4 questions to ask a carrier about their member experience
Ask carriers these 4 questions to find a carrier that instills trust, drives digital engagement and improves outcomes for your clients.
Member experience is no longer a support function. It is the way employees judge whether their health plan works — and that shift is reshaping what employers should expect from their carriers.
Today's health insurance carriers are investing more than ever in member experience, particularly in digital tools and personalization. For employers, that investment is worth paying attention to: Carriers that are genuinely committed to improving the member experience tend to produce employees who feel more confident in — and satisfied with — their employer-sponsored benefits.
2026 data shows the market is moving in the right direction. The J.D. Power 2026 U.S. Healthcare Digital Experience Study found that member satisfaction with digital tools rises significantly as members become more familiar with their plan’s platform.1 At the same time, the Press Ganey 2026 State of Health Plan Member Experience report highlights that consistency, access and trust are emerging as the strongest drivers of member loyalty.2
Brokers and consultants may find real, differentiated value — by asking the right questions to identify which carriers are building confidence within members that the plan will help them at the moment they need care.
A strong member experience should be evaluated across 4 dimensions: trust, adoption, comprehension and human support. Here are 4 questions to guide those conversations:
1. How are you building member trust — not just satisfaction scores?
Many health insurance carriers track satisfaction ratings. Fewer can speak credibly to the behavioral drivers of trust: resolved problems, transparent communication and a consistent experience across every touchpoint.
The shift underway is significant. A recent survey — which gathered responses from 7,500 members across more than 160 health plans — found that 85% of members now expect their insurer to be actively involved in their overall well-being.3 That figure was just 57% in 2021.3 This isn't a niche expectation anymore. It's table stakes across virtually every member demographic.
Ask carriers: What does your trust-building strategy look like — not at renewal, but throughout the plan year? Look for evidence of proactive outreach, transparent claims communication and mechanisms that help members feel seen rather than a transaction. The carriers making progress on this front have moved from reactive service models to ones built around anticipating what members need before they have to ask.
2. What does your digital experience look like in practice?
Digital tools have become a standard part of every carrier pitch. But there’s a meaningful difference between having a mobile app and having an experience members actually use and return to. The J.D. Power 2026 U.S. Healthcare Digital Experience Study found that satisfaction with digital tools rises significantly with member familiarity: The more consistently members engage with a platform, the more they value it.1 It's not enough to make digital tools available. What sets carriers apart is helping members adopt those tools so they can easily do what they came to do.
UnitedHealthcare, for instance, has continued to make enhancements to its digital experience to help improve member engagement and simplify navigation — but the right question is always: What does the data show about how members are actually using these tools? The answer is clear: 89% of members who contacted UnitedHealthcare used a digital channel, such as the UnitedHealthcare® app and myuhc.com®.4 That kind of adoption is the result of building digital experiences that are genuinely useful, and increasingly, AI is what's making that possible.
Take, for instance, Avery, UnitedHealthcare’s generative AI companion, which is available to eligible members through the UnitedHealthcare app and myuhc.com. Avery learns from member interactions to provide personalized, benefits-aware guidance in real time — helping them check the network status of a provider; find quality, affordable care options; understand costs upfront; and even schedule an appointment with a provider on their behalf. When a member needs more support, Avery transfers them directly to a live Advocate. It’s the kind of connected, end-to-end experience that keeps members from turning to out-of-pocket consumer apps to fill gaps their plan should already be covering.
Ask carriers: Can you show us what the member journey looks like end-to-end — from finding a provider to understanding a claim? Request a demonstration, not a presentation. The right carrier won’t just describe their digital tools — they’ll show them in action.
3. How are carriers helping ensure members understand and are making the most of what’s available to them?
One of the most underappreciated challenges in employer-sponsored health benefits today is the gap between the benefits that are available and the benefits that employees are aware of and understand. In fact, 46% of employees feel confident managing their benefits independently, but only 23% report that they genuinely understand them — a 23-point gap that a recent study links directly to deferred care decisions, higher out-of-pocket spending and poor return on employer investment.5
Employees are not asking for more benefits; they're asking for clarity and relevance.6 The benefits landscape is often defined less by a lack of options than by a lack of certainty. Employees want benefits that are easier to understand, aligned with their specific needs and supported by guidance that helps them make sound decisions.
Ask carriers: What does your member education and benefits communication strategy look like beyond open enrollment? The most effective carriers sustain engagement year-round, with personalized nudges, clear explanations of coverage and proactive guidance before members encounter moments of confusion or financial surprise. Push for specifics: How does the carrier help ensure members understand — and actually use — what they've enrolled in?
4. What happens when a member needs help that goes beyond self-service?
Self-service digital tools and resources are only part of the member experience equation. When members face complex, chronic or emotionally difficult health situations, digital tools may not be sufficient. What they need is an Advocate — someone with the expertise and authority to help navigate them through a system that still leaves many Americans feeling like it treats them as a number rather than a person.
Robust member advocacy services have become a genuine differentiator among carriers. Not all advocacy models are equal, however. Ask specifically: Who are your member advocates, how are they trained, and when and how do they engage members? The depth of advocacy support — whether it extends to members with special needs, complex diagnoses or chronic conditions — says a great deal about how a carrier conceptualizes its responsibility to members.
The carrier's ability to provide 1-on-1 support from a dedicated, trained expert is particularly meaningful for members navigating specialty care, behavioral health or situations where care coordination across multiple providers is required. Look for carriers that can demonstrate the measurable impact of their advocacy programs — not just program availability, but real outcomes in member satisfaction, navigation efficiency and care decision quality.
Cost and coverage will always matter. But in an environment where even satisfied members are switching plans,2 and where trust in health plans sits at historically low levels,1 the carriers that will retain and engage members over the long term are those building for something more durable than a good renewal quote.
Asking the right questions now — about trust, digital adoption, member understanding and personalized advocacy support — can help you select a carrier that may help improve outcomes for your employees. That's a value proposition that holds up well beyond the renewal conversation.
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