E   E   M

Enterprise
Enrollment
Management
A Process In Transition                       Carrier
The health insurance small-group
enrollment process is a prime targe...
Large HealthCare
Carriers Look to Improve
Small Group Enrollment
Overhauling the small group enrollment
process can drive ...
Small Group Enrollment
Challenge
The current manual process is
encumbered by hand-written forms,
redundant processes and p...
A Costly Problem                                           Executive
The current Quote-to-Onboarding process
is costly, ti...
Employee/Employer
Frustration
The current process wears down the entire
value chain, including the end customer.




     ...
The Driving Forces
Health industry technology is moving at a
breakneck speed. This rapid pace of
change is driven by compe...
From Old to New
The old process & systems of multi-tiered
layers and redundancy, needs to be
replaced as the new emerges.
...
The Keys to Delivering
EEMS Success
To achieve enthusiastic adoption, stakeholders
in the enrollment process must experien...
Key Number 1:
Value
Distinctive benefit, service, and
productivity value-adds relative     Gains in
to the prior manual pr...
Key Number 2:
Ease of Use
Intuitive ease of use including a highly
polished look and feel in the user interface

         ...
Key Number 3:
Control
Complete control and visibility into their
enrollment application process.               Fill out
  ...
Key Number 4:
Security
A confidence in the impenetrable personal
and health information security.             HIPAA
      ...
Key Number 5:
Support
Instantaneous access to customer service       24 Hour
                                             ...
Enterprise Enrollment
Management Improvements
for Small Groups
•Less confusing and resource consuming.
•More manageable an...
Enterprise Enrollment
Management Improvements
for Small Groups
•Effective broker control of group information
•An ability ...
Enterprise Enrollment
Management Improvements
for Small Groups
•Accuracy and productivity improvements driven by
measurabl...
Enabling Technologies
& Standards Are Here
Optimization of the enrollment process is
now possible through the use of matur...
Engagement
Lifecycle
Achieving this effective experience is
dependent upon a good start that fits
cleanly into the engagem...
Engagement
Lifecycle                                                        Advantages to integrating
Achieving this effec...
The Benefit
Reality Gap
Although 93% of employers think it’s
important for their employees to
understand & appreciate their...
Health Portals
Will Thrive
Complementing the value associated with
improving the small group enrollment
process efficiency...
Critical
Functionality
To ensure the re-engineered
enrollment process achieves
the full range of opportunity, it
must have...
Critical                                                         Separating the small
Functionality                       ...
Employer
Portal
Features:
•Online enrollment for employers
•Data and statistics about employee enrollment
activity through...
Broker/
Agency Portal
Features:
•Multi-user interactive environment that enables
brokers to assist in the completion of an...
Employee
Portal
Features:
•A clean, uncluttered, visually appealing look
•A rapid, intuitive enrollment experience
•A leve...
CRM/xRM
Functions
Interface
Why xRM Functionality:
•These systems provide excellent
tracking tools, workflow management,
a...
Rich
Dashboard
Features:
•Customized Broker Dashboards
•Customized Employer/HR Dashboards Analyze
critical business metric...
Security Suite
Rock Solid and Fully Compliant
Security
•SAS 70 facilities and procedures, with
offsite redundancy and load...
The Business
Case is Made
•Comprehensive integration and development
 of a small group enrollment lifecycle is now
 practi...
The Topline Strategies
Total Story
 TopLine Strategies delivers the complete integration and development of sales and mark...
Next Steps
Visit the TopLine website, social sites or
call us to learn more about Enterprise
Enrollment Management.




  ...
Learn More
                              View TopLine Strategies’
                              Slideshare Presentation on...
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Enterprise Enrollment Management (by TopLine Strategies)

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Download our whitepaper on EEM here -> http://www.toplinestrategies.com/eem

Cost pressure on health carriers has been intense for years, and health care reform is increasing that pressure further. Health insurance carriers are targeting the small group enrollment process for optimization. Most small group employer and employee enrollment processes are encumbered by hand-written forms, parcel delivery services, and four or more layers of redundancy. Change has to come. To realize the promise an optimized enrollment process can deliver to health insurance carriers industry-wide, the broker, employer, and employee must embrace the carrier’s new enrollment workflow with enthusiasm.

This piece outlines the strategic roadmap to get there.

Published in: Technology
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  • Sounds like a new opportunity emerging in healthcare and tech.
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  • Great! It's very helpful.
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  • Thanks Michael. I am assuming 'enterprise class' tools are classified as highly secure, especially for healthcare.
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  • Paranoid Army wrote 'Is this only achievable through xRM, or are there other platforms which can handle this type of implementation?'

