Two years ago, we wrote about the speculation throughout the industry of the death of small group plans. The thought was at the time that due to continually rising healthcare costs, lack of penalties for not offering health insurance benefits (for groups < 50 employees), and the introduction of subsidies for individual coverage on the exchanges that small group plans would be reduced to nothing by now. However, these rumors of the small group segment’s demise have been greatly exaggerated, and two years on, we continue to see the relevance and growth of the small group plan.

There are a number of reasons that the small group segment has staying power. One, reform adjusted the employee count classification for small groups upwards to 1 to 100 members instead of 1 to 50- adding more groups to the segment. Two, the plans available on the Exchanges are not attractive (e.g., large deductibles, limited networks, etc.) when compared to small group plans. And three, companies have continued to have to offer benefits to attract and retain the best employees. While these benefits include medical coverage, there are many other ancillary benefits that can be offered to employees alongside their medical coverage.

If your health plan is going to focus on this market, how do you service the groups AND their employees efficiently – optimizing both the customer experience and efficiency? Today, most groups still receive quotes through brokers or benefits consultants who collect data manually by handing out paper forms to employees to complete. The health plan then keys that information into their system. This is an extremely time-consuming, manual process for ALL involved.

Technologies are available to help automate this process. Small groups can get their own quotes and complete their enrollment online. These online processes allow you to scale and there are two models generally used; online and “spreadsheet” enrollment. In the online option, a broker uploads the member roster, sends out personalized emails for each to choose a plan and sign up, then each employee logs in and completes the application or waiver online. Administrators can see the progress as people enroll and intervene as necessary. The second option is for a benefits consultant or broker to collect physical forms, enter the information into a pre-formatted spreadsheet and then upload the entire enrollment with one click. This process is a favorite of brokers and can make enrollment a quick and efficient process for them to handle.

By enforcing the business rules up front, the platform can eliminate the back and forth that happens in a typical manual enrollment process where underwriters do not have all the information they need in the initial submission. In the automated, platform-based solution, only complete information, in the correct format, will be submitted, meaning less work for insurance carriers as this information no longer needs to be chased down, keyed in, and manually verified by them. The platforms can enforce participation and plan eligibility rules to further decrease the fall-out and manual work that typifies enrollment processing today.

One of the most effective automations you can employ is the automation of the renewal generation and notification cycle - a process that consumes a large amount of resources at more manual plans. Your solution needs to guarantee not only the smoothness of the intake of the business, but also focus on making the retention of these groups easy for your staff and easy for your brokers to use.

Today, we continue to see the relevance and growth of the small group market across the country. Small Group plans are still here, and in fact, they are growing. New tools are available that can allow your plan to get into this market and be competitive with the established players. Click here to learn more.