Open Enrollment Essentials: How to Build Lasting Relationships with Members

Last year, the Affordable Care Act’s first open enrollment period delivered a wake-up call to many health insurance companies. Insurers who are accustomed to serving large employer groups learned that competing for individual customers requires a different approach to marketing and customer care. With the 2016 health insurance open enrollment period quickly approaching, the pressure is on insurers to further improve their strategies for retaining members and attracting new customers. This is particularly important for engaging individual health plan buyers who prefer to compare plans and rates. As such, health insurers need to cater more effectively to individual customers and address their needs and preferences.

The Obama administration set a goal for nine million people to sign up for health insurance last year, which the administration surpassed. More than 10 million people have insurance that they purchased through the Affordable Care Act’s exchanges, according to the Department of Health and Human Services.

However, insurers learned that the individual consumer market wasn’t as profitable as the market for employer groups. From what we’ve heard from clients and in the media, it turns out many new customers need more care than expected and payers across the U.S. plan to increase their rates for the next enrollment period. Rate increases will, of course, impact consumer choices, but there are other ways for insurers to compete beyond price.

Here are three tips to keep in mind when preparing for the 2016 open enrollment period and beyond.

Be Transparent

As consumers shop for health plans, information transparency will be critical for winning new customers as well as retaining members. People want to have a clear understanding of what is and isn’t included in their coverage. Make it easy for consumers to find this information on your company’s website or when speaking with a representative. While some customers prefer to do their own research online, many still want that human connection. Making associates available to quickly answer consumers’ questions about their options over the phone can be a huge differentiator.  

Gather Intelligence

To retain members, insurers must focus on the full end-to-end customer journey. There are many ways to do this, but our view starts with understanding the customer’s needs and preferences. There’s still very little data available about the needs of individual health plan buyers but companies should start by building on information from last year’s open enrollment period. This data is critical for identifying patterns in new members’ shopping behavior and expectations. For example, many people prioritize convenience and a company may learn that members prefer to access their member ID card through a mobile app, based on customer feedback and other insights.

Personalize the Experience

Building a one-to-one relationship with members is also crucial but it’s not something payers focused on in the past. Data management solutions can help payers streamline member information and bring a new level of personalization to its interactions with members.

While the individual consumer marketplace offers new opportunities to gain members, payers still have a long way to go in adopting a customer-centric mindset. It’s tempting to try doing everything at once, but remember that building customer relationships takes time. 


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