Despite being a core business process, quote to card remains a major pain point for most health plans. Many health plans still run a paper-based, manual process, which significantly slows down enrollment and leaves providers prone to error. Some have digitized their process but rely on multiple, disparate systems, thereby creating silos that prevent one department from sharing data and analysis with the next. Both of these situations are problematic because quote to card has a direct impact on health plan sales — and without a streamlined, interconnected process, it’s impossible to reduce costs, increase efficiency, and improve service.

And that’s without the added pressures of changing regulations, increased competition, and a rapidly growing health insurance market — with so much stacked against them, what are health plans to do?

We’ll give you a hint: Modernize the quote-to-card process.

The 6 Steps of the Quote-to-Card Process

Transforming the Quote to Card Experience Supporting Graphic

Before we get into modernization, let’s first make sure we have a clear understanding of the different steps that comprise the quote-to-cash process.

  • Step 1: A health plan receives a request for proposal (RFP) from a broker on behalf of their client (typically a company looking purchase a group plan for its employees). The RFP details the client’s expectations and requirements, such as dental, vision, pet insurance, an FSA and/or HSA, and so on. Using this RFP as a framework, the health plan provider pulls different products from its catalog in order to create a custom benefits package and quote for the client. The health plan then shares this quote with the broker.
  • Step 2: The broker presents proposals from various different health plans to the client. The client chooses the proposal that best meets their needs.
  • Step 3: The broker acts as a liaison between the client and the health plan provider as they work out the details of the benefits package.
  • Step 4: Once both parties are happy with the benefits package, the client completes the purchase. The health plan provider puts together packets for each tier of the plan, and the client sets up plan information so that individual employees can begin enrolling.
  • Step 5: Open enrollment, which typically kicks off in the fall and wraps up around New Year’s, begins. The health plan closely monitors employee enrollment.
  • Step 6: Open enrollment ends, and the health plan issues cards to each of the client’s employees who opted in.

Transforming the Quote to Card Experience Supporting Graphic

You’ll notice that brokers play a key role in this process — in fact, 88% of companies use a broker to buy healthcare plans. In order to do their job effectively, brokers need to understand the processes different health plans use for building quotes and servicing clients, which can be a tall order given the fact that most brokers work with multiple clients and present proposals from several different health plans to each of those clients. Similar to health plans, brokers are also subject to industry regulations, making their jobs even more challenging.

Relationship building plays an important role in the health insurance market. In order to be successful, health plans need to attract brokers’ business and retain their support; the easiest way to achieve both of these goals is to make a broker’s job as simple as possible by taking a connected, modernized approach to quote to card.

What Does It Mean to “Modernize”?

When we say that health plans need to modernize quote to card, what we’re really saying is that health plans need to adopt systems that support data analytics and automation in order to enhance quote to card.

Simply by virtue of what they do, health plans have access to a wealth of information in the form of product data, company data, member data, historical data, and so on. Unfortunately, many health plan providers are unsure of how to put this data to good use and, as a result, it remains untouched, tied up in a variety of disparate systems. Data analytics helps solve this problem by providing health plans with data-driven insights into what they’re doing well, where there’s need for improvement, and how to improve in a meaningful way.

For example, let’s say a client’s group plan was up for renewal but rather than renew with their existing insurer, they decided to switch to a different health plan. Without data analytics, the insurer would have no way of knowing why its client opted not to renew and would be prone to repeating whatever mistake it was that drove them away. With data analytics, however, the insurer could review historical data, narrow down the reason why it lost the client, and get targeted recommendations on what it might do differently the next time a client comes up for renewal to incentivize them to stay. For example, the insurer might extend the client’s coverage options, add new plan features, or even offer a more customized plan.

