The complex value chain within health insurance from carriers through marketing agencies and agents down to members means multiple players in the ecosystem collect, analyze, and use data in different ways. And those different systems have evolved separately, often in ways that are not compatible with each other.
If carriers are not leveraging the data that agents collect, they are missing an opportunity to enhance consumer insights, develop more tailored products, and create communications that drive conversion and sales. Carriers who can access and share plan, claim, enrollment, churn, and commission data can strategically use this complex distribution system for growth.
But reliable, timely, accurate data remains a challenge for many carriers, which can impact agency growth and downline optimization.
In today’s world of big data and AI, why has data quality continued to be difficult for carriers? And what can they do about it?
Over the years, many insurance carriers have bought and sold blocks of business from other carriers as their product portfolios and business strategies have evolved. Each block of business has its own legacy system for enrollment, commissions, and more. Migrating data from one legacy system to another is a massive undertaking, so the short-term solution is often managing multiple systems. And those short-term band-aids often stay in place much longer than a carrier intended.
If each FMO and agent only sold products from a single system, data quality would be pretty straightforward. But, of course, they are not. As agents sell different products, they need data from multiple systems that don’t communicate with each other. Things like commission management become infinitely more difficult when each system has its own data sources and own processes for calculating commissions, but they need to be combined into a single commission statement.
Agency growth at call centers often relies on selling customers new policies, which means churning them from their old policies. Enrollment data for the new policy and disenrollment data for the old policy are likely in different systems. The agent needs to get the enrollment data right for their commission, but there is less incentive to ensure the disenrollment data is reported and updated correctly. Customer churn can create duplicate records or missing data, which is further exacerbated by inconsistent processes across various antiquated systems.
The structure of insurance downlines and the number of agents entering and accessing data make carrier insurance data complex and challenging. Most older systems are designed for P&C insurance and cannot manage unlimited hierarchies. Carriers have typically invested more in claims data and processing, but large volumes of data exist on the enrollment and commissions side as well. For carriers that pay downlines directly, the amount of data required to manage enrollment and commissions can be too much for legacy systems, limiting their ability to add downlines and grow.
Regulations and associated data requirements are constantly changing. Legacy systems often force carriers and health plans to implement workaround solutions to access the data they need for compliance. Manual data processing across multiple systems can result in more errors that impact overall data quality for the carrier and downlines. Regulation workarounds can also make it more difficult for agencies and downlines to access accurate data to serve customers in an efficient and compliant way.
Carriers that collaborate with agents to use data-driven insights also help agents increase their book of business, which drives agency growth and loyalty. More transparent, accurate data can facilitate commission management accuracy and carrier loyalty. 76% of agents say they would send more business to carriers that are easy to do business with.
Overcoming these data challenges may not be as difficult as many carriers think. e123 has helped carriers and distributors streamline data collection, transparency, and accuracy for years. Learn more.