Affordable Care Act navigator Nini Hadwen (R) works with Marta Aguirre as she shops for health insurance during a navigation session put on by the Epilepsy Foundation Florida to help people sign up for health insurance under the Affordable Care Act on October 8, 2013 in Miami, Florida.
Affordable Care Act navigator Nini Hadwen (R) works with Marta Aguirre as she shops for health insurance during a navigation session put on by the Epilepsy Foundation Florida to help people sign up for health insurance under the Affordable Care Act on October 8, 2013 in Miami, Florida. - 
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As of December 31, the government says more than two million Americans have signed up for insurance through the state or federal health exchanges – some for the first time. Nearly 4 million more have enrolled in Medicaid.

It's akin to waking up to a new car in your garage, but not necessarily knowing how to drive. And consumers will be the first ones to tell you, there’s a lot to learn about health insurance.

According to a recent report from the Urban Institute, less than half of Americans with insurance felt like they had a good grasp on basic health insurance terms like premium, deductible and covered services.

“A lot of our focus has been on on-boarding a customer,” saysBrian Lobley of Independence Blue Cross in Philadelphia. "What do we do to make that first experience not only useful to them, but to understand it.”

For example, Lobley says consumers might be tempted to purchase a plan with low monthly premiums, but he says that might come with expensive co-pays. 

“And you’d be better off paying a little bit more per month to have a lower out-of-pocket cost,” he says.

Insurers want the customer experience to be positive the first time out. Because if it is, those customers could they stick around for years to come.

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Follow Dan Gorenstein at @dmgorenstein