Impact of Benefit Inserts on Health Plan Selection and Utilization Among Renewing Covered California Members

NCT07136233 | Active Not Recruiting

• 1 other identifier: CCA-NOTICE-INSERT-2025
• Study Type: interventional
• Target: 1,600,000
• Locations: 1 country
• Sites: 1

Brief Summary

The study aims to evaluate the impact of an informational flyer insert on health plan selection and health care utilization among Covered California renewing members during the 2025 plan year. The flyer highlights the enhanced Silver plan benefits, which were expanded in 2025 to include all enrollees, regardless of income level. Key benefits include $0 deductibles, lower monthly premiums, free preventive visits, and reduced costs for primary care, emergency care, and medications. The main questions the study seeks to answer are:

• Does the informational flyer help overcome barriers that prevent consumers from switching to more beneficial plans?
• Does the flyer encourage current Silver Plan enrollees to increase health care utilization, such as preventive visits, primary care, and medication usage, by highlighting enhanced benefits like $0 deductible and lower costs? To address these questions, researchers will compare outcomes between households that receive the flyer insert and those that do not. Covered California's administrative data will provide individual-level information on plan selection, while claims data will offer insights into healthcare utilization patterns. This approach will help determine the effectiveness of targeted communication in driving selection of more beneficial plan and improving healthcare utilization.

Conditions

Outreach Intervention

Outcome Measures

Primary Outcomes (2)

• Enrollment in an Enhanced CSR Plan

  A binary indicator for whether a consumer enrolled in an Enhanced CSR plan in 2025 open enrollment period.

  Up to 4 months

• Health care utilization outcomes among individuals enrolled in enhanced CSR plans in 2025.

  Utilization will be assessed using binary indicators for various healthcare services, including primary care visits, emergency room visits, specialist visits, hospital admissions, and pharmacy claims. For each service type, the measure will reflect the number of visits or claims per 1,000 enrollees during the 2025 plan year.

  1 year

Secondary Outcomes (4)

• Consumer engagement:

  Up to 4 months

• Out-of-Pocket Health Care Spending

  1 year

• Enrollment Tenure

  1 year

• Uninsured Status

  1 year

Study Arms (2)

No-Flyer Group

NO INTERVENTION

Renewing Covered California households who do not receive the informational flyer insert during the 2025 plan year. They only receive a standard renewal notice informing them of their upcoming coverage renewal and encourages consumers to shop for coverage ahead of the next coverage year.

Flyer Group

EXPERIMENTAL

Renewing Covered California members who receive the informational flyer insert during the 2025 plan year along with a standard renewal notice informing them of their upcoming coverage renewal and encourages consumers to shop for coverage ahead of the next coverage year.

Behavioral: Informational Flyer Insert on Enhanced Silver Plan Benefits

Interventions

Informational Flyer Insert on Enhanced Silver Plan Benefits BEHAVIORAL

Alongside the standard eligibility notice informing participants about their upcoming coverage renewal, an informational flyer is also included. The flyer explains that everyone is eligible in 2025 for the Silver plan regardless of income and highlights its benefits, such as $0 deductibles, lower monthly premiums, free preventive visits, and reduced costs for primary care, emergency care, and medications.

Flyer Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Households who qualify for automatic renewal of their Covered California health plan as of October 4.
• Households that were enrolled in Covered California on the subsidized application.

You may not qualify if:

• Households that were no longer enrolled as of January 31, 2025. This includes people who chose to cancel their coverage in 2024 and those who were automatically disenrolled due to changes in eligibility during the open enrollment period.)
• Households that were included in the affordability crosswalk
• The affordability crosswalk is a Covered California process that moves eligible individuals with lower incomes to Silver CSR plans during renewal.
• This population includes members with incomes below 250% of the federal poverty level who were enrolled in Bronze plans and eligible for $0 premiums with Silver plans, members below 200% of the federal poverty level who were enrolled in Gold plans, and members below 150% of the federal poverty level who were enrolled in Platinum plans.
• Approximately 23,000 members are excluded from the experiment due to this restriction.
• Households with members enrolled with the carrier Valley Health Plan and Dental Health Services.
• This group was excluded due to changes in plan availability that necessitated a special notice.
• Approximately 30,000 members are excluded from this experiment due to this restriction.

Sponsors & Collaborators

• Covered California: lead

Study Sites (1)

Covered California

Sacramento, California, 95815, United States

Location

Study Officials

• Emily Kohn, Masters of Public Policy

  Covered California

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Data Specialist

Study Record Dates

• First Submitted: August 8, 2025
• First Posted: August 22, 2025
• Study Start: October 4, 2024
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): July 30, 2026
• Last Updated: August 22, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)