Growing enrollment in a state health insurance exchange is a lot like a virtuous circle. As enrollment increases, it can lead to a better risk mix that results in lower premiums. Because the exchange has a healthier mix of participants, health plans may be more likely to participate because they can price appropriately and earn market share. That increase in competition can also reduce premiums for enrollees. As a result, you’ll likely see more enrollees.
It becomes a virtuous cycle.
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The problem, though, is that selling health insurance in a state healthcare exchange isn’t easy. There are several factors that contribute to consumers choosing not to buy insurance in a state health insurance exchange, including:
- Younger and healthier consumers are more risk-tolerant. Similar to how they are less likely to plan for retirement, younger, healthier consumers are less likely to purchase health insurance.
- People assume they won’t get seriously ill. This optimism bias, according to Tali Sharot in Current Biology, results in as much as 80% of the population believing that events will be better than they actually are. It’s exacerbated in individuals who have never suffered a serious health issue; because they have never needed to pay for a catastrophic health event, they don’t expect to have one in the future.
- Overcoming the status quo can be difficult. Those that have never had insurance don’t see a need to buy it. It’s difficult to get individuals to take action to change their current status.
- Insurance can be an unknown. Those who don’t understand health insurance will have a fear of making the wrong choice. As a result, they feel no decision is better than making a bad decision and don’t act.
Plus, selling coverage in the individual exchange market is more difficult than employer group, Medicare and Medicaid coverage. Employers can leverage things like auto-enrollment and pay a significant portion of the premium, lowering individual costs and streamlining enrollment. Most consumers qualify for Medicare upon turning 65 and are generally more aware of the need for insurance because of their age. Medicaid is a public insurance program available for little to no cost to the consumer, so it’s easier to convince those eligible to enroll because there aren’t generally financial barriers to entry.
As a result, it’s vital that state healthcare exchanges implement sound marketing strategies and campaigns to improve enrollment and thus create a virtuous cycle that ensures the continued viability of the marketplace.
To help, we’ve put together this list – in no particular order – of 7 of the best state health insurance exchange marketing campaigns.
2013 Colorado: Building a Brand.
There’s a Rule of 7 in marketing that says that it takes about 7 impressions for a brand to earn a sale. Colorado took that rule to heart with their launch campaign in 2013. While most states waited until the fall to start promoting their new health insurance exchange, Colorado was much more proactive, creating a brand launch campaign that ran from July to September. Colorado followed that with an enrollment campaign from October to March aimed specifically at enrolling members.
Why is this important? The state’s research found that Coloradans had a very low awareness or understanding of their exchange. As a result, the state’s first goal was to build brand awareness over the summer. Their strategy was to build broad, statewide reach and impact, so they targeted TV, radio, print, partnership programs, business publications and search engine marketing to reach as many Coloradans as they could. Their core message: “When health insurance companies compete, there’s only one winner: You!”
As the open enrollment period neared, Colorado began to be more targeted in their messaging. Colorado created ads for specific groups of people that they wanted to encourage to enroll. For example, the state launched a video ad featuring a Coloradan that had just turned 26 and no longer eligible for her parents’ insurance. A number of Spanish language ads targeting their relatively large Hispanic population were also launched. The state even created an ad targeting ranchers.
The result of these two campaigns was that Colorado had the fourth-highest enrollment in the state exchanges after the 2013/2014 open enrollment period and exceeded the Centers for Medicare and Medicaid’s target for Marketplace enrollment by 30%.
Takeaway: Building your brand and awareness year-round is almost as important as a coordinated marketing push during the open enrollment period.
2014 Kentucky: Building a State-Specific Brand
Kentucky faced a challenge enrolling individuals in their new state health insurance marketplace in 2013. The state had voted overwhelmingly against Obama in 2012, who lost the state by nearly 4% more in 2012 than he had in 2008. Obamacare was one of the primary reasons for the significant defeat.
