Examining health insurance literacy for employer-based health insurance education.


Many employees report being satisfied with the health plans offered by their employer; however, research shows that they do not understand the key terms and concepts needed to effectively choose and use a health plan. Health insurance terminology and concepts are complicated and require various competencies for comprehension and application, and many individuals face barriers when it comes to effectively using health insurance. Most insured people in the United States under the age of 65 are insured by an employer-sponsored health plan, creating an urgent need for education and acknowledgment of barriers in the work sector. The issue of low health insurance literacy (HIL) was explored through the examination of existing literature, uncovering that while education exists for the public sector, the work sector has not adopted a HIL framework due to the lack of research. To address the lack of research, a qualitative case study focused on employees at a large nonprofit based in Denver, Colorado. The sample included nineteen employees from the Human Resources department, with access to the same health plans and education. The case study was divided into two phases, utilizing a questionnaire and interview to address the research questions. The study explored the current HIL of participants, reasons why health insurance is difficult to understand, and barriers to HIL. Transformational Learning Theory guided the development of the research questions, data collection, and data analysis for the case study. The findings from the case study provided evidence of the need for HIL education in the workplace. An in-depth analysis determined gaps in HIL and uncovered emerging themes regarding barriers to HIL. Based on the results of the study, the recommendation for a workplace HIL program includes the incorporation of reflection on past experiences using health insurance, practice calculating health service scenario costs utilizing the employee’s specific health plan variables, and the allowance of time for questions to increase transparency and break down past assumptions about health insurance. Further research should be conducted to learn more about the impact of training design and implementation.



Health insurance literacy. Employee benefits. Transformational Learning Theory. Andragogy. Health plans. Employer-sponsored health plan.