Anthem/Blue Cross insures the “uninsurables”

Innovation Design


Some years ago, Anthem Blue Cross —California’s number one health insurer— confronted an intractable problem. After three failed attempts they concluded they were incapable to insure the 41% of their state’s uninsured young adults, predominantly male, age 18 to 34.


How do you protect people who have no sense of their own mortality? When you’re young-n-dumb-n-game to skateboard down an escalator, the budget priority between insurance premiums and beer money seems pretty plain.

&uninsurableThe client’s frustration showed in their description of the fruitless attempts to “insure the uninsurables.”

Todd McCullough knew that where objective need lurks, opportunity beckons.  His Doblin team’s early research confirmed his suspicions.

This otherwise seemingly irrational cohort of risk-takers DO invest in health insurance. They call it a helmet.

Observational research tells the tale.

Try this. Challenge a skaterboy to buy heath insurance. Follow him with a camera. No wonder he’s vexed. Our subject rolled in to a main street insurance office. He was told “we only service claims here. We don’t sell insurance.” (quizzical look – “serve claims? Huh?” )

He asked for a link. Sorry. Not an option. No store front, no website, no app. The only method? “Call this number. An insurance agent will visit you at home”.

Priceless befuddlement (“Visit my home? But I’m sofa-surging over at Benjie’s.”) Glengarry Glenross much?

End of conversation. Skaterboy rolls, tempting fate.

eye chart

By age 20, many young adults confront their first blurred vision.


Dental care presents one of the only consistent health concerns across young adults, largely due to out-of-pocket expense.

It took only a few representative “uninsurables” to craft the more apt description: “young invincibles” Empathy reveals a set of beliefs and behaviors completely incompatible with contemporary health insurance. The sales channel was both foreign and ill-suited. The offering missed the only two things this cohort cared about – vision and dental — after-market supplements in conventional insurance, not even underwritten by Anthem.


Todd’s team translated their discoveries into design principles and built a model that would appeal. Online sign-up, under 3 minutes input, covering vision and dental as primary features.

The chief actuary refused. “My 30 years of experience has taught me that it takes at least 20 minutes of in-person eye contact for an experienced insurance rep to determine if a candidate is insurable.”

That was the crux of the issue.

Partnering with his own Actuarial department, the team disproved the Actuary’s received “wisdom”, showing it to be true but under only certain conditions. They demonstrated a prototype wireframe (sample computer screens) to illustrate how with a few clicks Anthem could achieve enough confidence to issue 30-day coverage, while collecting additional insurance data.

This new form of insurance adhered to the design principles. Simple options. Online sign-up in under 3 minutes. Three program “sizes”, small, medium and large. Vision and dental covered in year one. Quick rewards and instant gratification.

The client took a risk. They piloted an edgy new insurance, rebranded Tonik. It was so surprising it was featured irreverantly on Jon Stewart’s Daily Show, a free marketing bonanza targeted straight into the heart of the target market. The client sponsor and Chief Marketing Officer valued the spot at $50 million of free advertising. Enjoy it as much as we do.

The result?

33,000 customers in year one (four times our projections). Net $2M to bottom line year one. Higher margins earned through the direct online channel. Agents who might have otherwise been alienated are now equipped to sell to parents. And Anthem launched a $1B new line of business, with no new underlying products required.