Case Study

HGS Turns Challenges into Conversion, Retention Opportunities for Fortune 200 Insurer


Amidst marketplace uncertainty and cost-containment challenges, health payers are also coping with the staffing and implementation pain points related to extraordinarily busy open enrollment seasons. For these enterprises, today’s strategies increasingly incorporate BPO workflow management expertise, expense reduction, and sales innovation. In 2013, one major ACA, Medicare, and Medicaid managed care organization turned to HGS for precisely customized licensed sales support related to non-specific call volumes, staffing requirements, and call flows.

Since the onset of our partnership, HGS has provided the licensed sales capabilities, agility, compliance, and innovation to assist with implementation of a fast-ramp telesales program. As a key channel partner to this client’s significant ACA and Medicaid enrollment growth, HGS has delivered breakthrough value such as sales conversion of 40.4% combined with an 88% payment rate for the 2017 open enrollment period.

Our Solutions

1. Agile Support of Scale, Seasonality

How We Do It

HGS employs a large team of licensed staff members with specific strength in the health insurance market, specifically individual sales. Our team members provide inbound and outbound services enabled by a best-in-class CRM, integrated telephony platform, and real-time reporting and analytics to maximize sales results and drive better day-to-day decisioning.

HGS takes a proactive, nimble approach to the client’s staffing needs. Our Open Enrollment Season planning starts each spring; however, we readily adapt staffing strategy to respond to the client’s needs and ever-changing market conditions. Additionally, we play a key role in the client’s aggressive, economical approach. To support the client’s building market share, HGS employs automated outbound email and call campaigning to rapidly and persistently follow up on new leads. HGS also uses sales innovations such as research and analytics of previous year sales leads to maintain productivity across the entire enrollment period. 

Business Result

Our agile sales approach, built to scale with the client, is rewarding in both conversion and retention. With agility in planning and outbound/inbound efforts well aligned to opportunity, we’ve delivered a conversion of up to 40.4%.

2. Decreased Acquisition Costs

How We Do It

HGS is adept at aligning and tailoring team size to forecasted need. Open enrollment often calls for moment-by-moment staffing adjustments, and we bring the experience and best practices—across a high-profile portfolio of both large and mid-size payer clients—to respond to the client’s changing needs. HGS’s proven call flow approach is made even more efficient with proactive communications and marketing support, such as follow-up calls and email campaigns to finalize decisions. Because HGS understands the human element of one-call closing, team members are grounded with a strategic, sound process also focused on emotionally connecting and relationship building.

Business Result

A significant proof point of our model? It’s our decreased acquisition costs to 4-5% of premium. Notably, one-third of HGS’s contacts for this client are one-call closes and a total 20% of HGS sales for the client include binder payments. This is supported by HGS’s sales approach as well as a user-friendly payment entry that drives conversion while also decreasing costs, long term.

3. Strong Agent Retention

How We Do It

Another strong HGS deliverable and metric is sales culture. HGS starts with a recruiting process that assesses for the right skill sets, language support, and call center adaptability. HGS training is a 30-day classroom and laboratory focused program that ensures product knowledge. This involves intense product education and customer call roleplaying, with a strong coaching focus, and nesting with mentoring. HGS assists in sales licensing management for staff members, by state, with a plan to augment the resource requirements for any client. We employ industry-leading licensing partners as a critical component of our client support in this area.

Business Result

As a result of our employee recruiting, engagement, and training, we have achieved strong agent retention, with attrition of only 1.6% per week and 20.9% for entire OEP.


Looking ahead, the client has started discussions with HGS regarding expansion of our outbound campaigns and voice recognition technologies. Additionally, we’ll glean lessons learned from our sales innovation, including our email campaigns, to optimize results for the next sales year. Finally, there is potential for HGS to expand support into additional geographies—adding to the long list of regions where we already sell to this client’s members. There is a strong and stable foundation of trust and collaborative partnership to build on. In only four years, HGS has delivered lower costs and strong conversion and retention, as key support of the client’s strong, growing, sustainable foothold in an increasingly complex marketplace.