Design & Innovation Challenge: Benefit Selection for Financial Security

Commonwealth has partnered with CHXD to launch an innovation challenge to prompt the financial, healthcare, and design community to envision a solution that will help employees with incomes under $55,000 balance their health and financial needs at open enrollment.

One of the factors that is increasingly contributing to financial insecurity is health expenses–the average annual deductible grew 125% from 2006 to 2015, causing out-of-pocket health care costs to quickly grow. Part of those rising costs may be attributed to the increase in high deductible health plans (HDHPs). As health insurance markets continue to evolve, employers who offer health insurance are increasingly offering HDHPs.

HDHPs are attractive because they provide short-term cost savings on premiums to both the employer and employee. However, unless they are well designed, they increase the risk of out-of-pocket health expenses for employees, which can lead to medical debt, delayed medical care, missed work, and loss of productivity in the workplace. Lower-income employees, who often do not have access to financial resources such as savings and affordable credit, are particularly at risk.

HDHPs can be offered alongside a range of savings products designed specifically for health care expenses–Health Reimbursement Accounts (HRA), Flexible Savings Accounts (FSA), and Health Savings Accounts (HSA) are the most common. HSAs are specifically designed to accompany HDHPs to offset the risk of the higher deductible.

However, employees with HDHPs do not even have an HSA. Of those that do, more than half of employers offering coverage through HSA-qualified HDHPs do not contribute towards the HSAs that their workers open. According to the Kaiser Family Foundation, only 29% of workers with employer policies have HDHP coverage with a savings option.

With health, productivity, and financial security on the line, both employers and employees stand to benefit from HDHPs that are designed to mitigate the risk of the deductible by increasing savings.

The purpose of this challenge is to deliver innovative solutions so that people are able to make decisions that work for their finances without jeopardizing their health.

To further understand this problem space, please check out the Center for Health Experience Design’s Participatory Workshop Debrief and the Commonwealth Consumer Research Summary. In collaboration with Commonwealth, we have compiled this research to provide challenge participants a deeper understanding of the decision-making process employees undergo during open enrollment. We hope you will use this debrief, Consumer Research Summary, and the additional resources linked below, as the start of your own design process.

About Commonwealth

Commonwealth is a mission driven non-profit organization that strengthens the financial opportunity and security of vulnerable people by discovering ideas, piloting solutions and driving innovations to scale. We collaborate with consumers, the financial services industry, employers, policy makers and mission-driven organizations to build solutions to make people financially secure. Our efforts over the last 16 years have spawned new financial products and public policies responsible for helping 300,000 Americans to accumulate nearly $200 million dollars in savings. Our work has been featured by The Wall Street Journal, New York Times, the Atlantic, and USA Today.

Submission Criteria

The submission requirements include:

• A written design brief (not to exceed 2,250 words) describing the concept, the design principles it follows, and how it meets the evaluation criteria. This is your chance to explain all the details.
• A brief video (less than 3 minutes) that illustrates the concept. What does your solution look like in practice? This is your chance to show the value in your design (think kickstarter).
• Visual compositions (including information, layout, and aesthetic) of the tools/materials
• A journey map that illustrates changes to the enrollment process and ongoing health financial management provided by the health and/or financial organizations involved throughout the covered year that addresses the employee’s specific experience.
• Please provide a public link to all submission component files. Judges will use these links to view your submission documents.

Recognition & Prizes

Winners of the challenge will receive recognition and prizes including:

• Winners will receive up to $5,000 in cash prizes:
  • $2,500 – Prize 1: Best Open Enrollment Solution
  • $2,500 – Prize 2: Best Ongoing Support after Open Enrollment
  • Honorable Mentions: Entries that do not win but demonstrate a compelling concept or solution may receive an honorable mention
• Winners will be announced at Mad*Pow’s Financial Experience Design (FXD) Conference, on October 25, 2018 in Boston, MA
• Winners will draw national attention from organizations across the health and financial ecosystem, as well as the press
• Winners will be promoted throughout the Center for Health Experience Design and Mad*Pow networks
• Winners may have the opportunity to work with organizations engaged with the challenge to implement their concepts (in whole or in part) in the real world

Evaluation Criteria

Please review all resources and information on this page and consider them in the concept you develop for your challenge entry. They provide the basis on which entries will be judged. Winners will be selected based on the following evaluation criteria:

Core Criteria

• Addresses top concerns associated with the current open enrollment experience (See Center for Health Experience Design’s Participatory Workshop Debrief for listing of top concerns)
• Addresses challenges that come with HDHP enrollment
• Addresses needs of lower-wage workers as outlined in challenge description and resources provided
• Usefulness and understandability of employee-facing materials and tools (including any materials and tools used in open enrollment and/or those offered throughout the year)
• Use of human-centered design process in creation of concept (see human-centered design guidelines)
• Uniqueness and creativity of solution

Additional Criteria for Prize 1: Best Open Enrollment Solution
(Focusing on the design of materials/tools employees encounter during the open enrollment process itself.)

