In 2015, insurance carriers are seeing unprecedented opportunityfor new growth, thanks in large part to the Patient Protection andAffordable Care Act (“ACA”) and other market forces; this isespecially true for those offering Voluntary Benefits (VB). Onesource cites 60 percent growth in VB sales from 2013 to 2014attributable to the ACA (see “It's not business as usual: The newface of insurance brokers” in The Institute for HealthCareConsumerism, January 2015).

At the same time, these market forces are causing unprecedenteddisruption in the distribution of these coverages, adding cost andcomplexity for carriers. Here we discuss how to mitigate some ofthis channel disruption, and describe how carriers can positionthemselves for long-term success, through the syndication of onlineservices, in particular enrollment and evidence of insurability(EOI).

Syndication – making key services available online across avariety of platforms and exchanges – allows carriers to controlbranding, compliance, and cost. Syndication also makes it easierfor the carrier to tap into additional distribution channels.

Syndicating Enrollment

When a carrier chooses to syndicate enrollment, the enrollmentchannel provides a link to the employee as a part of the overallenrollment experience. When the employee selects the link, a secureconnection is established and relevant data are exchanged; then theemployee is brought via single sign-on (SSO) directly into thecarrier's own branded enrollment service to make the elections inthe carrier's various offerings.

If the employee elects coverage(s) in excess of the GI, thesyndicated service should be able to present the state-, product-,and applicant-specific EOI questions and record the answers. Whenthe employee has confirmed (e-signed) their submission, anyautomatic adjudication of jet-issue decisions can be performed.After this, control is returned to the enrollment channel and thedata about the employee's elections are made available so that thechannel can present a comprehensive view of the employee's benefitchoices and payroll deductions.

Syndicating EOI

Even when it is not practical or desirable to syndicateenrollment, the process of collecting EOI information can besyndicated. After the employee has made and confirmed the benefitelections, the enrollment channel sends information about theemployee and the elections to the carrier's syndicated EOI service.The service should then determine whether the election requiresEOI; if the enrollment channel has configured the EOI rules, thisprocess can verify that the rules were run properly for theemployee and their election. When EOI is required, the employee isbrought into the carrier's branded, compliant EOI service viaSSO. While in the EOI service, the employee is presented thequestions appropriate to the state, the coverage, and theapplicant(s). After submitting the EOI, the service should beable to apply automatic adjudication rules for jet-issue decisionsand inform the employee in real time about those decisions. Theservice should then present completed state-compliant forms to theemployee for printing and record-keeping. Finally, the employee isreturned to the enrollment channel and the data about any decisionsmade, and the corresponding coverage levels, are made available forthe channel to include in the overall confirmation.

This “stand-alone” EOI service should also be usable by thecarrier for enrollment channels that cannot integrate in real time.In this model, the enrollment system of record will send thecarrier a file of elections – typically at the end of theenrollment window. The service should support flexible data importtools so that essentially any tabular format can be read. Theservice should also be able to notify employees via email or paperletter of the need to provide EOI and should support periodicreminders for those who have not completed the process.

Whenever EOI services are made available online, it is criticalto remember that some applicants still prefer not to providemedical information online. Therefore, any EOI service needs toprovide a printable state-compliant form that the applicant maycomplete for off-line submission.

SS&C's BRIX online enrollment and administrationplatform has been used by our clients to syndicate various servicessince 2007. Starting with enrollment services, our clients areoffered an integrated solution to third-party enrollment firms,enabling quoting enrollment in individual voluntarycoverages. In 2008, our online EOI module was first deployedas a syndicated service by one of our other clients. Our clientshave syndicated their online services to a wide variety ofenrollment firms, benefits administration platforms, and privateexchanges – even to some of SS&C's competitors' platforms.

By choosing to syndicate, our clients made it easier forthird-party enrollment firms to distribute product, since thethird-party platform (3PP) needed only to call our BRIX WebServices and perform SSO authentication using industry standardmethods. Our clients have been able to use our private-labeloffering to promote and protect their brands to ensure that all oftheir compliance mandates are met, and to be able to expand tochannels not previously available.

By using our notification and reminder capabilities, one of ourclients has achieved an impressive 88 percent completion rate forthe nearly one-half million online EOI applications started bytheir users.

To learn more about SS&C's BRIX online enrollment and administrationplatform, view our whitepaper or please contact Jeff Merrill, at860-701-5003 or [email protected].