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How to grow your insurance company efficiently and effectively with AEP and beyond
'Tis the season! Medicare's open enrollment period, that is. It's time again for Medicare beneficiaries to find a Medicare Advantage plan that meets their unique needs. For insurance carriers, agencies, and MGA/MGUs, the Annual Enrollment Period (AEP) is where you can transform your operational efficiency and ensure your organization is equipped to handle increased business activity without sacrificing productivity.
The insurance industry faces a lot of pressure during Medicare Open Enrollment
Medicare Advantage enrollment In the year From 2023 to 2024, it grew by more than two million beneficiaries, with approximately 32.8 million eligible individuals enrolled in some type of plan.
That's a lot of people looking for insurance agents over the next few months to understand the ins and outs of Medicare plans and navigate the ins and outs of enrollment. Insurance companies are under pressure to onboard and appoint enough producers to handle the growing business. Is your organization agile enough to navigate this temporary expansion smoothly, or will the number of manufacturers leave you struggling to stay afloat?
For the unprepared, Medicare Open Enrollment Season means:
Full administrative costs
Recruiting, onboarding, managing and firing additional producers during Medicare Open Enrollment increases the workload of existing employees tenfold. If your current operations aren't set up efficiently, you may find it difficult to pay existing employees to work extra hours or hire additional administrative staff to handle the extra work. Without the ability to scale operations quickly and efficiently, open enrollment can be a real drain on an organization's bottom line.
High compliance risks
More manufacturers means more licenses to verify and monitor. Typically, boarding and boarding manufacturers (and everything in between) come with specific regulatory requirements for each state in which a manufacturer sells, and Medicare Open Enrollment is no exception.
In fact, agents and brokers tasked with enrolling individuals in Medicare Advantage plans are held to strict regulatory standards set by the Centers for Medicare and Medicaid Services (CMS). In April 2024, CMS introduced changes to its regulations for Medicare Supplement, Medicare Advantage, and Part D insurance carriers and agencies. We have published A complete breakdown of legal changes and their implicationsBut here are some of the changes that insurance companies can expect to see in this year's AEP:
- Changes to Medicare payment requirements: The 2024 Medicare final rule narrows many billing conditions. As a result, carriers can anticipate more aggressive coverage disclosure requirements. CMS has also expanded its ability to pay overpayments, which means providers and agencies may face more pressure on claims.
- Current Access and Prior Permissions: While the new prior authorization rules won't be fully implemented until 2026, active carriers are taking steps to introduce greater uniformity and transparency. Changes include stricter return times, more detailed explanations for consumers and acceptance APIs For a more automated and streamlined pre-authorization process.
- Transaction Protections: Stricter regulations regarding advertising and marketing releases for Medicare Advantage and Part D plans are tightening carriers' advertising compliance reviews and requiring manufacturers to submit additional materials for review.
Unhappy producers
Even the smallest degradation in system performance can cause significant delays in production onboarding. Slow and inefficient onboarding means longer wait times before the manufacturer can sell. Manufacturers suffer when the systems your organization relies on for distribution management fail to scale consistently.
Don't forget, Medicare Open Enrollment is annual, which means the experience you provide to manufacturers this year will influence their decision to partner with you next time. If the entire manufacturing experience in your organization is inefficient, time-consuming, and disorganized, there's a high chance that manufacturers won't return, and you'll end up spending more time, money, and resources recruiting next year. .
Without an active and efficient distribution channel management strategy, these results are warranted for insurance carriers, agencies and MGA/MGUs to navigate the annual Medicare enrollment season. But AEP isn't the only example where being able to handle change on a manufacturer's head pays off. Consider how well your current systems are handling:
- On board hundreds of emergency adjustments due to natural disasters
- Participate in a merger or acquisition
- Rapid market expansion or entry into new verticals
Best practices for a successful Medicare open enrollment period
With millions of seniors and people with disabilities seeking support, Medicare's open enrollment season is undoubtedly a busy time for our industry. Done well, AEP allows an organization to demonstrate how efficient and integrated its operations are. But without the right preparations and tools, it can quickly become stressful and expensive. Set yourself up for success during Medicare Open Enrollment by following these best practices:
1. Prepare staff with adequate training and resources in advance
Medicare enrollment can be a confusing time for consumers. Between researching different options, understanding changes and differences, and navigating federal websites, it's no wonder Many individuals do not change plans during this period.
Knowledgeable manufacturers are critical to your provider's mission for a successful Medicare Open Enrollment season. It's a good idea to provide any educational materials and resources that help manufacturers familiarize themselves (and their beneficiaries) with the various Medicare plans and their benefits before the AEP. And don't forget to include the 2024 CMS rule changes and their impact on your distribution force in your training.
2. Dial in your onboarding process for a superior manufacturing experience
Set yourself up for a successful AEP this year and every year by creating positive, enjoyable producer experiences and working relationships right from the start. If you're still relying on individual manufacturers to manage their own data during onboarding, you're introducing efficiency and compliance risks to your business. These things slow down the manufacturer's speed to sell and cause frustration.
Now consider the benefits of using an automated solution to automatically capture and process manufacturing data, removing time-consuming manual labor from your distribution partners' dashboards and ensuring that data is always complete, accurate and accessible. Building a more efficient and positive experience builds loyalty and encourages manufacturers to partner with you year after year.
3. Prioritize easy scaling for flexible systems and automated solutions
If the addition of NPNs negatively affects your system's performance, then navigating AEP effectively can be challenging to say the least. More flexible systems can turn that challenge into an opportunity by enabling manufacturers to quickly adapt to the flow of business with little or no business disruption.
By investing in software that can maintain operational integrity while scaling Without By adding additional costs, streamline distribution processes to accommodate not only current cycles, such as Medicare Open Enrollment, but other changes your organization may face in the future.
The most successful organizations invest in technology, integrate it with their existing systems, and scale up (and down) to meet changing market needs and conditions without losing value.
Can Your Distribution Channel Strategy Handle Medicare Open Enrollment?
Or, more importantly, can it accommodate open enrollment while keeping the ball rolling, without increasing administrative costs and/or negatively impacting the producer experience? If the answer is no, it's time to update your distribution channel management strategy to include more modern, scalable solutions.
Unlock the Medicare enrollment season and transform your distribution network from a holding back to an asset that drives growth with AgentSync. Whether you're looking to streamline your onboarding process, strengthen your compliance efforts, or manage the future growth of your business, we've got you covered. Talk to an AgentSync expert And start transforming your distribution channel management strategy today.