Client Challenges Today
The growing Medicare supplement market continues to present challenges to U.S. health insurance providers. The average net profit margin across the industry currently stands at 4%—a number driven down by slow and ineffective legacy systems, substantial sales and marketing expenditures, and high administration costs. Selling a fairly standardized product, Medicare supplement providers are forced to compete on a combination of price and quality of service. Given such demanding customer expectations, optimizing distribution channels and enhancing operational efficiency have emerged as the industry’s true sources of competitive advantage, separating the high performers from the crowd.
Solution and How We Work
Capgemini has an extensive footprint in the Medicare supplement insurance, servicing more than 15 clients with integrated third party administrator (TPA) services. We bring over 20 years of experience providing services as stand-alone offerings for the Medicare Supplement industry in the following areas:
- New business and underwriting
- Policyholder services and call center support
- Premium administration
- Claims administration
- Agent support services
We have invested in a modern, highly efficient shared-services platform which combines automation and straight-through processing with our ability to deploy Medicare Supplement industry’s best practices to consistently deliver significant value to our clients. Our turnkey solution includes origination, underwriting, issuance, and distribution of Medicare Supplement policies electronically and via regular mails. The entire sales platform can be integrated with existing policy administration system or our TPA environment for an end-to-end administration of the product.
We process over six million Medicare Supplement claims a year through our integrated suite of applications that combines leading third-party software and Capgemini’s proprietary applications to deliver end-to-end administration, automation, continuous optimization, and increased visibility for decision making.
- Licensed in all 50 states with global delivery centers in North America, Mexico, and India that enable us to scale up and respond quickly to our client’s needs
- From approved filing to a policy sitting in the hands of your customer, we can do it all in 90 days!
- Proven claims capability offering 98+% auto adjudication of claims for enhanced efficiencies in claims administration
- A flexible and scalable application portfolio comprised of our state-of-the-art policy administration platform
- Near real-time analytics for driving and optimizing block performance
- Complete technological and operational integration, which enhances efficiencies and ensures superior responsiveness to market demands
- Highly qualified and experienced staff of underwriters, claims processors, registered nurses, actuaries, and customer care professionals
Contact us today at firstname.lastname@example.org or connect with one of our experts.