So when ad agency Doe-Anderson was picked to help rollout the new health exchange, they knew they had to distance the marketplace from Obamacare. In their research, they found that although Kentuckians were against Obamacare, they were in favor of quality, affordable health coverage. They started by creating a localized name for the exchange – kynect – so Kentuckians would see the exchange as a local effort, not part of the perceived bureaucratic Obamacare package. Finally, they used positive messages that showed that Kentuckians now had access to affordable health coverage.
With that strategic state-specific framework in place, the state used a number of tactics and channels, leveraging animated characters representative of Kentuckians on TV ads, radio ads, print ads, billboards and social media. The state also targeted distinct populations, targeting outreach to the immigrant community, African Americans, young adults, veterans and the LGBT community. They even created a targeted campaign to enroll individuals in coverage as they re-entered the community after release from prison or jail.
The results were widely positive, earning plaudits from the New York Times, The Washington Post and the President. Kentucky had the highest per-capita enrollment in the nation and 52% of enrollees were in the desirable under-35 demographic, compared to 28% nationally. Kentucky was able to halve the uninsured in the state and outperformed the national enrollment rate more than 3 times.
Takeaway: Understand your audience and create marketing campaigns that highlight the positive of what they perceive to be a negative.
2017 NY State of Health Statewide Ad Campaign: Showcasing Positive Consumer Experiences
The 2018 open enrollment period for the NY State of Health insurance exchange was their fifth. To highlight the benefits of the health insurance exchange, New York wanted to tell the stories of enrollees from the past five years. The result was the “4 Million Reasons to Enroll” campaign, which highlighted some of the 4 million real people that had enrolled in health insurance through the New York State of Health.
Because New York had already gone through multiple open enrollment periods, they were also able to leverage data from those experiences to provide more targeted marketing strategies. For example, they sent 1.2 million personalized emails to people who had created marketplace accounts to remind them to enroll in 2018 coverage. They also had found in past enrollment periods that online banner and pop-up ads were successful in past campaigns and continued to purchase them to help target specific populations.
New York also recognized that political messaging could slow their enrollment plans. In the face of repeal and replace efforts, New York’s messaging clarified that after factoring premium tax credits, marketplace premiums would be the same or lower than in 2017. They also explicitly stated they were open for business and that contrary to what many thought, the individual mandate was still in effect in 2018.
Individuals interviewed by urban.org found the 4 Million Reasons to Enroll campaign to be a memorable and effective campaign. The results bear that out, with New York experiencing a 4.2% enrollment increase in their state healthcare exchange, the sixth largest jump among all states in a year where the average marketplace enrollment decreased by nearly 4%.
Takeaway: Leverage past results to improve future campaigns. Leverage happy members to tell your story.
2017 MD Health Connection: Leveraging Technology to Improve Enrollment
In 2016, the Maryland Health Benefit Exchange wanted to increase enrollment among young people, those with low incomes and African Americans and Latinos. When they examined those groups, they discovered the primarily depend on their phones for online access more than other groups. Their research found that about 13% of Americans with annual household income below $30,000 rely on their phones for internet access, compared to just 1% of those earning more than $75,000.
To meet their goals of increased enrollment among that population, Maryland create an app – Enroll MHC – to make enrollment easier for the population that depends on their phone for internet access. The app made it easier for consumers to use their phone to apply, compare prices and ratings of various plans, to view notices and they could even use their phone’s camera to upload documents necessary for verification.
For their efforts, the Maryland Health Benefit Exchange won the Best Marketing Technology Campaign award from the American Marketing Association’s Baltimore chapter. Within a year they had generated more than 100,000 app downloads, becoming the most popular health insurance marketplace enrollment app in the country. In fact, 26,000 enrollments were completed via the mobile app, nearly 66% of which were by young adults, and 89,000 verification documents were uploaded by mobile phone cameras to help complete enrollments. Though overall enrollment in exchange plans declined year-over-year, the number of young adults under age 35 that enrolled increased by almost 15%.
Takeaway: Meet your members where they are. Eliminate as many obstacles to enrollment as you can.
