The client
The client is a Fortune 500 company that markets and administers health benefit consumer services in all the 50 US states, Washington DC and Puerto Rica, and has international business interests in Western Europe.

Business challenge

Aegis has a long history of partnering Fortune 500 healthcare companies and large PPOs.

With over 10 million customers and more than 20,000 employees in the United States, and as one of the largest healthcare companies in the world, this healthcare provider required a sophisticated customer lifecycle management solution. Call volumes were on the rise as demand increased for Private-Fee-For-Service (PFFS) health plans, Medicare Advantage Prescription Drugs (MAPD) and Prescription Drug Plans (PDP), while the client also experienced significant spikes in volume during the enrollment seasons.  It was critical for this industry-leading healthcare provider to work with a partner who had a thorough understanding of the healthcare industry and a proven ability to hire and train the right people to deliver accurate and personalized service, and to ensure compliance.

The solution
The healthcare provider selected Aegis to support its contact center initiatives, starting in 2005 with PFFS, MAPD and PDP programs throughout the year and then open enrollment seasons in 2006. Aegis attained a strong knowledge base, particularly in the areas of licensed recruitment, appointment facilitation and compliance. Aegis established a dedicated team to manage the process to recruit licensed agents for ongoing and seasonal programs. This process included identifying previously licensed agents, including former Aegis employees with high performance records, recruiting non-licensed agents and placing them through a Kaplan Financial course for licensure and recruiting agents with at least one license, and procuring licenses in any other state required by the client. To complement this recruitment process, Aegis provided training on an ongoing basis to thoroughly  prepare agents for the task at hand.  Aegis hired a full-time Compliance Manager (licensed in Life and Health as well as Property and Casualty) to ensure compliance with each state’s individual licensing process and renewal schedules.  Aegis quickly recruited and trained approximately 1,000 licensed and non-licensed professionals in three US delivery centers. 

Key services provided by Aegis include:
	Customer care for benefits, access to care, status, dental and enrollment in English and Spanish.
	Inbound verification and verification callbacks for outbound calls in English and Spanish.
	Interactive inbound calls to confirm that members fully understand the plan they selected.
	Outbound verification in English and Spanish, using both a predictive dialer and a preview dialer.
	Outbound service calls made to members who recently signed up with the client to verify that they understand the plan they selected.
	Inbound and outbound SEP, inbound AEP (AEF), and English and Spanish PR / SEP callbacks.
	DMS-assisted appointment setting.
	Inbound calls from members who are opting for a plan change or have questions about healthcare plans.
	Customer care concerning the client’s partner program.

Results and key benefits

Aegis has been a star performer. Working together as a team with Aegis, we deliver highly accurate and personalized customer service to our customers.

Aegis is a top-performing customer lifecycle management provider for this healthcare provider due to Aegis’ ability to consistently meet or exceed expectations and to outperform other third-party providers. In 2009, Aegis has met or exceeded all goals put forth by the client. In fact, Aegis has exceeded all quality goals established by this healthcare leader. Aegis is a trusted partner and supports over 55 per cent of the total volume of  this client’s contact center initiatives. 

Key benefits include:
	Improved customer care.
	Met or exceeded quality goals consistently.
	Met or exceeded handle time goals consistently.
	Reduced support costs.
	Reduced call center technology and development costs.