Corporate Insight

Explanation of…Benefits?: EOB Statements

Posted on April 27, 2018

Explanation of benefits or EOB statements are meant to provide clarity for costs associated with healthcare services. Though not bills, these statements detail claim elements—such as cost of procedure—to help members understand their coverage. While these documents should aid understanding, the variety of statements offered by leading health insurers indicates that there is no standard practice for organizing the data delivered to members. This report reviews digital EOB statements offered by the Healthcare Monitor coverage group firms.

Of the 17 firms in our coverage group, we found that only 14 provide EOB documents online. Of these 14, only one insurer provides a digitized statement that is more than just a downloadable PDF. A little under half of these firms provide colorful statements, with only five using visual representations to separate the tables and text. Due to limited creativity from the health insurers in this report, there is room for improvement in terms of increasing transparency and understanding health insurance benefits, services and costs.