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Outclass the competition.

The ACA’s industry-wide expansion presents a chance for carriers to invest in improving enrollment and renewal rates, ensuring they stay at the forefront of the competition.

Competing on pricing alone is challenging. However, successful plans also dedicate resources to the smooth flow of technical and operational processes, which directly affects member experience. A seamless user journey, efficient back-end processes, and member-centric capabilities are vital for membership growth and retention.

One ACA plan successfully tackled these challenges by taking a phased approach to enrollment & billing management.

Phase 1: Streamlining enrollment processes for rapid growth

Carriers are stepping up their user journey. Are you prepared to compete?

In a market that revolves around consumers, carriers are facing growing difficulties in capturing and retaining members’ interest. And let’s not forget the significance of first impressions.

The enrollment experience is the deciding factor for many.

One national carrier was able to scale their membership by automating enrollment through nightly file processing. Not only did individuals gain faster access to their benefits, but the carrier was able to enroll more members with less manual effort.

Phase 2: Transitioning to an end-to-end enrollment & billing platform

Financial reconciliation is a headache for many carriers.

Tricky data integrations, changing policies, and a countless number of exceptions can make reconciliation a complex and costly process. Carriers that don’t nail down financial reconciliation can experience inaccurate terminations and unhappy members.

After using Softheon exclusively for enrollment processing for two years, this national plan expanded the scope to include end-to-end enrollment, billing, and payment processing.

Financial reconciliation now happens in near-real time with limited manual inputs.

After the change, membership growth on the unified platform skyrocketed to over 300% more than the industry average at the time. The carrier was no longer reliant on trying to patch together multiple systems.

Check out the full use case to see how this united enrollment & billing platform improved renewal and effectuation rates.

Phase 3: Setting yourself up with technology that scales

Change in the ACA is constant. To keep up, carriers need adaptable technology.

This carrier continues to expand into different states, regardless of the type of Exchange. However, supporting both the Federally Facilitated Marketplace and State-Based Exchanges can create complications internally.

The carrier successfully entered multiple new states with platform flexibility. To keep enrollments accurate and compliant regardless of Exchange, Softheon provided a customized enrollment file for each state.

To learn more about how a national carrier consistently outperformed in the ACA market, download our use case.