This Is Not a Bill: UX Perspective on EOBs

In the spring of 2025, I needed physical therapy to address a prolonged ankle injury. I felt such relief when my ankle started to show progress, and I was able to walk normally again.

In July, that relief transfigured into fury and fear when I received a thick stack of EOBs from my health insurer, all reading “YOU MAY OWE $80” for each of my two dozen PT visits.

This can’t be true, I thought. I paid a significant copay for each visit—how could I still owe $80 more? My eyes glazed over as I did the math and my heart rate picked up. I read the document again, scouring for answers. Why can’t I figure out what’s going on?

Unfortunately, this scenario is common among 20-somethings handling their health insurance, revealing a fundamental flaw in one of healthcare’s most ubiquitous communications: the Explanation of Benefits. Despite a name promising clarity, EOBs routinely leave users more confused than when they started.

Corporate Insight’s recent Health Plan Monitor research into Gen Z healthcare literacy revealed a startling reality: 70% of young adult survey respondents classified as “low literacy.” This was a startling contrast to other generations which had only 40-50% low-literacy individuals. The study also showed that while consumers are generally familiar with claims, they struggle with understanding EOBs.

CI’s User Experience team dove into this stat with further qualitative interviews focusing on comprehension of Explanations of Benefits. Together we uncovered that Gen Z aren’t “lazy” readers avoiding fine print. They’re engaged consumers actively trying to understand their healthcare coverage, but patients across generations find that these documents speak an entirely different language than they do.

Gen Z research participants from our EOBs UX study consistently explained that they were unable to find answers to their questions about services received, or costs or coverage explanations. Given that providing these answers is the core function of an Explanation of Benefits, hearing these struggles from respondents was concerning.

As one study participant put it, “It’s honestly more confusing than helpful. There are too many numbers that are thrown at you, and you’re just supposed to absorb it and make it all make sense.”

When faced with a document they can’t decode, members often disengage until a problem (like an unexpected bill) forces them back in. This defensive strategy might protect users’ mental bandwidth in the short term, but the accompanying “avoidance penalty” leads to real costs on both sides. Confused members delay payments, call support more often, and dispute bills they don’t understand. They also lose the ability to plan for healthcare expenses or make confident care decisions—leaving them frustrated and financially uncertain.

For insurers and employer partners, the fallout is equally significant. Every unclear EOB chips away at perceptions of transparency and competence, eroding trust that’s hard—and expensive—to rebuild. Over time, what begins as confusion can evolve into complaints to HR, negative impressions that influence plan renewals, and rising churn risk. In a business to consumer environment, member sentiment directly shapes satisfaction, so clarity is both good communication and good business.

This sentiment was articulated by respondents in our research, some of whom suggested that insurance companies seemed to be obfuscating amounts or leaving information incomplete and frustrating.

“I want to at least anticipate what I actually owe … it’s kind of like doing your taxes, because it says,‘how much you owe,’ but you have to figure out what you owe specifically. And if you mess up it’s like, ‘Oh, no, we need to go back and retract this,’ or ‘You have to redo this,’ and no one wants to do that much work. If you [the insurance company] are getting paid to provide a service, you should be more forthcoming about what it is. It kind of seems sneaky. It’s like, ‘Oh, we know you paid a hundred dollars, but we’re not going to put it on any of the records going to you. And we’re not going to tell you what you actually may or may not owe.’ It just seems very vague.”

Explanations of Benefits represent one of the most frequent—and influential—touchpoints between insurers and their members. Each document carries the potential to reinforce confidence in an insurer’s transparency, accuracy, and service quality. Yet the current state of EOB design too often turns that opportunity into frustration. Dense language, fragmented layouts, and unclear cost breakdowns make it difficult for members to understand what they owe and why. The result is a missed chance to strengthen trust, satisfaction, and long-term loyalty. Clear, intuitive EOBs are a strategic lever for improving member experience and reinforcing brand credibility across the insurer–employer–member ecosystem.

At Corporate Insight, our research highlights a clear takeaway: members want Explanation of Benefits statements that are easy to read, easy to trust, and easy to act on. In healthcare, clarity is part of essential care. Our full Health Plan report on EOBs delves deeper into this theme, combining insights from qualitative UX interviews and user testing of EOBs from leading insurers. It also previews EOB performance scores and rankings from CI’s annual Commercial Health Plan Experience Benchmark, offering a data-driven look at how insurers can build trust and improve member experience through better communication.

Contact CI for a preview version of the EOBs UX report, and learn more about our health plan research services and UX research team. And check out our Insights page for the latest customer experience trends across healthcare and financial services.