September 29, 2026

The Infrastructure Behind Clear Member Communications

Dylan Papa, SVP & GM of Commercial Growth and Partnerships

Why are healthcare member communications so complex?

When health plans talk about improving communications, the focus often lands on simpler language, better design or more digital options. All of that matters. But none of it can fix a problem that started upstream.

Take an EOB. A member wants to know what happened, what their plan covered and what they might owe. Those answers depend on claims data, benefit rules, payment information and plan requirements being accurate and connected before the communication is ever created.

Financial clarity is often where plan-member friction shows up most. Getting that moment right builds trust, supports retention and engagement and can ultimately help lower costs.

How can health plans balance clarity and compliance?

Healthcare communications have to meet federal and state regulations, accessibility standards, plan rules, required disclosures and delivery timelines.

But a communication can be compliant and still be hard to understand.

The real challenge is balancing accuracy and regulatory requirements with a member experience that feels clear and actionable. That takes more than document expertise. It takes an understanding of the healthcare context shaping the communication.

Health plans can build clarity and compliance into the claims communication process from the start, rather than treating compliance as a final review step. That means:

• Translating regulatory requirements into language members can understand
• Designing for accessibility early, not as an afterthought
• Confirming claims, benefits and payment information are accurate before a communication is created
• Keeping healthcare and regulatory expertise close to the process, so plans can reflect changes in federal or state requirements without sacrificing usability

Compliance sets the boundaries. Clarity determines whether the member can actually use the information.

Why does operational infrastructure matter to the member experience?

Members may never see the production systems, quality controls, workflows or capacity planning behind their communications, but they notice when those systems break down.

A delayed ID card can affect access to care. A late notice can create uncertainty about coverage and increase costs. An inaccurate EOB can make an already complicated healthcare experience even harder to navigate.

This becomes especially important during periods like annual enrollment, when volumes increase and deadlines don’t move with them. Health plans need enrollment communications operations that can handle scale, absorb spikes in demand and keep moving when disruptions happen.

Operational resilience is part of the member experience, even if members never see it.

How should health plans think about print and digital communications?

Healthcare communications aren’t moving neatly from print to digital. Members use both.

Someone may receive an EOB in the mail, check a claim online and pull up an ID card on their phone. To the member, those aren’t separate communication strategies. They’re all part of the same health plan experience.

The question isn’t print or digital. It’s whether the information stays consistent and meets members where they’re at. More channels don’t automatically create a better experience. Connected information does.

What infrastructure is needed to support clearer communications at scale?

Zelis supports communications reaching approximately 71 million health plan members annually. As part of its broader Member Communications strategy, Zelis is expanding its infrastructure with a new 46,000-square-foot production facility in Arizona, joining its existing operation in St. Louis.

The new facility adds production capacity and geographic redundancy for high-volume, time-sensitive communications. While the new facility prints millions of pieces of material and hundreds of thousands of ID cards a day, that’s only one part of the story. The broader opportunity is connecting healthcare context, compliance expertise, production operations and delivery channels into one communications ecosystem.

What does better member communication ultimately require?

There’s still a significant gap between how important clear healthcare communications are and how well the industry believes it’s delivering them.

According to the 2026 State of the Healthcare Financial Experience report from Zelis and Datos Insights:

• 96% of healthcare providers say helping patients understand their insurance coverage is very or extremely important — but only 29% say they’re effective at it
• Among health plans that consider clear EOB statements extremely important, just 21% rate their own as very effective

Closing that gap takes more than redesigning a document. It takes connected healthcare information, regulatory expertise, resilient operations and coordinated delivery channels.

Members shouldn’t have to understand the complexity of healthcare to understand a healthcare communication. The better that complexity is managed behind the scenes, the clearer the experience can be for the member.