    -From what I know, this approach would also work with other enterprise class tools that can handle the CRM tasks well.
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  • Well Done ! If the concepts in this presentation are adopted by more health insurance companies, it could make a big difference in how people understand and use their health insurance.
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Enterprise Enrollment Management (by TopLine Strategies)

  1. 1. E E M Enterprise Enrollment Management
  2. 2. A Process In Transition Carrier The health insurance small-group enrollment process is a prime target for breakthrough process optimization in the $2.1 trillion U.S. health care system. The enrollment process constituents are ready for change. Broker/Agency Employer Enrollment Employee TopLine Strategies
  3. 3. Large HealthCare Carriers Look to Improve Small Group Enrollment Overhauling the small group enrollment process can drive high returns on investment and significantly improve customer services. TopLine Strategies
  4. 4. Small Group Enrollment Challenge The current manual process is encumbered by hand-written forms, redundant processes and parcel delivery services, periodically interrupted by computers. Issues Manual Forms Redundant Processes TopLine Strategies
  5. 5. A Costly Problem Executive The current Quote-to-Onboarding process is costly, time consuming and error prone at Carrier and results in an on-boarding delay that costs the broker and the carrier. Carrier Delivery Guy Broker Manager at the Agency/Broker Employee /Family HR Manager TopLine Strategies
  6. 6. Employee/Employer Frustration The current process wears down the entire value chain, including the end customer. TopLine Strategies
  7. 7. The Driving Forces Health industry technology is moving at a breakneck speed. This rapid pace of change is driven by competitive pressures that are buffeting carriers and other stakeholders. •Carriers with large R&D budgets, especially large multi-state carriers •Brokers using new tools to pit one carrier against the other on price •Federal government health care reform and the changes likely to result from that effort on the national level TopLine Strategies
  8. 8. From Old to New The old process & systems of multi-tiered layers and redundancy, needs to be replaced as the new emerges. • What are the common requirements/keys of a successful Enterprise Enrollment Application System? • How do the constituent users /application personae express their interests and priorities? • How do these requirements translate into application features and functions? TopLine Strategies
  9. 9. The Keys to Delivering EEMS Success To achieve enthusiastic adoption, stakeholders in the enrollment process must experience: • Distinctive benefit, service, and productivity value-adds relative to the prior manual process • Intuitive ease of use • Complete control and visibility into the enrollment application process • A confidence in the impenetrable security of the personal and health information • Instantaneous access to customer service assistance Ease Value Control Secure Support of Use TopLine Strategies
  10. 10. Key Number 1: Value Distinctive benefit, service, and productivity value-adds relative Gains in to the prior manual process. Clarity Gains in Commitment Gains in Solid Understanding Gains in Efficiencies Gains in Effectiveness TopLine Strategies
  11. 11. Key Number 2: Ease of Use Intuitive ease of use including a highly polished look and feel in the user interface Intuitiveness (such as a “pixel-perfect” look and feel). Pixel-Perfect Comfort Familiar Experience Better Experience No Learning Curve TopLine Strategies
  12. 12. Key Number 3: Control Complete control and visibility into their enrollment application process. Fill out Form on Their Time Fill out Form at Their Place Promoted When Ready TopLine Strategies
  13. 13. Key Number 4: Security A confidence in the impenetrable personal and health information security. HIPAA Compliant Data Encryption Algorithms Intrusion Detection PHI Regulations TopLine Strategies
  14. 14. Key Number 5: Support Instantaneous access to customer service 24 Hour Self Service assistance. Support Full Knowledgebase & FAQs Anytime, Anywhere Access Instantaneous Access Multiple Simultaneous Access to Same Form TopLine Strategies
  15. 15. Enterprise Enrollment Management Improvements for Small Groups •Less confusing and resource consuming. •More manageable and completed more quickly. •More secure and private (health information and health privacy) than manual forms and physical exchange. •Applicant friendly including immediate access to assistance. •More broadly informative. For the Employer/ Employee TopLine Strategies
  16. 16. Enterprise Enrollment Management Improvements for Small Groups •Effective broker control of group information •An ability to deliver enrollment help to their client companies and groups and those associated with these entities. •On-boarding optimization (including health portal access) to afford them the broadest selection within the insurance carrier’s product set. For the •Complete agent visibility into the group and employee/associate enrollment lifecycle. Agency/Broker TopLine Strategies
  17. 17. Enterprise Enrollment Management Improvements for Small Groups •Accuracy and productivity improvements driven by measurable ROI. •HIPAA/PHI compliance. •Improvement in enrollee first impressions. •Advancing the perception with enrollees and brokers that the carrier is adding value to its insured clientele and broker community interests and priorities. •Integration to and compliance with, all established For the vital carrier IT data processing systems and standards. Carrier TopLine Strategies
