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For those without access to group health insurance, there's a definite desire for coverage. But for those covered though their employer, there's no need.

So how do you find those in need? In the over-65 market, it's simple: Target by age to find people who might want a Medicare supplemental product. In the under-65 market, though, it's more problematic. You can target small businesses with fewer than five employees, but that's a small universe. Finding freelancers, the unemployed and others who don't have group coverage isn't an easy task.

That's why direct response television is a key marketing medium for many Blue Cross Blue Shield organizations.

“In the individual market it's hard to identify people,” says Barbara Bridge, direct marketing specialist with Pittsburgh-based BCBS provider Highmark. “It's not like they bought a treadmill and you can go sell them a cross-country ski [machine]. We use the broadest media we can to get the maximum exposure to reach our audience.”

“The pool of people who are looking for individual coverage is constantly changing — as people change jobs, they're in and out of the market,” notes Dave Hazlehurst, director of individual and small group sales for Albuquerque-based Blue Cross and Blue Shield of New Mexico. “It's a matter of timing, and DRTV is the best for hitting them.”

With people under age 65 who meet the criteria — like the self-employed or early retirees — there's no way to find them specifically with any targeted media, agrees Warren Hunter, president and CEO of Wayne, PA-based agency DMW Worldwide, which works with both Highmark and BCBS of New Mexico. “You have to cast a wide net and say, ‘If you need this product raise your hand,’” he says. “All the people who call are very qualified prospects.”

Both BCBS organizations have been using DRTV for several years. Highmark — which has about 3 million members in 29 counties in western Pennsylvania and 800,000 members in the 21 counties in the central part of the state — has been using DRTV for more than 10 years. BCBS of New Mexico, which has used DRTV for a little over four years, has 225,000 members. Most members of both organizations belong to group plans: Highmark has between 400,000 to 450,000 individual members, while New Mexico has only about 30,000.

A new animated spot for BCBS of New Mexico began running at the end of last December. The “Chips Choice” creative — featuring a cartoon mannequin-like figure chipping away at a stone block to reveal the BCBS logo — “took it up a notch” for the organization creatively, says Hunter. Because the group was on a tight budget, earlier spots used still photos overlaid with moving type and a voice-over.

After a slow start, the new creative — promoting the Blue Choice plan — is outperforming the older commercials, says Hazlehurst. Lead costs are in the low $20s, while the older spot is running in the high $20s.

Other lead sources for BCBS of New Mexico include the yellow pages and occasional freestanding inserts in newspapers, which tend to run a higher cost per lead at between $30 and $40. Television does give a lift to the other mediums; Hazlehurst says he judges by the increased call volume to the company's regular 800 number, which doesn't appear in the DRTV spots.

Highmark began running a new DRTV spot in early January. The “Your Move” spot — featuring computer-animated game pieces hopping around a Monopoly-like board — is for Highmark's DirectBlue preferred-provider program. It's running against an older spot called “Get the Facts,” which features text and a voice-over. So far, the new spot has the lowest cost per lead and has generated more leads. ROI is judged by cost per sale, says Bridge, noting that it was too early to tell (at press time) what the ROI would be for the new spot.

CompleteCare, Highmark's comprehensive medical program, is also airing a new DRTV spot now. “Real World” follows the premise that if everyone were alike, everyone could all use the same healthcare. But because everyone isn't alike, CompleteCare offers a choice of deductibles and the freedom to choose any doctor or hospital. “Real World” is also running against an older, proven creative called “29 Counties,” also a text format with voice-over.

Historically, Highmark has run DRTV spots throughout the year and then done six to eight FSI campaigns as well. Because of budgetary constraints last year, the only advertising done was an FSI in September.

Incoming calls generated by the DRTV spots are typically handled by telemarketers who take down the prospect's name, address and date of birth. A fulfillment package with information and an application typically goes out within 48 to 73 hours, says Hunter. Follow-up is then handed by an outbound telerep — a licensed insurance agent who can walk people through the application process. “As they learn about your family situation, they might recommend a certain deductible amount or copay or some variation on the product, and quote rates,” he adds.

The main call to action in both the Highmark and BCBS of New Mexico DRTV spots is an 800 number. “From a philosophical point of view, I'm opposed to anyone in insurance sending a consumer to their Web site unless the site is set up so the consumer can actually purchase the product,” says Hunter. “Once you put somebody on the Web, it's like sending them to a shopping mall. If you've got them there on your site and they get frustrated that it doesn't work well or they can't get a rate quote, or they can't fill out an application or they can't enroll, they're going to go and see if there's someplace else they can. They'll go to Google and put in ‘health insurance.’ Next thing you know, they're shopping and you've lost them.”

But that's not to say the Web isn't a useful tool for BCBS organizations. Thirty-five percent of New Mexico's sales are direct, with the remainder coming from brokers. A small percentage, though, do come from its Web site (www.bcbsnm.com). Image advertising drives people to the site, says Hazlehurst, where they can download a PDF application and rate sheet.

Highmark has a visitor portal (www.highmarkbcbs.com) where prospects can find information on both medically underwritten and guaranteed issue products, says Bridge. For guaranteed issue products they can print out an application or request an information kit; for those that are medically underwritten, they can apply online and make the first month's payment with a credit card. Marcia Conley, director of marketing and provider communications for Highmark, notes that only the medically underwritten products are promoted via direct response advertising. “Guaranteed issue is sort of a fallback if someone isn't eligible for medically underwritten [plans],” she says.

Banner ads were tried in 2001 with poor results. In early March, Highmark tested an e-mail blast for the under-65 market. The criteria for lists, says Conley, was that people be in Highmark's service area and had already opted in to receive e-mails on financial health-related topics. “But we have no indication whether they have health insurance,” she acknowledges.

DMW Worldwide, which works with several BCBS franchises around the country, doesn't typically focus on creating campaigns for its medical insurance clientele that carry themes across different media.

“We gave up a long time ago on campaigns,” says Hunter. “If someone wants a campaign and is insistent on it, we'll develop that and try to test campaign A against campaign B thematically. Still, invariably parts of B work in some media and parts of A work better in other media. Because the nature of direct response is to produce the lowest cost per lead and lowest cost per sale, you end up mixing and matching anyway.”

“Ultimately,” he says, “about six months into the campaign year, you end up with a piece of direct mail, a freestanding insert and a DRTV spot that don't look alike anyway.”