lessons Learned
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Collaboration is Essential:
Close coordination between design, development, and API teams was crucial for overcoming technical limitations and ensuring a feasible solution.
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Adaptability:
Designing for a wide variety of coverage information required a flexible approach. Modular components and dynamic content were key to accommodating diverse user needs and balancing information without overloading the page.
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Performance and Accessibility:
Balancing content visibility with performance and accessibility was critical. Transitioning from PDFs to a web format enhanced usability and ensured the information was accessible to all users.
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Iterative Testing and Feedback:
Multiple rounds of iteration and user testing were vital for identifying and resolving issues, ensuring that the final design met user expectations and improved overall satisfaction.
The project underscored the importance of adaptability, collaboration, and performance optimization in addressing technical and informational challenges to deliver a successful redesign of the coverage page in the health insurance member portal.
Coverage and Benefits product team during a design review session