Themes
While we did not undertake synthesis for the data we collected, we did observe some themes in reviewing the data. 

Awareness and Information Needs

• Few of our ten participants were aware of the existence of non-medical supplemental benefits when choosing their plan or aware that they would receive them—in some cases, these benefits rolled out well after enrollment. Nonetheless, all beneficiaries appreciated their supplemental benefits.
• Beneficiaries generally became aware of their supplemental benefits through a letter or phone call after they enrolled in their plan. But much of their knowledge of how to use the benefits seems informal, anecdotal, informed by friends, and sometimes incomplete. Many did not know the range of potential locations they could spend money from a benefit card or have a clear list of what they can or can’t buy with it. 
• Beneficiaries are not always aware of why they are eligible for their supplemental benefits—some, but not all, understand that chronic illness or income make them eligible.
• No participants currently use a transportation benefit to access non-medical destinations, but some think it might be possible, and if they were more certain, they would be likely to make use of those benefits.

Challenges and Desired Changes

• Some beneficiaries have experienced initial challenges using their benefit cards to buy groceries related to incomplete understanding of how to use the cards, but they have resolved these challenges.
• Some beneficiaries have struggled to pay utility bills using their benefit cards and have not received competent support from their insurers in troubleshooting those challenges.
• Several beneficiaries noted they would prefer that their benefits rolled over month to month to offer them more spending flexibility.
• Several beneficiaries expressed confusion about why different supplemental benefits are loaded onto different cards (one beneficiary had a plan card that carried her OTC benefits, a debit card that carried her grocery and utility benefits, and a gas card that she received quarterly). The variety of cards has led to some challenge when trying to make use of each benefit.
• Those who have flexibility in how to allocate benefits across groceries, utilities, rent, OTC, and other needs appreciate it. Those who do not have that flexibility desire it.
• Beneficiaries were generally satisfied by the amount of their grocery stipend, especially given that they didn’t expect this benefit at the outset, but almost all noted they would be happy for the amount of their grocery stipend to increase as well.

Value

• Beneficiaries generally assess the value for supplemental benefits based on their immediate needs.
• Beneficiaries feel grocery benefits are helpful because they allow for less reliance on food banks and SNAP and help to reduce financial burden on family caregivers. 
• Beneficiaries appreciate benefits that enable them to pay their utility bills (though no one was receiving enough money to meaningfully contribute to their rent).
• While many beneficiaries do not currently make use of transportation benefits offered by their plans, all could see the value of those benefits and could forecast the need for them, especially transportation to medical appointments. None had considered the possibility that an insurance-provided service might transport them to non-medical locations, but around half expressed desire for such a service and believed it would meaningfully impact them. 
• Among potential supplemental benefits, beneficiaries appreciate the stipend for groceries and utilities because it does the most to offset their monthly expenses, but they also see great (in some cases, greater) value in in-person support for cleaning, self-care, and social support—one who had this service wanted more, and others could see its future value.