With the Affordable Care Act now a reality, the confusion around coverage, costs, and situation-specific needs has caused forward-looking health plans to adopt a range of interactive and educational tools to guide and assist consumers during enrollment. In this guide, you will learn about the 10 best consumer experience practices being used today such as intelligent virtual assistants, specialized calculators, video, and mobile apps.

3. Introduction
Designing and selecting the right healthcare consumer
experience is probably one of your chief concerns as the
Affordable Care Act is now a reality, especially as it relates
to cost mitigation and essential plan requirements.
Beyond the obvious feature and function needs, what
about consumer and employee engagement? Is this a key
part of your initiative? Have you thought about how you
will ensure increased participation or member retention
while reducing the burden on HR or member customer
service departments?
Targeted engagement strategies integrated into the pre,
post, and ongoing enrollment processes can help you
achieve these goals and more. On the following pages,
we’ll review why facilitating consumer choice and
engagement is key to lowering costs as well as acquiring
members and fostering healthy member populations.
Further, we’ll present 10 best practices being used today.
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Introduction

4. Why Engagement Should Be Part of Your Strategy
Online retailers have set the
standard for an effective and
engaging shopping experience.
Current practices such as using
product comparison tools,
behavioral analytics, chat, and
virtual assistants create a
superior customer experience.
These practices are expected
and desired by consumers and can make the difference between
a loyal plan member or one who will abandon their application at
the first sign of difficulty.
Concurrent with singular transactions, consumers want to be
engaged before and after their shopping experience. Carriers
have the unique opportunity to deliver targeted messaging based
on employer data, health questionnaires, usage and
communication preferences. Similar to other service industries,
consumers want the choice of when and how they interact --
retail stores, online self-service, kiosks, phone, or by mobile
device.
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36% are willing to
switch insurers if offered
the ideal experience.3

5. 1. Offer a Range of Education and Engagement Options
In 2010, the ACA expanded health
insurance coverage to 30 million
Americans. Analysts predict 11 million
in 2014 to a high of 32 million in 2021
enrollees depending on state by state
Medicaid expansion.4 Further, reports
indicate that more employers than
ever before are interested in
leveraging a private exchange with
44% saying they will switch to an
exchange model within the next 3-5
years.5
What is certain is that consumers, whether they are sent to an exchange
by their employer, switching from individual plans to an exchange, or are
purchasing insurance for the first time, need varying levels of education
and guidance.
According to the Health Research Institute, most enrollees will be less
familiar with the insurance system; in 2014, approximately 75% of public
exchange enrollees will be newly insured. Education efforts by states and
insurers will need to progress with the changing needs of exchange
members as they transition from the newly-insured to experienced
customers. 6
That said, how users interact with your exchange depends on their buyer
persona. Taking into account primary personas and offering several ways
to seek help and select plans sets the framework for your interaction
models. On the next few pages, we’ll briefly cover the personas and then
take a deep dive into the best practices of the interaction models.
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In 2014,75%of public exchange
enrollees will be newly
insured.5

6. Gstar_M002Custom_300DPI_ab copy.tga
In the Enroll UX 2014 project formulated to create the best exchange user
experience, they defined several buyer personas which require varying
levels of education and engagement.7
Personas:
Based on these key differentiators, the exchange should provide tools to
match the desired user experience. On the following page, we briefly
review some examples by persona.
1 1. Offer A Range of Education and Engagement Options
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Passenger
GET IT DONE FOR ME
How they want to
engage: Hands-off.
How they want to feel:
Unburdened.
What they’re willing to
give up: Control for
convenience.
Apprentice
HOLD MY HAND
How they want to
engage: Hands-on.
How they want to feel:
Like they’re doing the
right thing and
making appropriate
decisions.
What they’re willing to
give up: Speed,
convenience, and
flexibility.
Engineer
GET OUT OF MY WAY
How they want to
engage: Detail by detail.
How they want to feel:
Equipped to make
decisions and changes
when necessary.
What they’re willing to
give up: Very little.
Manager
KEEP ME POSTED
How they want to
engage: Only when
needed for oversight
and approval.
How they want to feel:
Confident and well-
represented; that their
time is used effectively.
What they’re willing to
give up: A certain degree
of control over the
process.

