Utah website aims to make smarter health insurance shoppers

Health insurance • Transparency tool a requirement of federal health reform.
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Utahns now have a web tool intended to make shopping for health insurance easier.

A online site created by the Utah Department of Health Insurance allows comparisons of consumer ratings. Soon, the site will have data showing how quickly insurers pay claims, how often they deny claims, the costs of denied claims transferred to providers and average out-of-pocket consumer costs.

Assistant Insurance Commissioner Tanji Northrup said the information, coupled with data on rate hikes, "will be valuable for people looking to evaluate an insurer, not just on prices, but as a whole company."

People who get health benefits through their employer don't have much choice in plans. But anticipating a day when more Americans will be buying coverage directly via virtual marketplaces, or health exchanges, federal officials issued rules requiring greater disclosure from insurers.

Utah's "transparency" web site flags insurers seeking price increases of 10 percent or more. Soon it will publish all rate hikes along with data showing why the rate hikes are needed.

Consumers will be able to tell, for example, how much of their premium dollars are being spent on actual medical care versus administrative expenses.

"All this can be useful," said consumer advocate Lincoln Nehring, a health policy analyst at Voices for Utah Children. "The question is how do you get the information into the right hands, to employers and consumers."

Nehring would like to see the information integrated into the shopping experience on Utah's web-based health exchange, Avenue H. For now, the two web portals are separate. There's a link to the transparency tool on Avenue H, but you have to click through several sections, and it's buried at the bottom of the "small businesses" page.

"I hope brokers begin to use this information, that they let consumers know it's out there and let it guide their selection of health plans," Nehring said.

Insurance companies, on the other hand, hope consumers base their purchase on multiple sources of information, which can highlight different aspects of performance.

For example, under the new website's measurements, the insurance giant United Health Care doesn't compare as favorably as SelectHealth and Regence BlueCross BlueShield, which dominate Utah's market. But it ranked No. 1 for claims-processing accuracy in the American Medical Association's 2012 report card, points out Kristen Hellmer, a spokeswoman for United Health Care. And it was highest in employer satisfaction in a 2011 report by J.D. Power and Associates.

Its HMO membership in Utah is "relatively small" and it's unclear how many members were included in Utah's consumer ratings, she added.

"We are producing the strongest service statistics across our businesses that we have ever recorded," Hellmer said.