2019 Washington Health Benefits Exchange: Leveraging Buyer Personas and Enrollment Stages
The Washington Health Benefit Exchange (WAHBE) set a goal to get 210,000 enrollees in 2020 plans. To get there, WAHBE created a marketing campaign based on market research that enabled them to target specific buyer personas. Additionally, they were able to outline an approach that varied the messages to the individual buyer personas based on where they were in the enrollment process. For example, from Oct. 1 to the beginning of open enrollment, the goal was to build awareness, which involved convincing the target audience segments that they needed insurance. During the enrollment period – from Dec. 1 to the end of open enrollment, the messaging’s goal was to get qualified users to sign up. They also smartly used post-enrollment messaging – encouraging enrollees to pay their first month’s bill.
The tactics used also varied by where the buyer persona was in the enrollment process. To build awareness, the focus was on social media, TV sponsorship, radio, video and native advertising – which are basically ads that don’t look like ads. At the enrollment stage, the focus was on more targeted, one-to-one marketing tactics, like leveraging social media, mobile, display and search ads.
Like other states learned, framing buying health insurance as a positive was also a goal of the campaign. The concept, “Plan for how you live” framed the approach as a positive that welcomed enrollees to access healthcare coverage in a way they could afford. Washington also leveraged a level of humor in the campaign to make it more memorable than a simple message to enroll in healthcare.
By creating buyer personas and creating tactics and messages aligned with where those personas were in the enrollment process, Washington saw to 212,000 enrollees, about 2,000 more than their goal.
Takeaway – Understand who you’re trying to reach and target messages to who they are and where they are in the process.
2018 Nevada Health Exchange: The cost of not being insured.
Like the Washington Health Benefits Exchange, Nevada’s Silver State Health Insurance Exchange wanted to highlight how inexpensive health insurance is in order to engage the uninsured. But unlike Washington, Nevada decided to highlight the high cost of common injuries when compared to the cost of insurance.
The “You Can’t Afford Not to Be Insured” campaign kicked off in October of 2018. Each ad spot highlighted the cost of an accident or injury if the individual didn’t have insurance and played up the benefit of an associated qualified health plan. Nevada leveraged an integrated advertising campaign featuring online, digital, TV, print, radio, outdoor and a new channel, over-the-top (OTT) Internet TV. An associated public relations campaign also saw Nevada earn national hits from Yahoo Finance, ABC News and the Associated Press.
The exchange used a two-pronged approach, starting pre-enrollment in September with the message of “learn more” and then transitioned to a “it’s time to enroll” message Nov. 1. Run during a Presidential election, Nevada smartly decided to wait to launch TV and radio ads until the conclusion of the election in order to rise above the election noise.
The result of the effort? Enrollment increased– from a little over 89,000 to over 90,000 – from the 2017 to 2018 enrollment periods.
Takeaway – Don’t be afraid to accentuate the cost of not having insurance when considering your marketing messages.
2019 MNSure: Social Media Toolkit
In 2019, MNsure, Minnesota’s state health insurance exchange, added a new tagline “Unsure? Be sure. MNsure.org.” The tagline aims to remind Minnesotans that MNsure is the only place consumers can get financial help and compare health plans side-by-side. But it also has another goal – to encourage enrollees to take advantage of Minnesota’s network of certified navigators and brokers who can help consumers enroll for free.
Focused on increasing enrollment, Minnesota’s statewide campaign featured TV and radio ads in addition to billboards and other out-of-home placements at transit stops. Minnesota also used digital advertising to target general audiences, public program enrollees and private plan shoppers. The 2019 campaign also used new zip-code-level data to target areas of the state with high numbers of uninsured Minnesotans.
Because the core message highlighted the help that was available to consumers, MNsure also put together a social media toolkit that assisters could use to amplify MNsure’s message. The toolkit featured 10-12 canned messages for Facebook, Twitter and Instagram. The messages had associated images maximized for each platform.
The result of the program? Enrollment increased from 113,552 during the 2019 plan year open enrollment period to 117,520 during the 2020 plan year open enrollment period.
Takeaway: Make it easy for your partners to promote your exchange.
Certifi helps state health insurance exchanges improve enrollment and build a better member experience with state insurance exchange premium billing and payment solutions.