Predictors of Health Insurance Literacy Among University Employees


  • Laura K. Merrell
  • Dayna S. Henry
  • Sarah R. Blackstone
  • Timothy Howley



Health literacy, health insurance, employee education, health insurance literacy


Background: Health insurance literacy (HIL) is “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about plans, select the best plan for their own or their families’ financial and health circumstances and use the plan once enrolled”. Many Americans have low health insurance literacy, but this concept has not been studied to the same extent as general health literacy. Objective: The purpose of this study was to explore predictors of health insurance literacy among employees of a large public institution of higher education in the South-Atlantic. Design: This single-setting cross-sectional study employed an online, anonymous survey administered to approximately 3,000 employees at a large university in the USA after open enrollment in state health insurance. The survey measured demographics and included a validated measure of health insurance literacy. Results: Using several multivariate regression models, results (N=480) indicated high overall HIL. Subscale means were highest for likelihood of using insurance plans proactively and confidence comparing insurance plans but were lower for confidence choosing and using insurance plans, indicating lack of understanding that may lead to poor insurance coverage choice and use. Employment category, income, race, and age also predicted HIL. Discussion: Based on the results, there is an opportunity for employers to provide information about health insurance policies. Health promotion programs should also seek to increase HIL through educational programs and policies to ensure both adequate coverage and ability to use health insurance in such a way that it promotes and protects one’s health.



How to Cite

Merrell, L. K., Henry, D. S., Blackstone, S. R., & Howley, T. (2021). Predictors of Health Insurance Literacy Among University Employees. American Journal of Health Studies, 36(2), 103–114.