E-Commerce Solutions for the Individual Market

The Affordable Care Act created a renewed emphasis on a previously underserved segment of the insurance industry: the individual market.  Since its passage, insurance companies have been challenged to engage individual customers, while controlling (if not reducing) overhead costs.  The difficult part of this call to action is that individuals have unique needs when it comes to buying insurance on their own:

  1. Shopping for insurance without an employer can be stressful and confusing.
  2. Managing your account and reporting life changes can a complex and time consuming process.
  3. Making premium payments is yet another bill to keep track of and manage.

If not properly addressed, the needs of the individual market can lead to burdensome manual processes and long-term increased spending.

Any solution should start with an attractive, easy to use shopping experience.  Customers should have an opportunity to get to know the organization, its values and offerings.  They should be able to compare important plan information such as premiums, coverage levels and deductibles.  Once a plan is selected, customers should be able to submit an online application in a matter of minutes.  Applications should be easily captured and shared for enrollment in back-end business platforms.

Once enrolled, members should be empowered to manage their accounts with self-service tools that allow them to update contact, demographic and payment information.  When members experience life changing events, they should be able to add/remove plan participants with ease.  All of these changes should be synced with back-end business platforms to facilitate efficient claims payment.

Payment collection features should recognize that some members are going to have difficulty paying premiums in full and on-time.  Administrators should be empowered with solutions to effectively record, communicate and resolve a failed payment.  If payment is not provided on time, administrators should have the necessary information to make decisions regarding an individual’s enrollment status.

Product owners should tackle these challenges head-on with a blend of both process and technology.  The business consultants and deep technologists at West Monroe Partners can work with your team to design, build and implement E-Commerce solutions that engage customers, drive sales and reduce administrative burden.

Tyler Moeller is an Experienced Consultant in the Customer Experience practice with a focus on the healthcare industry.

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Phone: 312-602-4000
Email: marketing@westmonroepartners.com
222 W. Adams
Chicago, IL 60606
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