Whether they are in-house departments or outside service providers, document centers that support health insurance companies can find some opportunities in the Affordable Care Act (ACA) and associated legislation. The ACA will impact the ways that insurance providers do business and how they communicate with their customers. Besides fundamental strategy shifts to comply with new regulations, these companies will be competing for business from individuals in addition to their traditional focus on groups. Selling directly to consumers will be a new experience for some of them - at least on the scale that is anticipated. Document operations will play a large role in facilitating these changes. The time to prepare is now.

As more provisions of the act become effective in 2014, tens of millions of new customers are expected to purchase personal health insurance. Between now and then health insurance companies will be cranking up their brand awareness efforts. In an attempt to become recognizable brands to the consumers who represent future business, health insurance companies may invest in advertisements on television, radio, print, web, events, and direct mail. These campaigns will need supporting material such as marketing collateral and enrollment kits. Document center managers should expect greater demands on their fulfillment operation starting now and continuing until well after individual consumers begin to sign up.

Consumer Marketing may be a new department
In some health insurance companies new consumer marketing departments are springing up. The individuals brought on to manage consumer communications may be new to the company. They may not be fully aware of the capabilities of the corporate print and mail center or the outsource partners that are already supporting marketing and communications for the company.

This would be a good time to make some presentations to these people, pointing out the experience of document center staff, hardware and software capabilities, and excess capacity that is available to them. Actively offering help and guidance now is a smart move that could result in better utilization of document center assets in the future.

Save money and be a hero
One aspect of the ACA of special interest to document operations is a requirement that limits the amount of money that insurers can spend on administrative and overhead expenses. Any steps that document operations managers can take to reduce the cost of printing, inserting, or postage frees up funds that can be spent in other areas. Finding ways to spend less without reducing the effectiveness of the communications, while also serving a new population of customers, is a value-add task that is within the capabilities of most document operations managers. Efforts in this area will be appreciated by health insurance organizations that struggle to get their administrative costs down to the ACA-prescribed levels that are capped at approximately 15% - 20% of premiums.
How Document Operations Can Help Health Insurers With the Affordable Care Act
Personalized on-demand enrollment kits triggered by web inquiry or post cards.
Folded self-mailers with QR codes connected to personalized landing pages.
Mailing list acquisition.
Householding - Combine mail pieces destined for the same address into the same envelope (while complying with individual privacy policies).
Merging mail streams for higher postal density - Requires standardizing on a common outbound envelope.
Lowering page counts - Reformat documents to fit on fewer pages.
Language preference - Produce documents in the language chosen by each customer.
Document versioning - Modular document design to minimize the library of versions.
Tracking - Use automated document factory technology to ensure regulatory compliance, avoid accidental privacy breaches, and respond to inquiries.
New customers may need education
Many of the new customers that are signed up may be purchasing health insurance for the first time ever. For others, it may be the first time they are required to compare policies and coverage on their own, without the support of a corporate group. Communications with these individuals need to be clear and understandable. Details such as deductibles, co-pays, and coverage limits may be new concepts for a number of customers who are considering purchasing their health insurance directly from the company, from new Health Insurance Exchanges, or are recently eligible as the result of expanded Medicaid qualification guidelines. Failing to set expectations or neglecting to explain processes in easily-understood language will lead to a huge increase in customer service call volume and will ultimately have an effect upon customer retention. Experts in customer communications may not write the content, but they can explain options regarding document formats, distribution channels, folds, use of color, etc.

Typical health insurance communications such as accident claim forms or Explanation of Benefits may need to be revised and simplified to make them easier for the newly-insured to understand. The new Summary of Benefits and Coverage (SBC) forms dictated by provisions in the Affordable Care Act may also need to be developed in a manner that will not confuse customers. Many documents may need to be produced in a language other than English, based on an insured's stated language preference.

Document operations that support health insurance companies may find themselves managing more document versions than ever before. Careful attention to the format of these new documents is necessary, with an eye towards composing documents on the fly from standard modules instead of maintaining large numbers of unique versions. Composition experts who work in document centers can be valuable resources as strategies for supporting the new document requirements are developed.

Health insurers who are successful in managing the changes mandated by the Affordable Care Act and are pursuing the signing of new business will flourish under the ACA. The document centers that support these organizations can play a big part in that success.

Mike Porter is an expert in Print and Mail operations and President of Print/Mail Consultants, an independent consulting firm that helps companies nationwide identify trouble spots in their production workflows. For more tips visit and sign up for Practical Stuff - the free newsletter for document operations. Your comments are welcome. Send them to