SaaS Saves CareFirst $200,000 Annually With Online Enrollment

With broker requests for online enrollment in the small-employer market escalating, CareFirst needed a new technology platform. "We were already establishing an online enrollment solution for the 200-plus employee market, in partnership with another Blue plan," explains Shekar Subramaniam, associate VP of broker sales for the mid-Atlantic BlueCross BlueShield insurer. "But our brokers were clamoring for paperless enrollment and transactions for the under-200 market because it's where the bulk of the volume is."

Starting with a clean slate in late 2006, Owings Mills, Md.-based CareFirst narrowed the list of available benefits enrollment and management options to a handful of vendors. Then, in early 2007, the evaluation team heard a presentation for a software-as-a-service-based solution from Benefitfocus (Charleston, S.C.). "[We] looked at each other and said, 'Why aren't we doing this?' " recalls Subramaniam, who says the solution offered the desired technology tools and Benefitfocus had extensive Blue plan experience.

Once a deal for the enrollment portal, branded CareFirst Connect, was inked in mid-2007, a cross-functional implementation team was formed and various underwriting requirements were ironed out. "Unlike other Blue plans, we operate in three jurisdictions," Subramaniam notes. "Because guidelines and ratings differ in each jurisdiction, we had to systematically define rules and establish eligibility requirements."

By early 2008 CareFirst ($3.5 billion in total assets) started IT integration and broker training. On the technology side, Subramaniam reports, an existing under-utilized B2B server farm was programmed to communicate with Benefitfocus. Essentially, he explains, Web servers at both companies communicate with each other via XML, passing requested data from CareFirst's internal systems to Benefitfocus whenever brokers log into the Connect platform to work through enrollment-related chores.

For broker training, CareFirst leveraged the Benefitfocus Video as a Service offering to create and distribute on-demand training videos. Benefitfocus captured detailed data about which training segments a broker completed and sent the information to the CareFirst sales team. According to Subramaniam, this provided sales staff with specific reconnaissance information and eliminated weeks of road shows for the CareFirst trainer, who spent only two days in the vendor's insurance-dedicated production studio creating the training videos.

Working the Kinks Out

After completing a successful test migration in November 2008, mass conversion of CareFirst's approximately 19,000 small-employer groups (two to 50 employees) began in January 2009. But two challenges quickly emerged, Subramaniam acknowledges. First, brokers received errors, which were traced to incorrect code mapping at Benefitfocus.

Although the vendor soon corrected the mapping errors, brokers were more concerned about a new re-enrollment requirement, Subramaniam recalls. "Since hundreds of small businesses have no changes from year to year, our brokers were dissatisfied with required re-enrollment," he says. "In the end, we implemented passive enrollment as the default option across the entire employee spectrum because it was more efficient and just made common sense."

By mid-2009 all small-employer groups were on the system, and the remaining employer groups were migrated as their renewals occurred. By January 2010 every existing account was converted and, according to Subramaniam, the rewards swiftly piled up.

"Errors have dropped by 15 to 20 percent, and, at the same time, we've reduced enrollment processing turnaround time by two days," reports Subramaniam. "We've already seen a staffing savings of approximately $140,000, and our paper costs have fallen by about 70 percent, which is about $60,000 to $75,000 annually."

Broker satisfaction also is soaring. "Our service calls from brokers have dramatically decreased," Subramaniam says. "In addition, brokers tell us they are seeing real benefits because they're dedicating more time to sales and less to managing paperwork."

In short, going paperless is proving transformative, Subramaniam says. "Enrollment and transaction bottlenecks have essentially been eliminated," he notes. "And brokers in our distribution system are happy. Those are big wins for us."

CASE STUDY SNAPSHOT

Company: CareFirst, Inc. (Owings Mills, Md.; $3.5 billion in total assets).

Lines of Business: Health.

Vendor/Technology: The Benefitfocus (Charleston, S.C.) SaaS benefits enrollment and management platform.

Challenge: Establish paperless enrollment capabilities for insurance brokers.

Anne Rawland Gabriel is a technology writer and marketing communications consultant based in the Minneapolis/St. Paul metro area. Among other projects, she's a regular contributor to UBM Tech's Bank Systems & Technology, Insurance & Technology and Wall Street & Technology ... View Full Bio