People who work in healthcare often refer to Open Enrollment as O.E., but that's not just an abbreviation, it's also the sound customers make when going online to shop for plans. Oh! Eeeee! For people buying qualified health (exchange) plans, the shopping experience is often confusing and overwhelming. Issues include: too many options to choose from, confusion regarding what is covered and what isn't, lack of clarity on which doctors are in- vs out-of-network, and complexity on what they must pay in premiums and out-of-pocket costs.

From the health plan perspective, the ACA open enrollment period (November 1 – December 15) puts a lot of pressure on resources since there is a greatly increased amount of shopping, enrollment and renewal activity in a condensed period. This pressure is seen from a people perspective with extra agent representatives needed at call centers for both inbound questions and for outbound selling efforts. The broker and agent channel is stressed as well, with health plans needing to make sure brokers have plan and price information well before the start of open enrollment and are trained adequately on product and benefit changes. Online quoting and enrollment portals are also stressed from a volume perspective with much more activity. If not designed properly, overflow from these stressed portals can result in an increase of call volumes due to customer inquiries.

While these problems are magnified during open enrollment, they are not unique to the open enrollment period. With all this pressure and activity, there are a few simple things all health plans should do to make the enrollment process smoother.

  1. Use Simple Language
    Health plans have a fondness for acronyms, which, while intended to make things easier to remember, often cause more confusion. Companies should avoid health insurance jargon and explain things in a way that everyone can understand. Let's face it, health insurance is not fun to shop for, and most people spend very little time doing it every year. While there is a legion of Apple devotees that can already recite all the features of the new iPhone, few people have a need to remember healthcare details from year to year. Make the language as simple as possible and offer easy to understand definitions, as well as examples of how the cost and mechanics of a plan work. A little simplicity and basic storytelling go a long way.
  2. Make Things Easy to Find
    Nothing is more frustrating when you are shopping for a health plan than having to navigate a labyrinth of multiple screens to get to the information you're looking for. There is often a valid reason for taking customers down a prescribed path where they are forced to enter in some basic demographic and income information. This helps them get to the best representation of plans available and what their actual price would be after subsidy. However, health plans could take a cue from Healthcare.gov, and provide an option to skip the entering of income information and jump straight to previewing the plans. Previewing the plans lets the member start window shopping right away without being burdened by the official shopping flow. If information is not easy to find, people will give up and go somewhere else.
  3. Make Plans Easy to Compare
    When customers finally arrive at the plans page, they are faced with a multitude of options. Health plans need to offer more intuitive questionnaires that help customers narrow down their options based on their medical history and estimated usage. Sorting and filtering plans are table-stakes, but plans can do a much better job in allowing customers to view side-by-side plan comparisons.
  4. Staff Appropriately in All Channels
    Health plans have the data that tells them which distribution channels their customers are buying through (online vs. broker. vs. tele-sales agent). Based on this research, plans need to mobilize their technology platforms and people resources appropriately to match the anticipated volumes. It is important to note the difference between where people shop vs. where they buy. Research shows that people use online portals for comparison, but many want to talk to a live person when enrolling, usually to ask follow-up questions and ensure they understand what they're purchasing. The "shopping" vs. "enrollment" activities are different and need to be accounted for.

None of these themes should be revelatory, but they are too often taken for granted and, therefore, not upheld. So, if your organization is in need of help, we are here! While this year's open enrollment resources should already be flushed out, planning for next year has already begun. HGS & Colibrium offer a wide variety of health plan solutions including quoting and enrollment platforms, healthcare specific CRM applications, and a vast array of business process outsourcing services with extensive experience in the exchange markets. Our solutions help health plans manage their business better, resulting in lower cost through efficiencies, increased revenue and a better overall customer experience. So, let's all buckle up for another exciting and hopefully smooth O.E. period. Oh! Eeeee!