7. 1 1. Offer A Range of Education and Engagement Options
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Apprentice: HOLD MY HAND
This buyer persona wants an informed guided experience.
They don’t just want to be led through the buying purchase
but become actively engaged. They benefit from virtual
assistants, online tutorials, video, and audio explanations to
help guide their decisions.
Passenger: GET IT DONE FOR ME
This buyer persona wants to be guided without getting
bogged down in the details. Help them make their decisions
quickly but accurately with as little hassle as possible. They
benefit from virtual assistants, FAQs or knowledge bases,
and simplified displays of plan choices.
Manager: KEEP ME POSTED
This buyer persona wants a guided experience; however,
without active engagement. Highlight important plan
decisions, provide an opt-in virtual assistant, and offer ways
for them to make comparisons between plans.
Engineer: GET OUT OF MY WAY
As the description implies, give them all options, but allow
them to control the experience. They may read all available
material, explore all the tutorials, heavily use FAQs, and
calculators, but it’s doubtful they want a guided experience.
They want the detail and the control.

8. Many choices are not necessarily a good thing. When consumers have
more than a few options at hand, they are likely to make inaccurate
decisions. By helping them narrow their choices, they will trust their
decisions and complete the enrollment process quickly.
Apart from asking basic demographic information and doctor choice, the
best tools ask dynamic questions that take into account healthcare
usage, financial comfort levels, and risk tolerance. In addition, the
questionnaires use jargon-free questions that are designed to reveal
lifestyle choices which help provide the best plan options.
One of the best examples of this tool was created by Bloom Health
Corporation. This decision support tool is used in tandem with their
private exchange offering called My Plan by Medica8. A best practice is
to offer the use of these types of tools just prior to displaying plans but
for those experienced shoppers give them option to take a more direct
route and display all plans. Do not force them through the more extensive
questionnaire process apart from the basic plan questions.
2. Use Intuitive Usage/Behavioral Plan Selector Tool
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9. This type of calculator factors more than just price and coverage levels. It
provides estimated annual costs based on premiums, net any credits,
and expected levels of use. According to Pacific Group on Health, there
are several best practices when using this type of calculator9.
3. Use a Cost at Time of Care Calculator
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Calculator Inputs
1. Make it an integrated part
of the plan selection
process.
2. Fully explain the rationale
and how the calculator
functions.
3. Ask about expected levels
of use rather than specific
conditions to allay privacy
concerns.
4. Ask different questions for
pharmaceutical versus
medical services use.
Calculation of Costs
1. Ask about their expected
services use by asking
them to match their
expected use to typical
yearly use profiles.
2. Sum the total costs of
premiums and deductibles,
net credits, net HSA
contributions if applicable,
and expected levels of use.
Displaying Costs
1. Emphasize the total annual
costs, because it’s more
clear-cut when doing plan
comparisons.
2. Display a vertical
calculation, you can include
annual and monthly.
3. Be clear this is not
guaranteed nor is a
budgeting tool.
4. Allow for what-if scenarios.
Figure9
User Preferences questions assessing expected medical services use.

