Blue Shield California
Enrollment Platform
The Problem.
The Blue Shield California enrollment process is disjointed, time-consuming, cumbersome to navigate and lacks transparency resulting in customer frustration and distrust
The enrollment process is primarily manual, complex, variable and incapable of scaling.
Biggest Take Aways.
Paper - based processes and business rules
Disjointed systems with out-of-date integration requiring “human glue”
Heavily reliant on manual workarounds and processing
Transforming the experience.
The platform goals
•Single platform – seamless and easy Broker and Employer experience across full lifecycle (new, renewal and maintenance)
•Streamlined enrollment processes – eliminate inconsistencies and errors of manual processing
•Automated, accurate enrollment & underwriting
•Broker/Employer self-service and transparency
•Faster turnaround and near real-time confirmation
•Improved data quality
•Satisfies market demand for digital experience
•Foundational to future innovation and market shifts (3rd party broker integration, direct to employer…)
The financial goals
• Increase sales and retention by 1% for 3 years
• Significant Admin Savings:
• Reduce broker and employer calls by 24%
• Increase straight through automation to 95%
• Deliver broker / employer self-service and eliminate manual (paper) processing
– achieve 95% digital adoption
• Reduce corrective processing and system fallout
• Lower IT and business operational costs (consolidate technologies)
• Future speed to market and business agility (expect reduced ongoing maintenance costs)
The multiple systems used before we created the Enrollment Platform
Phase 1 Outcomes
“[The tool is] very user friendly. It matches the Master Group Application exactly so
this is easy to do.”
“The process is so fast once you’ve submitted one or two groups. I did one the other
day in 10 minutes!”
“Very slick!
“Are you kidding me! I LOVE IT! So easy and fast!!! Nice work BSC!”