But consumers—even those who are otherwise ostensibly financially savvy—can have trouble when there are just two options, or even just one. An example of that was seen at NerdWallet, a San Francisco-based Web company that specializes in educating and "empowering" consumers in their financial choices, including banking, home buying, credit cars and insurance.
Taylor Bernal, a 25-year-old who handles NerdWallet's social media, found this out firsthand. She was originally covered by what was then the company's sole health plan offering, Blue Shield of California, and she visited a walk-in One Medical retail clinic.
"I was having breast pain and my grandmother is a breast cancer survivor," Bernal said. "After a manual exam, the One Medical folks felt it would be important for me to get another look. They told me I was too young for a mammogram, so they ordered that I get an MRI instead."
"I asked the doctor how much he estimated it would cost, and he said it shouldn't be more than a couple hundred dollars," Bernal recalled. "I was referred by them to the St. Mary's Medical Center to get the MRI done. I later received two bills that were over $500—one from the technician who conducted the MRI and another from the doctor who reviewed it. I found that my insurance refused to cover any portion of it, but they would have covered a mammogram instead."
"If I would have known my insurance wouldn't cover the MRI, I probably wouldn't have gotten it done and instead went with another option," Bernal said. "I consider myself to be knowledgeable, working at a personal finance company, and even I got kind of screwed."
Bernal recalled the lack of price transparency, and that unpleasant hit to her wallet, last year, when NerdWallet decided to revamp its benefits to give employees more options for 2015: either a Kaiser Permanente HMO, or health maintenance organization plan, or a PPO, or preferred provider organization plan, from Aetna.
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"We were given speeches by the representative from Kaiser Permanente and a representative from Aetna," said Bernal. "I could just look around and see everybody was confused."
"Our health team recognized that, and said, 'Let's see what we can do,'" Bernal recalled.