Close Close
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards

Life Health > Health Insurance > Health Insurance

PPACA: The exchange contact centers

Your article was successfully shared with the contacts you provided.

This summer, the Obama administration and Enroll America have organized aggressive campaigns to encourage eligible Americans to enroll in health coverage through the new Patient Protection and Affordable Care Act’s (PPACA) online health insurance marketplaces.

By 2016, it is predicted that more than 25 million people will use these exchanges to buy health insurance.

With the marketplace open enrollment period beginning Oct. 1 and running through March 31, insurance agents and brokers should keep in mind that contact centers will be on the front lines of the PPACA rollout.

The contact centers must offer members and prospects access to live agents with the correct policy and plan options available, and answers for the many questions that consumers will surely ask.

While the marketplaces will be new frontiers for managed care, many contact centers have deep health care expertise, including experience with the start of the Medicare Part D program, and they are well-qualified to help individuals navigate the complexities of health insurance and buy the right plan.

For many Americans, shopping through these marketplaces will be their first experience with buying health insurance.

Leading up to and throughout this open enrollment period, contact centers will be focused on optimizing their efforts in the following five areas:

  • Agent training programs – Before the beginning of the enrollment period, call center agents will go through comprehensive agent training programs with stringent quality assurance standards. Agents will be trained to perform across multiple platforms, coached to attentively listen to customers, and empowered to help customers make decisions. They will continue to go through additional training and education as necessary throughout the enrollment period.
  • Compliance – To protect data safety and security, contact centers will focus on compliance and employ a full range of physical and operational systems and networks. The centers understand how critical it will be for them to be knowledgeable about – and 100 percent dedicated to following – all local, state and federal laws and regulations under PPACA.
  • Utilization of integrated technology platforms – A contact center should always act as a natural extension of a company and brand. To deliver a seamless experience, a contact center needs to make sure that its tools, such as its customer relationship management (CRM) systems, are fully integrated with the in-house operations of the exchange. Direct access to data will make the system easier for the agents to use and improve the quality of agent interactions with the consumers who are buying the health insurance.
  • Scalability – When the marketplaces open, contact centers will be faced with the challenge of nimbly ramping agent capacity up or down based on demand. They will need to deftly handle deviations from forecasted volume to ensure proper service levels and low hold times.
  • Quality reporting – Reporting protocols will be set before the start of the enrollment period and employ a custom technology application, such as a dashboard that lets all authorized individuals see and evaluate program performance data in real-time. 

Full transparency of performance data and analytical information can help exchanges and insurers track progress rapidly, and adjust program protocols rapidly, if necessary, to achieve business objectives.

See also:


© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.