A Regence Health Insurance survey shows steep health plan learning curve with confusing terms that may keep people from getting full benefit of coverage.

"Almost nine out of 10 people in this country have some kind of health insurance coverage," said Robert Harris, who oversees Regence's market research. "But our focus groups show they don't understand the language and that makes them afraid to use it. It will be difficult for many health system reform ideas to get traction when people literally don't know what we are talking about."

Regence research measures - for the first time - true levels of consumer understanding of health insurance concepts. Previous surveys gauged self-reported understanding, but Regence asked 961 people with insurance to define terms and calculate their bill.

Only 60 percent answered correctly just half the time while four in 100 achieved an 80 percent score.

Fear and embarrassment keep people from asking what words mean, according to research following the survey

"One thing we learned is that glossaries don't cut it," said Harris. "Our industry must simplify our language to help people get full value from their health plan."

Regence offers member education and assistance features.