  18. 18. Enabling Technologies & Standards Are Here Optimization of the enrollment process is now possible through the use of mature enabling technologies that incorporate industry standards and best practices. These include: • Dynamic forms • Pixel-perfect user interface standards • Data encryption algorithms • Workflow management systems • Interaction tracking through Relationship Management systems (xRM) • Advanced dashboards that leverage instant access in-memory Business Intelligence • Electronic medical records (EMR) standards Securely hosted personal health management portals that carry health data that is fully compliant with HIPAA and PHI regulations TopLine Strategies
  19. 19. Engagement Lifecycle Achieving this effective experience is dependent upon a good start that fits cleanly into the engagement (on-boarding) lifecycle process. Undifferentiated Client Benefit Qualified Pre-Enrollment Enrolled Market Understanding Lead Commitment Client Opportunities Satisfaction Health & Benefit Management xRM/BI xRM/.Net Portals for Application Marketing xRM/CRM Enrollment Employee and Completion Automation Quotation Application Family Management Enabling Technology TopLine Strategies
  20. 20. Engagement Lifecycle Advantages to integrating Achieving this effective experience is dependent upon a good start that fits health portals and the cleanly into the engagement (on-boarding) lifecycle process. enrollment application Undifferentiated Client Benefit Qualified Pre-Enrollment Enrolled Market Understanding Lead Commitment Client Opportunities Satisfaction Health & Benefit Management xRM/BI xRM/.Net Portals for Application Marketing xRM/CRM Enrollment Employee and Completion Automation Quotation Application Family Management Enabling Technology TopLine Strategies
  21. 21. The Benefit Reality Gap Although 93% of employers think it’s important for their employees to understand & appreciate their benefits, only 19% believe employees actually do. 1-in-5 believe employees actually understand Think it’s Important 19% that they Understand 93% TopLine Strategies
  22. 22. Health Portals Will Thrive Complementing the value associated with improving the small group enrollment process efficiency are other high value benefits to the carrier. These include advantages resulting from integrating the enrollment process to employee and family health management portals. The benefits could: •Enrich enrollee experience •Improve first impressions •More permanently connect the carrier with the insured •Increase health portal usage by insured In the long run, these components of the expanded enrollment solution may have an even more positive impact for insurance carriers than the enrollment process improvement. TopLine Strategies
  23. 23. Critical Functionality To ensure the re-engineered enrollment process achieves the full range of opportunity, it must have six important feature categories: •Employer Portal •Employee Portal •Broker/Agency Portal •CRM/xRM Functions/Interface •Rich Dashboard •Security Suite Employer Portal Employee Portal Broker/Agent Portal CRM/xRM Functions/ Rich Dashboard Interface Security Suite TopLine Strategies
  24. 24. Critical Separating the small Functionality group enrollment process To ensure the re-engineered improvement effort into enrollment process achieves the full range of opportunity, it discrete phases and must have six important feature aligning each with its categories: distinct return on •Employer Portal •Employee Portal investment will manage •Broker/Agency Portal •CRM/xRM Functions/Interface risk and ensure •Rich Dashboard measurable success. •Security Suite Employer Portal Employee Portal Broker/Agent Portal CRM/xRM Functions/ Rich Dashboard Interface Security Suite TopLine Strategies
  25. 25. Employer Portal Features: •Online enrollment for employers •Data and statistics about employee enrollment activity through reporting capabilities •Highly personalized employer dashboards •Bills and payments follow-up •Comprehensive tracking and reporting capabilities of enrollment and renewal processes •High visibility into all insurance plan partners Vision •Key contacts for employers with up-to–date information Robert Wallace •Ability to administer multimedia including educational podcasts, videos, and animations •Ability to administer robust health libraries, articles, and daily news for sharing with employees •Secured and targeted messaging to employees on health-related issues •Short-form health insurance brochure •Terms to know •Ability to view enrollment information any time •Ability to manage the enrollment process •Detailed audit trail to track changes over time TopLine Strategies
  26. 26. Broker/ Agency Portal Features: •Multi-user interactive environment that enables brokers to assist in the completion of an application, either in person or over the phone •Support for broker monitoring of application completion process by account •Renewal support through proactive triggers and alerts •Online access to most up-to-date forms •Easy support for calculation of shared commissions between brokers and agents •Support for cross-selling and up-selling to new and existing clients TopLine Strategies
