Carriers’ Post-Health Reform Success lies with Compensation Management and Customer Relationship Management Technologies


There has been much talk about the changes that the Patient Protection and Affordable Care Act (PPACA) will bring to the way health plans operate. In a previous blog post, we mentioned a few points that could influence decision-making and alter existing processes for health insurance organizations. Of these points, maintaining a medical loss ratio (MLR) of 80% for individual and small-group products seems to have taken a foremost role in restructuring the business processes of health plans.

MLR Measures Depend on Compensation Management 
This article in the AIS’s Health Business Daily points out how some health plans are already beginning to restructure the way they pay their brokers and agents in an effort to reduce the percentage of premium dollars that go toward commissions.

Conversations with a few of our clients have brought out similar stories on their plans to change commission structures, and how incentive compensation management technology will be an integral factor in allowing them to be responsive and move quickly on these necessary business decisions.

With compensation management technology, carriers can quickly restructure commissions and compensation plans, communicate these changes to their agents and update credentials and appointments, to quickly put new strategies into action.

CRM Is Essential to Compete in a Widening Market
Another PPACA mandate that insurers are bracing for is the large number of potential insureds that will be flooding the marketplace. As the potential customer base grows, competition for market share will be fierce. To succeed, carriers’ customer service must be top notch. 

Advanced CRM technology helps carriers establish an enterprise-wide customer service orientation, improving service and sustaining market share.  According to Adam Honig, President and CEO of Innoveer Solutions, “Insurers With the Best CRM Will Win”. He cites five main areas that carriers should focus on to improve customer service, including implementing “CRM systems that provide [insurers] with a complete view of a member as well as their requirements.”

In his own words, “Insurers that excel at member service will continue to attract more customers and build their bottom line, enabling them to make their services even better.”

With the right package of compensation management and CRM technologies, insurance carriers will be well-positioned to react with agility to the realities of reform and successfully contend with increased competition.


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