By: John Zimmerer, VP Healthcare Marketing at Smart Communications

Health payers are always looking for ways to streamline health insurance policy renewals. That’s because the process of renewing a health insurance policy varies widely by line of business. Everything from the set of communications and documents required to how a plan is offered differs from Medicaid to Medicare to ACA-compliant to group plans.

In this post, we look at ways health payers can streamline health insurance policy renewals, saving substantial time and money in the process.

Complying with Rules and Regulations

Some elements of the renewal process are dictated by federal and state governments. For example, in the U.S., Congress, CMS and HHS have a lot of influence on Medicare and ACA-compliant individual plans and supporting materials. And each state puts its own seal, so to speak, on Medicaid offerings. Payers can expend a lot of effort and spend a lot of money each year updating thousands of Medicare and Medicaid templates due to regulatory changes.

Regardless of market or plan type, health insurers need solutions for building and maintaining policy documents and plan communications that:

  • Enable business users to create and update templates without relying on IT
  • Leverage reusable content across plan types wherever possible to minimize overhead
  • Use conditional logic and variables to drive the inclusion of words, paragraphs or sections
  • Separate brand and style elements from content to make managing multiple brands easier
  • Include review, commenting and approval capabilities to accelerate workflows
  • Can evaluate content and recommend changes based on readability, tone and more
  • Include regression testing to ensure all possible iterations are generated
  • Provide delivery channel (digital and print) flexibility in the design process
  • Can orchestrate delivery across channels, including providing fail-over capabilities
  • Can be deployed entirely in the cloud or in a hybrid model

Speed and agility are essential to health insurers. Getting new plans through regulatory reviews and out to market quickly means processing more renewals, keeping more customers, maintaining underwriting margins and meeting mandated enrollment deadlines. This is especially important for Medicaid and Medicare Advantage plans which have seen enrollments surge in recent years.

In order to operationalize this speed and agility, it’s imperative for insurers to understand their content and where it lives. A visual relationship map of their content can help to accomplish this as well as manage risk. The relationship map helps template administrators understand the shared content objects that make up their templates. When a shared object needs to be updated (e.g., a logo, a signature, a disclaimer, a snippet of text), the changes are automatically applied to all templates that use that object. Using a visual relationship map, template administrators will know in advance which templates will need to be reviewed and approved.

Payers also want to minimize the risks inherent in the renewal process. Missed delivery dates can result in fines and penalties. Errors that creep into the documents can increase print and postage expenses. And enough bad experiences for members can and do translate into lower STAR ratings.

Solutions Trusted by Leading Health Insurers

Our solutions, professional services and partners have already helped dozens of health insurers simplify the task of creating and maintaining the full array of policy renewal assets, including:

  • Annual Notice of Change (ANOC)
  • Evidence of Coverage (EOC)
  • Pre-Enrollment Checklist (PECL)
  • Notices (e.g., Notice of Privacy Practices, Disenrollment Notices, Non-Renewal Notices)
  • Provider and Pharmacy Directories
  • Summary of Benefits and Coverage (SB and SBC)
  • Summary Plan Description (SPD)

These materials are often based on model documents for each plan type. Insurers need a solution that can import model documents in Microsoft Word or PDF to use as a starting point.

Insurers often need to support multiple brands. Modern customer communications management (CCM) solutions employ a layered model that separates content from styling and branding and maximizes the use of reusable objects. This allows the same content to be created once then used across multiple plan documents. This also simplifies translation efforts and minimizes the effort to comply with accessibility standards.

Plan documents frequently need to go through multiple levels of internal and external reviews. Modern CCM solutions incorporate workflow functionality that can bring internal and external stakeholders together to review, comment on and quickly revise plan documents to get them to market quickly.

Streamline Health Insurance Policy Renewals

Smart Communications has helped to streamline health insurance policy renewals for leading insurers that rely on its ISO-certified and HIPAA-compliant Conversation Cloud™ platform. We have helped to increase their efficiency as much as 80% and lower the cost to produce renewal-related materials by 50% on average.

Contact us to request a demo to see how we can simplify health insurance policy renewals for you.