Case Study

Decoding Disenrollment to Increase Employer Group Retention

The Client & Challenge

A top-ranking health insurer was experiencing high disenrollment numbers among their employer group members.

The insurer was motivated to find out why disenrollment was happening and win back this business. They knew the first step in doing so was to understand the experiences and perceptions of the disenrolled groups. The insurer was banking on these insights to help them determine how their employer group products and services could be better designed and/or positioned to meet the needs of both current and disenrolled members.

The Solution

We partnered with the health insurer to help them find the bigger story and “why” behind employer group members disenrolling. One of the main objectives was to understand the impact that ease of use had on retention, including ease of working with the insurer (especially during pre- and post-enrollment periods), understanding communications, using online telehealth and billing tools, and receiving service support.

Key topics of interest also included why the group members chose to leave, better understanding key drivers of satisfaction across different aspects of their experience, how the insurer compares to the disenrolled members’ new insurers (which are key competitors), and what could have been done to keep their business. Also of interest was gaining a better understanding of the influence that employer brokers may have in their decision-making process.

To cover all these bases, we developed a comprehensive study to monitor disenrolled groups and identify pain points specific to the enrollment process, communication, customer service, online resources, and billing. As part of the study, we conducted in-depth interviews with disenrolled groups, which were incredibly revealing.

The Wins

Overall, the disenrolled groups reported high satisfaction with the health insurer and viewed them as popular, modern, approachable, and trustworthy. However, premium increases had become a major sticking point and were the prevailing reason for disenrollment. While this was great information for the insurer to know, decreasing premiums may not always be an option.

Fortunately, our research found that demonstrating value in other ways and working to decrease pain points around billing, service, and communication could help retain members and even win back the lost business.

Beyond lowering premium costs, our research uncovered several action areas that were of high importance to members: increasing awareness of online telehealth offerings and tools, improving billing communications and automation, and providing more proactive, knowledgeable service support. We also found that employer group brokers had a fairly large influence over employer decision-making when it came to renewing vs. disenrolling and going elsewhere.

We worked closely with the insurer to identify viable member experience solutions based on the findings and present them to stakeholders throughout their organization. Then, we took it a step further and consulted with the insurer to develop and justify internal initiatives to improve retention.

This could be YOUR win.

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