Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 31, 2021
Date Accepted: Jun 14, 2021
Date Submitted to PubMed: Aug 13, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Informed Decision-making for Health Insurance Enrollment: A Review and Survey Study
ABSTRACT
Background:
Health insurance enrollment is a difficult financial decision with large health impacts. Challenges such as low health insurance literacy and lack of knowledge about choosing a plan further complicate this decision-making process. Therefore, to further support consumers in their choice of a health insurance plan, it is essential to understand how individuals go about this decision.
Objective:
This study aimed to (1) review the literature to understand how enrollment decisions have been studied in the past and (2) understand the sources of information used by individuals to support their employer-provided health insurance enrollment decisions.
Methods:
First, a historical review of research on health insurance plan selection and the sources of information used to support these decisions was conducted between 1980s to the present. Second, an electronic survey of 151 UF full-time faculty and/or staff was conducted. The survey consisted of 4 sections: Demographics, Sources of information, Health insurance literacy and Technology acceptance. Descriptive statistics were used to show the demographic characteristics of the 126 eligible respondents and to study the response behaviors of the remaining survey sections. A correlation analysis was performed to understand the strength of association between our variables. Logistic regression models were built and used to further analyze significant predictors.
Results:
In terms of demographics, our sample is mostly female (82%), married or in a domestic partnership (63%) and with a small household (1-2 people) (69%). Respondents assessed themselves to have moderate-to-high health insurance literacy as well as acceptance towards technology. The most selected and top-ranked sources were Official Human Resources’ VBC Alex and Official employer or state websites. A logistic regression modeling for official versus non-official primary source of information resulted in the significance (ꭓ2 = 14.848, P = 0.005) of an interaction term predictor with the variables gender and health insurance usage.
Conclusions:
Although this work is preliminary and encountered several limitations, which will be addressed in the next steps, we identified the main sources of health insurance information among full-time employees from a large state university and found that most respondents need between two and three sources to gather all the information they desire. Finally, using logistic regression, we discuss that gender and health insurance usage seem to be influential factors in the selection of official sources of health insurance information as a primary source.
Citation