  27. 27. Employee Portal Features: •A clean, uncluttered, visually appealing look •A rapid, intuitive enrollment experience •A level of usability that increases enrollee acceptance •Ability to grant employees instant access to benefits elections through online confirmation statements •Ability for employees to self-print their own health insurance ID card •Benefit overview displayed in a way that lets employees self-service most questions in this area •A universally familiar tab interface •Clear labels •Express prescriptions/claims •Big buttons including instant access to help with a “chat button” •Multimedia including educational podcasts, videos, and animations •Robust health libraries, articles, and daily news for sharing with employees •Simple tools such as a "go back" key •A clear “percent complete” bar providing a continual message of progress toward application completion •An "application summary" of remaining responses to be completed •Language preference options to support non- English speaking employees TopLine Strategies
  28. 28. CRM/xRM Functions Interface Why xRM Functionality: •These systems provide excellent tracking tools, workflow management, auto-campaigns, strong reporting and back office integration •It’s the xRM automation and customization of xRM that -- • Enables the delivery of the form, • Encourages the timely completion of the enrollment process • Reminds the constituency of available resources TopLine Strategies
  29. 29. Rich Dashboard Features: •Customized Broker Dashboards •Customized Employer/HR Dashboards Analyze critical business metrics with customizable dashboard views that illustrate your organization’s state of health •Provide—on a “click”—with KPIs, maps, rankings, forecasts, progress against benchmarks, activities status, customer service, and contextual details to authorized stakeholders •Enable fast, reliable business decisions based on accurate and usable information •Optimize the human investment with a reporting connection that links up with customer data stores to extend business intelligence—and help monitor changes or trends •Identify where help is required •Provide a separate data repository built to optimize data load time but minimize query effects on response time of the live enrollment/CRM environment •Track key metrics such as: •Enrollment by Broker •Enrollment by Employer •Enrollment by Industry •Percentage to Completion •Campaigns Sent •Most Difficult Questions •Number of Campaigns TopLine Strategies
  30. 30. Security Suite Rock Solid and Fully Compliant Security •SAS 70 facilities and procedures, with offsite redundancy and load balancing •PCI compliant hosting including 2-factor authentication for system users •HIPAA compliance end to end (see detail below on this vital topic) Integrity Confidentiality Availability Security Risk Security Remediate Secured Training Evaluate Responsibility Analysis Strategy Third Parties TopLine Strategies
  31. 31. The Business Case is Made •Comprehensive integration and development of a small group enrollment lifecycle is now practical. •However, to achieve the promising returns that an Enterprise Enrollment Management system can deliver for small groups, carriers must gain enthusiastic adoption across the wide multi-organization workflow. •The combination of mature enabling technologies makes this achievement possible with integrated health management web portals, secure hosting and data encryption, in-memory dashboards built with state-of the art Business Intelligence toolsets & Relationship Management platforms (xRM) to manage interactions and workflows. •Careful application of project management methodologies is essential. Separating the small group enrollment process improvement effort into discrete phases and aligning each with its distinct return on investment will manage risk and ensure measurable success. TopLine Strategies
  32. 32. The Topline Strategies Total Story TopLine Strategies delivers the complete integration and development of sales and marketing technologies to corporations and institutions. We analyze client requirements and apply innovative processes and technologies to improve and strengthen our client’s revenue streams and customer interactions. The experience of our team and disciplined project management practices ensure our clients timely delivery and measurable results. Core Practices: Key Partnerships: •Relationship Management •Marketing Automation •Enterprise Content Management •Business Intelligence •CIO & CTO Services •IT Human Resource Consulting & Staffing Our analysts, project managers and application development engineers have extensive experience with the requirements of mid-enterprise corporations and institutions, including the following: Comprehensive Lifecycle Approach: •Financial Services •Insurance and Health Management •Education & Government •High Technology •Energy & Resource Management •Firms with complex channels (agents, brokers, franchisees, partners) You can learn more at www.toplinestrategies.com TopLine Strategies
  33. 33. Next Steps Visit the TopLine website, social sites or call us to learn more about Enterprise Enrollment Management. 1 2 3 TopLine Strategies on Twitter TopLine Strategies on Facebook TopLine Strategies on Slideshare Visit www.toplinestrategies.com Call (480) 503.8584 x257 TopLine Strategies’ Social Presence TopLine Strategies
  34. 34. Learn More View TopLine Strategies’ Slideshare Presentation on xRM Download our Whitepaper at http://bit.ly/toplineemmswp TopLine Strategies

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