10. 4. Use Videos and Tutorials
They say a picture is worth a thousand words. Taking that one step
further, adding video enriches the online experience for users who desire
more in-depth explanations. Benefitfocus is one of the leading private
exchange technology providers. Through their unique platforms and
video library app, they are able to serve up timely videos at the user’s
discretion. These videos explain everything from ancillary or voluntary
benefits to explaining in versus out of network providers.10
Online tutorials are similar and can be useful for more in-depth concepts
such as explaining the full range of consumer directed health plans.
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The Benefitfocus library.10

11. 4. Use Interactive Web Elements and Embedded Help
As consumers go through the process, they may need quick answers or
you need to ensure that they take note of important information. These
tools take the form of hover information, help buttons, FAQs, and sliders.
Additionally, a virtual assistant can enhance these elements through
audio and visual cues.
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12. 5. Display Column Dimensions and Narrow Choices
Based on the ConsumersUnion11
and Pacific Group on Health
Studies12, they have found using 6 or
fewer plan dimensions (features) and
no more than 3 plan choices aids
cognitive processing. In fact, study
participants chose higher value plans
when plans were displayed in a
column format than in a row format.
However, you can still offer the
flexibility to see all plans available,
and as people become more
experienced with shopping for insurance, column vs. row becomes less
important.
In addition to columns,
consumers are
sensitive to the amount
of information
displayed. Also
according to the
Pacific Group on
Health Studies, limited
choices combined with
ways to filter the
information meets all
consumer preferences.
They recommend using
total cost and then one
other filter such as
doctor in plan, quality
ratings, and plan rules
as a good first start.
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45% of consumers made
plan choices that matched
their preferences when
columns were used versus
34% for consumers who
viewed rows.13
Plan A
Plan B
Click the image above to watch Hanna explain how the app helps
employees understand the relationship between their healthcare
usage and costs for different types of plans.
http://player.vimeo.com/
external/
71906058.hd.mp4?
s=46b8a49dcaf40fda4e1
0bbaae5a04631

13. An advanced intelligent virtual
assistant is one that uses emotionally
expressive 3D animations combined
with guided assistance. They can
communicate with natural language
response and be deployed on tablets
to further enrich the experience.
Intelligent virtual assistants have
many advantages:
✓ Reduce costs by deflecting calls to the
service center
✓ Operate 24/7 when your agents aren’t
available
✓ Create loyalty and brand engagement
✓ Provide consistent information
✓ Offer a human-like connection
✓ Increase voluntary benefits enrollment
✓ Motivate consumers to complete
enrollment
✓ Help consumers make better plan decisions
✓ Increase application accuracy
✓ Improve the overall online customer experience
Additionally, intelligent virtual assistants (IVA) can be used in tandem with
any other decision support methods you offer such as live chat, email,
videos, FAQs, and sorting tools. In fact, the IVA ensures that these tools
are used when appropriate and needed.
6. Use Advanced Intelligent Virtual Assistants
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50%of online
customer self-service search
will be done using virtual
assistants in 2015.14

14. 7. Offer Optional or Voluntary Benefits
Based on the growth of high
deductible health plans (HDHP),
cost-conscious consumers can seek
extra protection in case of a major
medical issue by purchasing critical
illness or accident coverage. At this
time, this offering is only available on
private exchanges.
Regardless, Joseph L. Murgo, from
Aetna voluntary plans, stipulates that
due to the possible increases in
HDHP enrollments on private group exchanges and state exchanges,
voluntary benefit offerings will see an increase in popularity as people
search for ways to offset cost-sharing.15
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77% of employers
believe that Voluntary
Benefits can increase
employee satisfaction with
their benefits.15
http://player.vimeo.com/external/62551206.sd.mp4?
s=83e4bed71d033fa041502fb646475abb

