Case study · Customer Service

Incoming Customer Communications With Scalable Solutions

A fast-growing CO-OP health plan beat its Open Enrollment membership target with 72,000+ new members, as Fusion CX absorbed unusual call spikes and cut wait times with intelligent routing.
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Incoming Customer Communications With Scalable Solutions
Target beaten
new-membership goal exceeded for Open Enrollment
Client
Leading Consumer Operated & Oriented (CO-OP) health plan and insurance company
Industry
Healthcare · Health plans
Services
Open Enrollment inbound calls, membership support, project management
Delivery
Dedicated staffing model
The results

Open Enrollment, handled at scale.

Results for the Open Enrollment period.
72,000+ | new members added to the health plan 1 | dedicated team for all Marketplace enrollment calls
01Challenge

An all-hands-on-deck enrollment season.

The influx of incoming calls swamped the client's workforce, to the point that even the CEO answered phones. Service quality fell short of expectations, and even after doubling the internal team from 16 to 32 plus five enrollment specialists, staffing issues persisted.

Unusual call spikes

From existing members and prospective buyers.

Falling service quality

CX failed to meet expectations.

Staffing shortfalls

Doubling the team was not enough.

Long wait times

Callers waited too long and abandoned.

02Solution

A dedicated team for Open Enrollment.

Fusion CX analyzed the client's requirements and KPIs and designed a customized solution that handled all call activity from the Marketplace Open Enrollment.

Custom enrollment program

All Marketplace enrollment calls handled.

Healthcare project management

Executives with deep health plan experience.

Formally trained agents

Education on every aspect of the health plan.

Continuous learning

Improvement programs for each agent.

03Impact

More than 72,000 new members.

Intelligent call routing directed new-membership calls to Fusion CX's expert agents, significantly reducing wait times. The client exceeded its new-membership target for Open Enrollment, adding more than 72,000 new members.

A dedicated staffing model increased flexibility and improved service quality, reducing expenses and improving CXM.

Scalable, specialized support turns an enrollment surge into growth instead of a service crisis.

04Key insights

What other programs can take from this.

  • Seasonal enrollment peaks need a scalable, dedicated staffing model.
  • Intelligent routing gets high-value callers to the right experts fast.
  • Formal product training helps agents support members accurately from day one.
Download the full case study

In this case study, you’ll see:

How unusual call spikes swamped a fast-growing health plan
How a dedicated, health-plan-trained team handled all Open Enrollment call activity
The results: shorter waits and more than 72,000 new members
PDF
CO-OP Health Plan
Case study · Customer Service

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