Simplified Explanation of Benefits Statement (EOB)

When Aetna launched one of the first consumer-directed health plans, the Aetna HealthFund, call-center traffic began to spike. When a new employer began offering the plan, employees were confused and called the 800 number.

Time spent auditing calls in the service center quickly revealed that the plan was marketed in one way, and reported on in another. Members weren’t sure how to use the plan or how many employer dollars remained in their “account,” skewing important health care decisions.

The solution was a simplified Explanation of Benefits (EOB) statement. Key to the effectiveness of the new reporting was involving consumers from all walks of life in the research and design process. Question basic assumptions about what users did and did not understand resulted in a simplified EOB with plain language, easy-to-follow math, and clear informational graphics.