HEALTH INSURANCE

MARKETPLACE

A Novobi Case Study on using Odoo to create a supplemental health insurance marketplace.


Solution: Odoo Implementation & Automation 

Industry: Health Insurance

 

THE CLIENT

North American Health Plans (NAHP)

North American Health Plans is a unique and innovative health insurance service that provides comprehensive coverage at 30% to 50% less than traditional marketplace plans with the freedom to see any doctor, any hospital, anywhere. NAHP is provided exclusively by North American Life Plans, a national independent insurance marketing organization. Together, NAHP and NALP provide agents and consumers solutions to the health care dilemma.


OBJECTIVES

Architect a HIPAA compliant, single platform solution to:

  •     Automate the quotation and enrollment processes for new customers

  •     Manage customer accounts and agent profiles

  •     Calculate and disperse agent commissions automatically


CHALLENGES

NAHP allows individuals to access affordable, supplemental health insurance through their marketplace. Someone seeking health insurance is connected to an agent who finds a quote from available carriers. They are enrolled, payment is processed, and the agent receives a commission on the sale from the carrier. 

While the workflow seemed straightforward, the client's legacy process required a number of delicate and complicated tasks. Growth had been challenging due to decentralized, manual, and inconsistent processes the company had in place. With a network of agents supporting customer acquisition, quote generation, and on-boarding, it became clear that manual processes for managing and tracking the customer journey and agent commissions were not scalable. In addition, limited ability to provide customer self-service meant on-boarding and relationship maintenance had to be handled by agents entirely in time consuming processes.  

Furthermore, the highly complex and regulated insurance industry creates a number of challenges for scale, the largest of which is requirements for HIPAA compliant data storage and transfer. HIPAA compliance for companies operating online historically relied on dedicated servers which come at a high cost. Though AWS began offering more affordable compliant options in 2017, the process of migration is often tedious, expensive and time consuming.

The combination of prohibitively expensive secure hosting as well as manual legacy processes hindered the client's ability to scale quickly and effectively in a growing market. 


Novobi's Approach was to Utilize:

  • Cost effective HIPAA architecture on AWS  that is fully complaint, scalable, and affordable. 

  • 3rd party integrations  to deliver advanced fin tech features required by the build scope

  • Odoo, a mature open source business application platform  to focus on rapid development and functional requirements rather than reinventing basic technical principles

  • Cloud development and hosting  for global access and rapid development

"The team at Novobi has exceeded our expectation, delivering an elevated level of expertise needed to scale our infrastructure and providing innovative solutions. Their experience with back-end, as well as customer interfaces, enables our team to quickly deploy business solutions. We are impressed with their project, risk, and budget management capabilities. They provide industry-leading project tracking and reporting, appropriate for large scale implementation while minimizing bureaucracy when necessary. Ha and his team communicate clearly and proactively. I would confidently recommend them."

- Paul Andries
IT Director NAHP

THE SOLUTION

Novobi was tasked with building a modern, powerful enterprise software platform to replace legacy systems and processes. By combining software with cloud-based technology and data analytics, they created an innovative, efficient, and most importantly scalable solution for the client.

Novobi built upon the open source framework of Odoo, an enterprise software platform that can be expanded with custom feature development aligned to the unique needs of the client. Development encompassed 3 key features for a powerful, single solution:

CRM: Novobi combined customer quotes, on-boarding, payment, and maintenance processes into a platform that acts as a robust customer relationship management tool. Application development included a portal for agents to create and save customer information to help generate quotes for coverage from several partner insurance carriers in real time without paperwork, phone calls, or waiting.

Payments, both one-time and recurring are securely handled online with full PCI compliance. In addition, legal documents, personal identifying information, and health information is securely transferred and stored in HIPAA compliant processes. Customers can provide this information securely in the platform without needing to interface with an agent directly, automating on-boarding processes that used to be manual.

Built on Odoo’s cloud-based framework, this powerful CRM is centralized, user-friendly, and can be accessed anywhere on any device. With real time quotes, easy access, and a central database, Novobi’s solution allows the client to close sales faster and more efficiently. 

Self-Service: In order to open an additional sales channel for the client, Novobi’s build scope included a self-service customer portal allowing individuals to create accounts and request quotes themselves. New contacts are automatically populated in the database and assigned to agents to handle going forward. Self-service allows customers to not only enroll on their own terms, but keep their profiles updated without agent intervention. 

Agent Commissions: The client's legacy process for handling commissions was largely manual and required heavy calculation from sales statements issued by insurance carriers. Novobi built a commission platform that automatically registers and calculates agent commissions allowing payment to be dispersed across stakeholders over time without error or manual tracking.  

The most essential portion of the Novobi build scope was standing up the client's applications and database on HIPAA compliant AWS servers. The first phase of application development spanned 10 weeks to deployment. In addition to fully secure hosting at greater cost savings than traditional dedicated servers, the AWS framework also supports rapid scale and centralized maintenance. Novobi recommended and applied best practices in hosting and data transfer and delivered fully.


RESULTS

IT Results of the Project

  • Migration: Existing systems and data were moved to HIPAA compliant AWS hosting for cost savings on secure, cloud servers.

  • Centralization: The application was set up to run on a single cloud platform with a centralized database for ease of maintenance and rapid scalability.

  • Automation:  Manual processes were automated for speed, efficiency, and accuracy in the system.

Business Results of the Project

  • Onboarding Workflow:  New customers are on-boarded faster, more accurately, and with full PII/PCI/HIPAA compliance between self-service and agent-driven options for greater ROI.

  • Commission Structure:  Agent commissions are quickly and automatically calculated online from digital carrier statements. 

  • Usability:  Odoo's framework provides a consistent, user-friendly, single platform to support the client and their agents. 

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