Advising In The Worksite

Selling Health Insurance In A COVID Environment

The top four quoting & underwriting integrations for group carriers

by Garrett Viggers

Mr. Viggers is Co-Founder, VP of Innovation & Product Evangelist for Limelight Health, developers of SaaS proposal-rating-underwriting platforms for the group health market. Visit

In a perfect world, there are many integrations that could truly streamline group quoting and underwriting workflows within the internal carrier ecosystem as well as the external group market ecosystem. It’s also becoming more clear that the results of COVID-19 and these pressures will eventually lead to more demand for selling online, enrolling online, and renewing online.

However, in today’s world of initial API (Application Programming Interface) capabilities for carriers and external partners, it’s important to call out the most critical integrations to start with. This approach lays a foundation that can lead to many more integrations as the ecosystem digitally matures. As an almost 20 year veteran in the group industry and focusing 10 years as a boutique broker on consumer-driven Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) tech solutions further exudes my desire for all involved in the group ecosystem to have a similarly delightful customer interaction as we see with Amazon, Google, or Apple.

We, in the group industry, have some work ahead of us. As we understand the current realities and complexities of quoting and underwriting workflows between group carriers and broker partners, it’s imperative for a modern SaaS tech stack to pave the way for integrations.

I see a future world where a group carrier has APIs and webhooks to push out and pull in data from external broker systems and 3rd party underwriting risk score providers. This could include all necessary Request for Proposal (RFP) data to streamline, and automate in some cases, the internal quoting process and when appropriate, serve up to underwriting with risk scores and recommended next best actions to take.

Just imagine the same group carrier having APIs and webhooks to push out quotes in realtime to digital brokers, and push out sold quote policy data to automate the setup in benefit administration systems. In a recent study by Novarica (May 2020) on Information Technology (IT) Budgets in 2020, 65% of life insurers are prioritizing or accelerating their digital initiatives to adjust to a completely virtualized business environment. This is an ideal scenario with carriers, broker distribution, and employers who purchase group benefits and are soon to be relying on digital solutions to do their jobs in a virtual environment.

In order for carriers to best serve in this new market and the COVID-19 landscape with APIs and integration efficiencies, it’s critical that they prioritize foundational integrations from which they can accelerate to scale with further ease of integration at their core. Ultimate efficiency for a carrier to streamline from pre-sale through post-sale comes down to letting the data flow. This eliminates double, triple, or quadruple entry in some cases. Based on a number of factors and research done while meeting with group carriers in the US, Canada, and abroad there is a consistent demand and/or desire for key integrations that better position carriers to quote and sell new business in addition to renew and cross-sell existing customers.

Four Integrations For Group Quoting

Below are our top four integrations for group carrier quoting and underwriting in light of a virtual work landscape.

Customer Relationship Management (CRM) Integration:

Beginning with the presale workflow process, most all carriers start with a CRM to manage and track new quote opportunities that are emailed in from brokers, or are entered in a broker system and made available. The CRM is not a quoting solution, though the data it collects is nearly all of the data needed to run an initial quote. A CRM integration is critical for quoting and underwriting in order to eliminate a double entry, error-prone process and decrease turn-around-times. Another result of this integration can help drive CRM user adoption. This is typically a challenge for many of us, but if the data is pushing and pulling from CRM to streamline quoting, it gives another reason to adopt an efficient workflow leveraging the integration.

Policy Administration System (PAS) Integration:

Once a case has been marked as sold in a quoting and underwriting system, it’s important to note that 100% of all groups need to be set up in the downstream PAS system. Carriers have implementation teams who do nothing except for manually entering and building out new cases where most of this data is already collected during the quoting process. As we will discuss in our 3rd top integration with external enrollment platforms, the volume of groups between small, medium, and large markets that enroll online is still nowhere near 100%. Therefore, the PAS integration based purely on volume and ROI efficiency is a higher priority integration that carriers can benefit from in providing a more compelling setup experience for the broker, employer, and employees. There are many use cases where all three of these customers are contacting the carrier asking about group or policy numbers, how a benefit works, or to discuss an upcoming known claim to better plan for. The answer of “we don’t see your employer group in our system yet”, “I’m sorry I can’t help you”, and “let me put you on hold (for a long time) and see what I can find out”, just doesn’t cut it in today’s landscape as I’m sure you get the picture. With this integration a sold quote integrated into a PAS can auto-generate group and policy numbers, and create the shell of the new case that can be accessed downstream when customer service calls initially arise.

Just imagine the same group carrier having APIs and webhooks to push out quotes in realtime to digital brokers, and push out sold quote policy data to automate the setup in benefit administration systems...

Benefit Administration/Human Capital Management (HCM) Enrollment Integration:
I’ll start by saying that in light of Q1 2020 COVID-19 disruption to in office face-to-face working environments, I believe that Q4 2020 online enrollment demand will be at an all-time high. It’s important for group carriers to understand how to go about integrating with “ben admins”, the different integration options, and how ben admins vary in their capabilities to support the integration and the associated group policy complexities. 

The three main ways ben-admins provide a magical online enrollment experience to employees is: behind the scenes mapping to back-end paper enrollment PDF forms to be downloaded and sent in to the carrier, EDI/file feed integrations, and API integrations that enable another level of value and efficiency that can truly benefit all stakeholders in the delivery process. My passion and vision for the group industry has always been to never forget the end customer and ensure they have access to the best options available. It’s my belief that a paper enrollment experience is not the best way to enroll in benefits. This hits on the challenge for carriers, brokers, and employers to change the way they have been used to enrolling with a stack of paper forms. Yes, it requires learning new technologies with economic questions to address. This includes who pays for the technology and what group size should be able to have an online enrollment experience. I believe groups of two (2) employees up to 20,000 should all have access to an online enrollment experience, but of course there will be different platform solutions to better support each group market segment. I believe we have an obligation to make it easier for groups to enroll online and this integration will be a key driver to increase adoption.

Data Lake/Business Intelligence (BI) Tool Integration:
The saying “if you build it, they will come” in this situation speaks to the value of data and is the foundation for the future Artificial Intelligence (AI) and Machine Learning (ML) value proposition that will become the norm in the next few years. Saying “if you build it” means building the API pipes from quoting and underwriting, and core systems to push all data into a centralized database that can then be made available to multiple teams in the organization to visualize and learn from. Let me be clear, this data should be flowing from the initial RFP opportunity all the way to a sold or a lost case. All of the data entered through the process can provide insights that drive understanding as to why you are winning or losing business. It’s critical to look at what the data is saying, or better yet, what story the data is telling. This story gives carriers the ability to respond to the data in a strategic and efficient manner.

In today’s current landscape, it’s important to understand how the end customer experience can be greatly affected by a non-integrated ecosystem. From quick quote turnaround times to speedy policy and billing setup to seamless online enrollment, these will all require great focus and determination. By blocking and tackling complex group data models, and understanding business rules to be supported from quoting and underwriting to other systems, we can continue to empower transformation in the group industry. An integrated ecosystem is a powerful ecosystem.