16. Creating healthy behaviors
through wellness engagement
and health coaching is
paramount to sustaining cost
effective health plans, reducing
the cost of healthcare services,
improving medication
adherence, and manifesting
permanent behavioral change.
Although most people want to
complete the enrollment
process efficiently and get on
with their day, it’s an ideal
opportunity to create member
loyalty and identify the free
wellness programs, rewards, and tools available.
✓Consider adding a special button in the sidebar
navigation to reveal a pop up box that
summarizes the wellness program.
✓Create a wellness video and virtual assistant
conversation for use during and after
enrollment.
✓Upon online approval, direct members to these
resources within the member portal.
✓Create a guided health risk assessment with the
member portal with the aid of a virtual assistant.
✓Offer people the ability to download health and
wellness mobile apps directly within the
exchange.
9. Keep Health & Wellness Engagement Top of Mind
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Watch Health Advisor Myra, a lifestyle health coach, assists
patients with completing the a Health Risk Assessment. In
this demo, she explains the process, and the importance of
a good program.
The CareFirst Pedometer App18
http://player.vimeo.com/
external/
44419507.sd.mp4?
s=56b62c33e795eeeb57cd
951bb6f95eac

17. 10. Provide the Right Experience by Form Factor
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Contrary to common misperceptions, not
everyone has a tablet or smartphone. For those
that do own these devices, usage activities may
come as a surprise.
According to the Adobe Digital Index, PCs drive
more website visits than tablets. And in their
analysis, consumers use PCs to visit websites
much more frequently, even though tablet and
PC engagement levels are similar19. However
there is a time and place for each experience.
Overall, consumers prefer to use
PCs for in-depth research,
comparison of alternatives, and
online purchasing. Top tablet
activities focus on reading news,
browsing, and watching media.
Finally, top smartphone activities
center around local search,
general search and social media
updates.20
Although this research still points
out PCs as the dominant form
factor, over time researchers
expect that tablets will erode this position to provide a superior PC like
experience. Now is the time to identify how your consumers currently
interact with your brand, to determine how to proceed with your mobile
experience.
Key Mobile Strategies:
Create a responsive design site that intuitively
identifies device resolution and dimensions and
adjusts accordingly. This is a good if not better
alternative to creating a mobile site.
Ensure that you design website elements and
buttons with mobile in mind - large and easy to
click.
Render all videos including virtual assistant
conversations in HTML5.
Create a mobile app that engages consumers for
the ongoing customer experience: open
enrollment, symptom checkers, doctor finders,
claims, coverage levels, PHRs, and ID cards.

