Do More Than Survive AEP

How quickly another Annual Election Period (AEP) is upon us.  This time of year is the perfect time to review your new member onboarding activities and AEP strategy.  We all know the sale doesn’t end when the application is turned in and membership begins.  This is where the rubber hits the road.

These are the four questions to consider going into AEP:

  1.  Are all plan resource documents updated with the 2016 plan benefits?  Picture this: A friend newly eligible for Medicare recently enrolled in a Medicare Advantage plan.  He experienced a benefit problem that nearly ended in a sales allegation all because a representative was relying on outdated benefit information.  This would have been avoided if everyone at the plan had the new benefit designs.
  2. Does health plan staff see the big picture?  It’s easy for us to focus on our individual operational components.  After all, the number of regulations and processes to manage a compliant Operations Department is significant and takes our full attention, but the big picture allows for cohesive programs and the ability to see what part we play.  Does Enrollment know the top issues that Reconciliation experiences?  Is there a feedback loop established to catch improvement opportunities early as we move into AEP?  Has Sales shared the advertising schedule and advertisements with Customer Service?  Customer Service can maintain that strategy and answer member questions about the campaigns for 2016.
  3. Are operational oversight tools in place?  Not only should all operational staff know the requirements governing their processes, they should know how to tell they are meeting those requirements.  The ability to oversee our own processes and know we are in compliance is empowering.  Not only can corrections occur immediately, but staff can be confident and efficient, focusing on the important actions supporting new and existing members.
  4. Is everyone focused on the goal — ensuring a positive member experience?  If applications are incomplete, is the Enrollment staff focused on sending a letter to get the application off their plate or focused on reaching out to the member to complete the member enrollment?  Are welcome calls in place to answer any lingering questions and ensure new members feel confident and engaged in their plan choice?

AEP was quick to arrive—it will be equally quick to come to an end.  Make sure it’s the AEP you designed rather than the AEP you survived.



In Operations, we naturally focus on our own internal processes and efficiencies, but now is the time to invest in making sure staff knows how their contributions impact members and the health plan.  Gorman Health Group’s experienced Operations team can work with you to set up strategic, efficient, and knowledgeable operations.   We’ve been in your shoes and know how to navigate through AEP. Visit our website to learn more >>

Join us on Friday, October 9, from 1-2 pm ET, as John Gorman, Founder & Executive Chairman at Gorman Health Group (GHG), examines the state of government healthcare programs and outlines proven tactics market leaders are implementing to cut costs, increase member satisfaction, and drive sustainable growth. Register now >>

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