Member satisfaction with commercial health plans has remained unchanged over the past three years despite significant investments by plans in new digital tools and improved customer engagement.

"By and large, health plans are delivering on the basics, but many are failing to deliver more meaningful emotional connections with their members," said Meaghan Hafner, senior director of health care solutions at JD Power. "Health plan members want to feel like their insurer is a trusted partner in their health and wellness. Accordingly, those that clearly communicate how their services work and deliver consistently positive experiences stand to set themselves apart from the pack."

The average overall satisfaction score for commercial health plans is 562 (on a 1,000-point scale), down one point from 2025 and three points from 2024, the JD Power 2026 U.S. Commercial Member Health Plan Study found. These findings reflect members' eagerness for quick claims resolutions, preventive wellness plans and reasonable in- and out-of-network costs. But as premiums and deductibles continue to rise, members have begun to say their relationship with their health plan has become more transactional.

Among key findings of the study:

  • Overall satisfaction holds steady. The national average satisfaction score for commercial health plans has remained steady for the past three years. For a second consecutive year, regional scores vary widely, from a high of 592 to a low of 527, indicating meaningful differences in how members experience service, communication and value across the country.
  • Cost concerns erode patient trust. Despite an industrywide push to improve member engagement, member perceptions of trust and partnership are not improving. Less than one-third of members say they feel their health plan is a trusted partner in their health and wellness, with many members describing experiences that appear more focused on cost management than on helping them navigate their health care.
  • Cost pressure is widespread. Overall member satisfaction drops significantly when premiums and deductible costs rise. More than half of commercial health plan members experienced a monthly premium increase this year, which contributed to a 116-point decline in satisfaction. One-third of members experienced an annual deductible cost increase, which drove a 111-point decline in satisfaction.
  • Claims resolution provides opportunities to differentiate. Timely claims resolution is one of the fastest ways to improve member satisfaction scores. Overall, 30% of members say they had either an excellent or perfect claims resolution experience. Satisfaction among members who experience an excellent claims resolution is 734, which is 120 points higher than among those who describe their claims resolution process as great (614) and 330 points higher than among those who describe their claims resolution process as good, just OK or poor (404).

NOT FOR REPRINT

© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.