18. guide powered by page 19
Sources:
1 ConsumersUnion, “What’s Behind the Door: Consumers’ Difficulties Selecting Health Plans”, ConsumersUnion, January 2012 (http://
www.consumersunion.org/pub/pdf/Consumer%20Difficulties%20Selecting%20Health%20Plans%20Jan%202012.pdf)
2 ConsumersUnion, “What’s Behind the Door: Consumers’ Difficulties Selecting Health Plans”, ConsumersUnion, January 2012 (http://
www.consumersunion.org/pub/pdf/Consumer%20Difficulties%20Selecting%20Health%20Plans%20Jan%202012.pdf)
3 Health Research Institute, “Customer Experience in Healthcare: The Moment of Truth”, Health Research Institute, July 2012 (http://
pwchealth.com/cgi-local/hregister.cgi/reg/customer-experience-in-healthcare.pdf)
4 Health Research Institute, “Health Insurance: Long on Options, Short on Time”, Health Research Institute, October 2012 (http://pwchealth.com/
cgi-local/hregister.cgi/reg/pwc-health-insurance-exchanges-impact-and-options.pdf)
5 AONHewitt, “Corporate Health Exchange Survey: The Time is Now Rethinking Healthcare Coverage”, AONHewitt, 2012 (http://www.aon.com/
attachments/human-capital-consulting/Corporate_Exchange_Survey_Report_Final_2.pdf)
6 Health Research Institute, “Health Insurance: Long on Options, Short on Time”, Health Research Institute, October 2012 (http://pwchealth.com/
cgi-local/hregister.cgi/reg/pwc-health-insurance-exchanges-impact-and-options.pdf)
7 Enroll UX 2014, “A New Standard for Pubic and Private Health Insurance Enrollment: Design Specifications Manual”, Enroll UX 2014, June 2012
(http://www.ux2014.org/download/final-deliverables/design-specs-manual/Enroll%20UX%202014%20Design%20Specifications%20Manual.pdf)
8 Bloom Health Corporation, “My Plan by Medica”, Bloom Health Corporation http://www.medica.com/myplanbymedica/)
9 Pacific Group on Health, “Consumer Choice of Health Plan Decision Support Rules for Health Exchanges: Issue Brief #2”, 2013 (http://
www.pbgh.org/storage/documents/PBGH_PlanChoiceBrief02_CostCalc_013113.pdf)
10 Benefitfocus, “Video App Library” (http://www.benefitfocus.com/apps/video/)
11 ConsumersUnion, “What’s Behind the Door: Consumers’ Difficulties Selecting Health Plans”, ConsumersUnion, January 2012 (http://
www.consumersunion.org/pub/pdf/Consumer%20Difficulties%20Selecting%20Health%20Plans%20Jan%202012.pdff)
12 Pacific Group on Health, “Consumer Choice of Health Plan Decision Support Rules for Health Exchanges: Issue Brief #3”, 2013 (http://
www.pbgh.org/storage/documents/PBGH_PlanChoiceBrief03_FiltersSorts_013113.pdf)
13 Pacific Group on Health, “Consumer Choice of Health Plan Decision Support Rules for Health Exchanges: Issue Brief #3”, 2013 (http://
www.pbgh.org/storage/documents/PBGH_PlanChoiceBrief03_FiltersSorts_013113.pdf)
14 Kate Legget, “Siri is Shining a Spotlight on Virtual Agents”, Kate Leggett’s Blog, December 14, 2012 (http://blogs.forrester.com/kate_leggett/
12-12-14-siri_is_shining_a_spotlight_on_virtual_agents?cm_mmc=RSS-_-IT-_-63-_-blog_2629)
15 Murgo, Joseph L., “Voluntary Benefits in a Post-Health Care Reform World”, Aetna, August, 2012 (http://benefitcommunications.com/upload/
downloads/Voluntary_Benefits_in_a_Post_Healthcare_Reform_World.pdf)
16 Pacific Group on Health, “Consumer Choice of Health Plan Decision Support Rules for Health Exchanges: Issue Brief #6”, 2013 (http://
www.pbgh.org/storage/documents/PBGH_PlanChoiceBrief06_DoctorSearch_021213.pdf)
17 eHealthInsurance, (http://www.ehealthinsurance.com/)
18 CareFirst, (https://play.google.com/store/apps/details?id=com.carefirst.social.pedometer)
19 Adobe, “How tablets are catalyzing brand website engagement” Adobe Digital Index Report, 2012, (http://success.adobe.com/en/na/programs/
digital-index/1205_13926_di_report_rise_of_tablets.html)
20Keynote Competitive Research, “2012 MobileUser Survey: MobileUser Preferences,Habits, and Expectations”, 2012, (http://www.keynote.com/
docs/reports/Keynote-2012-Mobile-User-Survey.pdf)
21 Aetna, Aetna Mobile App, (https://play.google.com/store/apps/details?id=com.usablenet.android.aetna&feature=search_result)
Written and Designed by Audrey Dalton, Director of Content Marketing
About CodeBaby:
CodeBaby Corporation, headquartered in Colorado Springs, Colorado, is a global customer engagement
technology company. Originally founded in Edmonton, Canada in 2001, by two Canadian physicians turned gaming
entrepreneurs, CodeBaby is able to deliver better health, engagement, and financial outcomes through their CIVA
benefits advisor solution. Deployed through a proprietary cloud-based customer engagement platform, benefits
advisor guides and engages consumers and employees on health exchanges and benefits platforms using a
combination of interactive web elements, decision support tools, and emotionally expressive, 3D intelligent virtual
assistants.
Ready to Learn How the CIVA benefits advisor and the Customer
Engagement Platform Can Help Optimize Your Health Exchange?
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