Evaluation of health and pharmacy benefit information in health plan information packages

Consumers have ready access to their health plan information packages, and the utility of this source in providing information about health and pharmacy benefits to consumers should be evaluated. A preliminary evaluation using a sample of student consumers enrolled in a variety of health plans was conducted. Findings revealed that consumer information is lacking in areas related to the definition of pharmacy benefit terminology, cost sharing for medications and services, provider selection, and referral processes. Managed care decision makers will benefit from understanding the informational needs of their members and from designing health care benefit information to accommodate these needs.