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

At the same time, these market forces are causing unprecedented disruption in the distribution of these coverages, adding cost and complexity for carriers. Here we discuss how to mitigate some of this channel disruption, and describe how carriers can position themselves for long-term success, through the syndication of online services, in particular enrollment and evidence of insurability (EOI).

Syndication – making key services available online across a variety of platforms and exchanges – allows carriers to control branding, compliance, and cost. Syndication also makes it easier for the carrier to tap into additional distribution channels.

Syndicating Enrollment

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

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

Syndicating EOI

Even when it is not practical or desirable to syndicate enrollment, the process of collecting EOI information can be syndicated. After the employee has made and confirmed the benefit elections, the enrollment channel sends information about the employee and the elections to the carrier's syndicated EOI service. The service should then determine whether the election requires EOI; if the enrollment channel has configured the EOI rules, this process can verify that the rules were run properly for the employee and their election. When EOI is required, the employee is brought into the carrier's branded, compliant EOI service via SSO.  While in the EOI service, the employee is presented the questions appropriate to the state, the coverage, and the applicant(s).  After submitting the EOI, the service should be able to apply automatic adjudication rules for jet-issue decisions and inform the employee in real time about those decisions. The service should then present completed state-compliant forms to the employee for printing and record-keeping. Finally, the employee is returned to the enrollment channel and the data about any decisions made, and the corresponding coverage levels, are made available for the channel to include in the overall confirmation.

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

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

SS&C's BRIX online enrollment and administration platform has been used by our clients to syndicate various services since 2007. Starting with enrollment services, our clients are offered an integrated solution to third-party enrollment firms, enabling quoting enrollment in individual voluntary coverages.  In 2008, our online EOI module was first deployed as a syndicated service by one of our other clients. Our clients have syndicated their online services to a wide variety of enrollment firms, benefits administration platforms, and private exchanges – even to some of SS&C's competitors' platforms.

By choosing to syndicate, our clients made it easier for third-party enrollment firms to distribute product, since the third-party platform (3PP) needed only to call our BRIX Web Services and perform SSO authentication using industry standard methods. Our clients have been able to use our private-label offering to promote and protect their brands to ensure that all of their compliance mandates are met, and to be able to expand to channels not previously available. 

By using our notification and reminder capabilities, one of our clients has achieved an impressive 88 percent completion rate for the nearly one-half million online EOI applications started by their users.

To learn more about SS&C's BRIX online enrollment and administration platform, view our whitepaper or please contact Jeff Merrill, at 860-701-5003 or jmerrill@sscinc.com.

 

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