CIO — The health insurance industry is one of the most complex on the planet. With hefty government regulations, it’s a tall order to offer high-quality coverage efficiently. And for Empire Blue Cross and Blue Shield of New York, which relies heavily on independent brokers to generate sales, success depends on making its product more valuable, more convenient and easier to sell than the competitor’s.

Empire took a serious look at its sky-high administrative costs and convoluted sales and enrollment process, and realized it had to streamline. Having a paper-based, delay-filled sales process wasn’t exactly endearing the company to brokers. And the practice of generating more than 60 copies of each new client’s enrollment forms was hardly helping Empire’s bottom line. An effort to reduce that paperwork evolved into a Web-based sales-force automation system that empowered Empire’s network of independent sales brokers to serve customers efficiently.

A Complex Sales Process

As the largest health insurance provider in New York, Empire manages more than 29,000 corporate employer accounts, of which about 26,700 are small to midsize companies employing 50 people or fewer. Empire services these "community rated" employers via some 1,800 registered independent sales brokers. Because each customer’s needs are different, brokers must produce customized coverage estimates for each one. For example, some companies want preferred provider plans, and some want health maintenance plans. Each plan has different "riders," or options, attached, such as vision care or prescription coverage.

In the past, a broker would call Empire’s broker relations department, pass along the customer’s specs and then wait for Empire to calculate a price quote. The broker then relayed the quote back to the customer, who would either accept it or ask for modifications?in which case the broker had to contact Empire again and request a revised quote. When a quote was finally accepted, the broker filled out and filed one set of paperwork while the customer filled out a group application and sent it directly to Empire. Whenever Empire revised its plan structure, brokers found themselves with outdated enrollment forms.

"We would use the forms we had on hand, submit them to Empire, who would reject them because our forms were outdated," says Thomas Vazoulas, an account broker with Corporate Consulting Services, an independent consultancy based in New York City. "Then we’d have to fill out more forms. It was discouraging to have to use up that much time just to redo forms and get the process done."

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