Five Priorities for Optimizing Health Plan Annual Enrollment

The Annual Enrollment Period comes around every year like clockwork for Medicare and Healthcare Marketplace coverage, as well as other health plans. This is a vitally important time of the year for every health insurance plan. The success or failure of an organization at maintaining enrollment and attracting new members can have a significant impact on its bottom line. Many plans commit a tremendous amount of effort and marketing resources as they work to grow membership, as well as retain members from the current year.

At the same time, the extra support needed to assist members investigating or changing plans creates a steep spike in human resources needs. Plans and the member care providers serving them commonly work very hard to hire and train the qualified teams necessary to handle large volumes of member inquiries. Moreover, just answering the call isn’t enough; every existing or potential member contact needs to be approached with professionalism, commitment, and compassion.

Five Priorities for Optimizing Health Plan Annual Enrollment

When annual enrollment occurs, here are five strategies that health plans should implement to maximize member experience and operational success during this crucial time.

1. Prioritize members facing disruptive plan changes and be ready with comparable plans.

Be prepared for heightened emotions among members faced with big changes in their health plans. Being proactive about helping members identify and choose solutions to a difficult problem can be a big winner when it comes to the quality of their enrollment experiences.

2. Emphasize plan value rather than just price.

Cost is only one of the important data points relevant to choosing a health plan. Develop support language and messaging around the benefits of a plan that encourage members to consider more than just what they will be paying for it.

3. Encourage members to use all of their benefits (gym memberships, mail order pharmacy, etc.) to stay healthy.

Health plan benefits work together to promote members’ wellness, which is good for everyone involved. Members who use a broader range of benefits are typically healthier, which is advantageous to the plan’s bottom line and operational performance.

4. Communicate marketing plans to maximize return on that spend.

Ensure that everyone involved in support is in the loop and using key messages developed to explain plan details. A best practice that pays off is for enrollment assistance to echo and reinforce the vetted, specialized language used to promote a health plan’s value.

5. Consider a triage approach to reduce licensed agent demand and maximize their output.

By necessity, highly skilled licensed agents earn a higher rate and are becoming harder to hire. Structure annual enrollment support so that these staff members are brought in for the highest possible value functions, not just to answer general member questions. When it makes sense, incorporate support hand-offs to use expertise most effectively.

Ultimately, annual enrollment requires the same kind of empathy-based support that health plan members deserve and receive throughout the year. Support needs to be delivered by advocates, rather than agents, who look beyond the transaction to provide ongoing healthcare advocacy that centers around the member or patient and is laser-focused on helping them throughout their health journey. Annual enrollment needs to be another opportunity to put the member at the center of an interaction that is grounded in competency, confidence, and compassion. This is how to begin making a difference in someone’s life from the moment they enroll.