• Addresses issues and opportunities associated with plan selection at open enrollment as outlined in the resources provided (and any additional research you may conduct).
• Incremental innovation—works within existing models (workflow, data, technology, employee facing materials, and tools)

Additional Criteria for Prize 2: Best Ongoing Support after Open Enrollment.
(Focusing on how the employee interacts with their chosen health plan throughout the year. This may include resources to support financial literacy, usability of the health plan and related components, e.g., EOB, FSA, HSA, HRA, and building understanding of individual needs before the next open enrollment period.)

• Addresses issues and opportunities associated with plan utilization after open enrollment as outlined in resources provided (and any additional research you may conduct).
• Alignment with modern consumer expectations
• Future forward innovation—evolves existing models (workflow, data, technology, employee facing materials and tools)

The Advisory Panel will provide assistance to participants on interpreting these criteria. This site will continue to be updated with answers to frequently asked questions. A Q&A webinar was held where questions were asked and answered live.

• Q&A Webinar Recording (44 min)
•  Q&A PDF

The Judges

Pictured Left to Right

• Anupa Bir, Director, Center for Advanced Methods Development, RTI International
• Amy Cueva, Founder & Chief Experience Officer, Mad*Pow
• Melissa Gopnik, Senior Vice President, Commonwealth
• Amar Hamoudi, Vice President, JP Morgan Chase
• Sarah Oltmans, the Managing Director, Health at Robin Hood
• Gary Robinson, Executive Vice President and Chief Marketing Officer, HealthEquity

• Jane Sarasohn-Kahn, Health Economist, Health Populi

• Dr. Bruce Sherman, Medical Director, Population Health Management, Conduent HR Services

Judging Process

Each submission will be evaluated by the Challenge Advisory Panel for the extent to which the concept meets the evaluation criteria. This information will be shared with the Challenge Judges for final review and selection.

Additional Resources

Relevant literature and articles

Kaiser 2016 Employer Health Benefits Survey (2016, Kaiser)
This report summarizes the results of the Kaiser Family Foundation (Kaiser) and the Health Research & Educational Trust (HRET) 2016 survey of private and nonfederal public employers with three or more workers on employer-sponsored health benefits.

Wage Matters: Emerging Evidence on the Impact of High Deductible Plans (2017, Bruce Sherman) PDF
This presentation provides data on the following: the current state of HDHPs, low wage workers and health status, the impact of HDHPs on healthcare use by wage category, and the implications for health benefits and the future.

Paying Out-of-Pocket (2017, JPMC)
This report summarizes JPMC’s research done between 2013 and 2016 on 2.3 million Chase customers’ out-of-pocket healthcare spending and the implications on their household financial health.

Commonwealth Fund Biennial Health Insurance Survey (2016, The Commonwealth Fund)
This report summarizes the survey conducted in 2016 by the Commonwealth Fund on consumers’ access to affordable health care over time.

National Business Group on Health (2015, National Business Group on Health) PDF
This report provides data from the survey conducted in 2015 by the National Business Group on Health on how large employers planned to comply with the provisions of the Affordable Care Act.

Relevant organizations

These organizations provide services and tools that help consumers navigate health benefits, estimate savings based on health plan, estimate the cost of care, and compare quality of care. The organizations and tools listed below are provided as examples to give challenge participants a sense for what is going on in the marketplace. This list is not all-inclusive and challenge participants are encouraged to do their own marketplace research and analysis.

Tools Offered by Benefit Providers:

• Picwell: online health benefits navigation platform
• Connect Your Care: HSA and FSA Plan Savings calculators
• Castlight: online health benefits navigation platform
• Health Savings Administrators: online healthcare savings and cost calculators
• Health Equity: online healthcare savings and cost calculators

Tools Offered by Independent Organizations:

• Guroo: online health expense calculator
• Healthcare Blue Book: online healthcare cost comparison platform
• Compare Maine: online healthcare cost and quality comparison platform for facilities in Maine

Participant FAQs

We are here to help.
We’ve provided the below FAQs to support your efforts with the design challenge, but please feel free to also send questions via email.

Why should I enter the Innovation Challenge?
To make the world a better place, of course! To tackle a compelling problem. To get lots of eyes on your brilliant designs. And for the chance to take home up to $5,000 in prizes.

Who is eligible to participate?
Refer to Eligibility Rules for Participating in the Terms & Conditions on the challenge website: The Challenge is open to teams and individuals. You can read more details about this in the Eligibility Rules for Participating in the Competition on the challenge website (Section II, Part B in the Terms and Conditions).

What do I submit?
A complete submission contains four parts (all parts should be submitted via public links in the submission form):

• A design brief under 2,250 words describing how your submission addresses the evaluation criteria [Note: The judges will be doing a lot of reading, so err on the side of legibility & brevity.]
• A visual composition that illustrates “what the employee sees.” This will include any materials the employee may see or tools an employee may interact with.
• A brief video (less than 3 minutes) that illustrates the concept. What does your solution look like in practice? This is your chance to show the value in your design (think kickstarter).
• A journey map highlighting your proposed solution.

When is the submission deadline?
September 25, 2018 by 11:59 pm.

