Managing Health Insurance
Marketplace Sales with Tuo® 360
and Business Process Outsourcing
Large healthcare organization turns to business process
outsourcing, as well as Tuo® 360, a CRM overlay from
Colibrium, an HGS Company, to upgrade its sales
infrastructure as it moved into the newly created
Health Insurance Marketplace
A healthcare organization that delivers health insurance solutions for the under-insured and uninsured in more than 20 states saw
the need to upgrade its sales infrastructure as it launched products in the newly created Health Insurance Marketplace. The health
plan turned to business processing outsourcing (BPO) through Customer Interaction Services (formerly Colibrium Direct) from
parent company HGS, as well as Tuo 360®, a CRM overlay designed specifically for the health insurance industry. With the BPO
solution and Tuo 360® in place, the health plan was able to:
•
•
•
Stand up an entire sales staff across the United States in a completely new insurance market and in time for open enrollment.
Improvements in sales metrics, including efficiency and close rates.
Meet the demands of open enrollment across multiple states.
The Challenge
As the company began to design Marketplace plans on its managed Medicaid
infrastructure, its leaders recognized that the internal sales team was not equipped
to manage the new product line. The in-house sales staff lacked experience in
direct-to-consumer sales. Furthermore, the team wasn’t large enough to address the
sales volume of the Marketplace’s open enrollment period. Instead, managing openenrollment for the new plans would necessitate a staffing-up and staffing-down
approach to sales.
The company’s in-house CRM, designed for member services rather than lead management, also didn’t fit the needs of the new Marketplace product line. Company
leaders wanted to retain this member services tool but did not want to build sales
and marketing functionality into the solution.
To operate efficiently in the Health Insurance Marketplace, this organization needed
a staffing solution that could adapt to the cyclical nature of the market, as well as a
CRM solution that the sales team could rely on to manage the direct-to-consumer
sales process.
“We expect to grow the
Marketplace product
line, so we know that
we have to continue to
get more efficient with
BPO processes. We look
to Tuo® 360-driven
enrollment to deliver
greater efficiency and
per-person capacity to
our sales organization.”
The Solution
The company turned to business processing outsourcing (BPO), an end-to-end sales platform that includes U.S.-based telesales
and Tuo 360®, a CRM overlay designed specifically for the health insurance industry. Colibrium’s licensed sales staff—exclusively
dedicated to the health insurance market—handles direct sales, enabling internal sales staff to focus on oversight and channel management. With this BPO solution in place, the company has the flexibility to staff up and staff down to meet the demands of the
Marketplace’s open enrollment period across multiple states.
Tuo 360®, tightly integrated with the call center telephony platform, delivers reporting and analytics that enhance the company’s
ability to make strategic sales and marketing decisions. The company’s teams use Tuo 360® not only to manage the sales pipeline
but also to understand how marketing efforts drive consumer interest.
Results
Together, Colibrium and the healthcare company stood up an entire sales staff across the United States in a completely new insurance market. “Colibrium had the sales staff and Tuo 360® solution ready and in place for open enrollment. That’s no small feat
when you’re addressing the Health Insurance Marketplace for the first time,” said the company’s Director of Sales. Most importantly,
the BPO solution solved the health insurer’s critical challenge of staffing up to meet the high sales volume of the Marketplace’s
open enrollment period.
Because direct-to-consumer sales in the Marketplace were a new phenomenon, the company isn’t able to assess whether the BPO
solution improved its sales processes in the first year. However, in the second year of operating in the Marketplace, the company did
experience improvement in its sales metrics, including efficiency and close rates.
The Director of Sales attributes this success to Colibrium’s flexibility and partnership mentality. “Colibrium approaches our business
relationship as a partnership,” he explained. “We work closely with them to communicate our expectations, assess projections, and
understand how they can adjust and flex staffing. This flexibility is key because we’re in an industry that is constantly changing. We
face a lot of uncertainty every year as we go into open enrollment, and Colibrium’s willingness to truly partner with us alleviates
that.”
Next Steps
To maximize efficiency and improve reporting, the healthcare company is in the process of upgrading to a new version of Tuo 360®.
The upgrade includes integrated Marketplace enrollment workflow—optimizing the interaction with Healthcare.gov through automation—that the salesforce will use to increase
efficiency. The solution enables sales agents to utilize a single platform, eliminating the
need to toggle between multiple systems.
“We want to continue to get smarter about how we do things every year,” said the Director of Sales. “We expect to grow the Marketplace product line, so we know that we have
to continue to get more efficient with BPO processes. We look to CRM-driven enrollment to deliver greater efficiency and per-person capacity to our sales organization.”
The company also continues to incorporate new marketing data and metrics into Tuo®
360. Proactively integrating sales and marketing data will enable the company to understand which frontend sales and marketing efforts deliver the most value—and to adjust
investments accordingly.
“We face a lot of
uncertainty every
year as we go into
open enrollment, and
Colibrium’s willingness
to truly partner with
us alleviates that.”
About Colibrium, an HGS Company
Founded in 2005, Colibrium, an HGS Company, delivers integrated software solutions designed specifically for the health insurance
industry. Colibrium’s award-winning Tuo® software empowers health plans with a best-in-class private exchange solution to enroll,
engage, and retain members in individual, group and Medicare markets. Colibrium’s pre-configured Tuo® 360, their CRM overlay
built specifically for Salesforce and Dynamics platforms, enables health plans to gain a 360 degree view of their members to improve marketing effectiveness, customer service and member engagement. For the past two years, Colibrium has earned industry
recognition including Microsoft Dynamics Partner of the Year for Health Plans and a recent listing in “Hype Cycle for Healthcare
Payers” report from industry analyst Gartner. For more information about Colibrium or view recent case studies and client results,
visit www.colibrium.com.
Fig. 1
The company’s teams use Tuo® 360 not only to manage
the sales pipeline, but also to understand how marketing
efforts drive consumer interest.
Results
»» Business process outsourcing solved the health insurer’s critical challenge of staffing up to meet the high sales volume of the Marketplace’s open enroll-
ment period.
»» In the second year of operating in the Marketplace, the company experienced improvement in its sales metrics, including efficiency and lose rates.
»» The Director of Sales attributes the health plan’s success to Colibrium’s flexibility and partnership mentality.
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