And that’s just one potential use case — other ways to leverage data analytics include:

  • Monitoring plan performance
  • Identifying cross-sell and upsell opportunities based on membership needs
  • Reducing operating costs and pursuing revenue growth opportunities
  • Improving the member/customer experience
  • Understanding coverage trends based on industry and/or region
  • Reducing regulatory and compliance risk
  • Developing competitive strategies
  • Enabling a more efficient quoting process for brokers

Transforming the Quote to Card Experience Supporting Graphic

Once a health plan has optimized its quote-to-card process using data-driven insights, the next step is to find ways to drive efficiency through automation. At a very basic level, this involves digitizing manual processes to reduce the risk of human error and accelerate the quote-to-card lifecycle; at a more advanced level, it involves plan optimization and better member experiences. Automation can be used for just about everything, from generating custom quotes to tracking where a client is in the quote-to-card lifecycle to monitoring employee enrollment.

A Truly Modern Quote-to-Card Solution

Modernizing quote to card requires investing in the right solution — namely, a customer relationship management (CRM) system with quote-to-card capabilities. That’s why we’ve built Hitachi Solutions Engage for Health Plans.

Engage for Health Plans is a purpose-built system designed to help health plan providers centralize systems, automate processes, provide self-service functionality, and move to the cloud in order to speed operations and improve data accessibility, consistency, and accuracy. Built on top of Microsoft Dynamics 365, the most powerful CRM solution on the market today, Engage for Health Plans includes innovative quote-to-card features, including a benefits library, benefit catalog, broker portal, and group and individual sales management tools.

The benefits library enables health plan providers to store detailed plan records and new product data within a single, centralized repository. With everything in one place, health plan sales representatives have an easier time developing custom plan packages to deliver to brokers by simply picking or choosing products from the benefit catalog.

The broker portal, which is built on a Microsoft Azure Portal Framework and is designed specifically for health plans, grants brokers easy access to everything they need to configure a quote. This portal enables brokers to run reports on a variety of metrics and utilize rich analysis and segmentation tools to target the best prospects both inside and outside a plan’s existing client base.

Ultimately, Engage for Health Plans streamlines the quote-to-card process by enabling health plans to offer existing and prospective clients the most appealing quotes possible and using CRM data to optimize member onboarding and renewals and offer more targeted service, thereby driving higher retention rates.

The Quote-to-Card Process in Action: A Case Study

When MVP Health Care, a nationally recognized, not-for-profit health plan, needed to leverage technology to improve its quote-to-card process, Hitachi Solutions recommended Engage for Health Plans. Engage for Health Plans is our purpose-built relationship management system, designed specifically for health plans and built on top of Microsoft Dynamics 365. Engage for Health Plans’ core quote-to-card functionality provides users with a holistic view of all data within a single system for superior opportunity management, group and individual segmentation, lead management, and more.

We started the project by first focusing on sales for small groups, primarily through brokers. In the past, the MVP Health Care used disparate legacy systems to monitor sales and marketing data, which prevented it from gaining true visibility into essential business processes. MVP Health Care’s team of brokers also quoted sales manually, entering information into spreadsheets and emailing it to the health plan — or worse, handwriting paperwork, scanning it, and sending it electronically. This approach not only prevented brokers from quoting accurately and at speed, it also prevented the company’s internal sales team from monitoring broker interactions.

Hitachi Solutions used Engage for Health Plans to develop a fully automated quote-to-card solution and custom broker portal on top of Microsoft Azure. Although MVP Health Care originally anticipated that it would take weeks to train its team of brokers to use the system, the portal was so user-friendly that training only took two days, saving the company significant resources.

We also implemented MVP Health Care’s group benefits library, which contains all of the information about the health plan’s product offerings. Using the group benefits library, internal users can now create products, which are automatically published to the broker portal; brokers can use this new product information to configure quotes.

Based on the success of the small group sales product, MVP Health Care is now moving to extend its broker portal capabilities to other lines of business within its sales department. That’s the power of automation, the power of the Microsoft platform, and the power of Hitachi Solutions.

Ready to optimize your quote-to-card process? Contact Hitachi Solutions today to find out what we can help you achieve.