Can I submit my design after the deadline?
No. So don’t procrastinate! We want to see your amazing work.

Can I send an updated design after the deadline?
Nope. You’ve only got one chance, so make it count.

How do I submit my design?
If you’d like to participate in the Open Enrollment Innovation Challenge, we request that you inform us of your intent to participate. This ensures an adequate number of reviewers and allows us to send timely reminders as the submission deadline approaches.The intent to participate is nonbinding–submitting the form does not obligate you to submit a design.

How will you judge the submissions?
We’re giving out two prizes. Both will be evaluated using a scorecard against a shared set of core criteria as well as a prize-specific set of additional criteria. An advisory panel will review all the submissions and make recommendations to our judges. These judges will do their own review and then select our challenge winners.

How are Prize 1 and Prize 2 different?

• Prize 1: Best Open Enrollment Solution — is all about incremental innovation: focusing on the design of materials/tools employees encounter during the open enrollment process as they exist in the current system and improving them.
• Prize 2: Best Ongoing Support after Open Enrollment — is about systems-level innovation: focusing on how one can support employees to make the best of their chosen health plan throughout the year.

Are there only two prizes?
There are only two cash prizes. We’ll also be giving out Honorable Mentions for entries that are outstanding in specific focus areas. If you have a specific passion or area of interest, feel free to focus your efforts on that. (e.g. just the enrollment interface or communication between the employee and the health plan, etc.)

How disruptive can my design be?
Forget thinking outside the box. There doesn’t even have to be a box. You can completely reinvent processes and systems, rethink collaboration, and re-envision the intersection of employees, insurers, providers, and financial institutions. But keep it within the realm of possibility, please.

Do I have to be part of a design team to submit my design?
No. The Challenge is open to teams and individuals. You can read more details about this in our Terms and Conditions.

I don’t know anything about benefit selection and related savings vehicles. Where do I start?
Every human-centered design project begins with research, and this one is no different. We’ve gotten the ball rolling for you with a research report and a wealth of other resources. Of course, to make this truly human-centered, you need to involve users in some aspect of your design process. Make your designs with them or run your designs by them, it’s up to you. The more human involvement, the better.

What is a “journey map” and how would it be used?
Journey maps visually demonstrate the overview of a consumer or patient’s experience from initial contact through engagement process. For example, where a patient first interacts with their health insurance at open enrollment and what touchpoints or engagement they encounter when they use it (or don’t) throughout the year. This would be used to show an employee’s interaction at open enrollment or to show an employee’s interaction with their health insurance. Your journey map will be used to demonstrate the process and experience from the employee’s perspective for the solution you’ve designed.

Where can I find out more about journey maps?
If you’re new to journey mapping, check out these articles:

• Using Customer Journey Maps to Improve Customer Experience
• All You Need To Know About Customer Journey Mapping
• Interactive Journey Maps: Take your design & strategy to the next level

What is the difference between the content in the video and the content in the written submission? Are you looking for something different?
The video will be more brief and to the point than the written explanation. The video will focus on the story of how the submission works and how it addresses key issues and evaluation criteria. The written explanation provides more opportunity for detail.

Can the design brief include graphics or can I only use words?
The design brief provides an opportunity for you to describe the concept in detail, the design principles it follows and how it meets the evaluation criteria. It should not exceed 2,250 words and you are permitted to use graphics to supplement the written explanation.

Are all 4 submission components (written brief, video, journey map and visual composition) required for both prizes?
The same 4 submission components can be submitted for both prizes as long as it is made clear in those submission components how the submission meets the evaluation criteria for both. You could also submit different components for each prize.

If an innovation is developed that incorporates both prizes, can it be presented as one product via one submission?
While the same submission components can be submitted for both prizes, it must be made clear in those submission components how the submission meets the evaluation criteria for both. If your team feels that your solution meets all the core criteria, all the criteria for Prize 1 and all the criteria for Prize 2, you can submit the same design brief, video, visual composition and journey map entry twice to be considered for both prizes. Alternatively, when submitting your work you could modify the components for each prize to emphasize how your work meets that specific criteria. We encourage the latter approach as it will help the judges understand why they should consider your submission for both prizes.

How market-ready do solutions need to be?
Solutions for “Prize 2: Best Ongoing Support after Open Enrollment” do not need to be close to market ready as they are more disruptive in nature. However, the more feasible submissions for “Prize 1: Best Open Enrollment Solution” are in the near term, the better, as the focus there is on incremental innovation.

How will my work be used?
The purpose of this challenge is to stimulate innovation and raise consciousness in the industry on the top concerns present for open enrollment and potential solutions. We’ll be creating a gallery of all the submissions. Your work will live in this gallery, where we hope it will inspire everyone who sees it. It may also be used in marketing and advertising, now and in the future.

Who owns my design after I submit it?
Upon submission, contestants warrant that they are the sole author and owner of the Challenge Submission, and that the submission completely originates with the contestant, that it does not infringe upon any copyright or any other rights of any third party of which contestant(s) is aware, and is free of malware. You can read more details about this in our Terms and Conditions.

I have more questions. Who can I talk to?
Feel free to send questions via email.