Four Ways to Make Sure EOBs Do Explain

Have you ever tried to make sense of health care bills after a serious illness? Did you fantasize about marching into your insurance company president’s office, handing him or her a box full of EOBs and demanding a real explanation of your benefits?


Jim Bracchitta, CEBS, leads off his communications article in the July issue of Benefits Magazine with a dreams-come-true anecdote involving award-winning journalist and author Stephen Brill. Brill had written extensively about the health care system for Time magazine, the New York Times and other publications. After having open-heart surgery, he figured he’d be able make sense of the EOBs that flooded in. But Brill was no more successful than most people in figuring out the bills and claims payments.

Unlike most people, he had access to high-power insurance executives and soon found himself interviewing the president and CEO of his own insurance company. At the end of the interview, Brill handed one of his EOBs to the executive and asked him what it meant. Of course, the executive couldn’t figure it out, either. And his excuse for the indecipherable EOB was the same excuse some benefits communicators might use: State regulations dictate what needed to be said.

[Related: Benefit Communication and Technology Institute, July 18-19. 2016, Boston, Massachusetts]

But an EOB is a piece of benefit communication. And, as is true of all communication pieces sent out by a benefit fund office, if the person who receives it doesn’t understand it, it has failed to communicate. The fund office may have to make multiple attempts to try to get the information across.

Bracchitta, an actor and a labor trustee for the Screen Actors Guild‒Producers Pension and Health Plans, writes in “Getting It Right the First Time—4 Tools for Evaluating Benefit Communications” that all communications should strive for the following:

  1. Simplicity
  2. Credibility
  3. Transparency
  4. Relevance.

That means avoiding legalese and “benefitese” most participants won’t get. Participants need to be able to trust what comes from the benefit office and believe they are hearing the whole truth, even if it’s hard to hear. Relevance can be challenging, Bracchitta points out, but finding creative ways to get the right information to people when they most need it is worth the effort.

Unfortunately, the most important communications are the ones, like EOBs, that are highly regulated. But being simple, honest, open and relevant in all communications will make it far more likely people will understand, pay attention—and appreciate their benefits.

Chris Vogel, CEBS
Senior Editor—Publications at the International Foundation



Comments (4)

  1. AvatarJeff Bogardus

    Four relevant and key points! Do you know of any really good examples that can be shared from the health insurance industry that makes those “highly regulated” EOBs more friendly? I personally struggle with creating Medicare Part D EOBs that make sense!

  2. AvatarJanice Scherwitz

    I’m actually a little surprised that this is still a “thing”. I think EOBs have gotten much more user-friendly over the last decade. I think the bigger concern is that most people don’t read them. If I had a dime for every time I stopped my Dad from the knee-jerk reaction of taking out his checkbook after receiving a bill from a provider without checking the EOB, I’d be writing this from a lounge chair at the beach instead of my office. 3/4 of the time what an employee or a Medicare recipient doesn’t understand has more to do with not bothering to read than it does an indecipherable EOB.

    1. AvatarJim Bracchitta

      @Janice: While I think EOB’s have gotten marginally better, I still think we’re a long way from where we need to be. I also think that the reason participants don’t read them is because they’re not designed to be user-friendly. Your poor dad should always read his EOB before he grabs his checkbook, but I wonder if he does that because the EOB addles him. The silver lining in that he has a pro-active daughter in benefits!

  3. AvatarEleonora Golbert, CEBS

    What government agency regulates EOBs? EOBs are generated by insurance companies. Benefits industry is regulated most of all but the DOL and the IRS. What control do benefit communicators have over EOBs? Thank you.


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