Support to State-Based Health Benefit Exchanges

States choosing to operate their own Health Benefit Exchanges (HBE)—rather than directing residents to enroll through the federal Exchange—were faced with the formidable challenge of enrolling tens of thousands of uninsured individuals and families during the 2013-2014 inaugural year of the Affordable Care Act. Unprecedented in scale and complexity, the volume of service requests and inquiries from multi-cultural consumers seeking assistance by phone, email, web chat and other channels could not be predicted in advance. Clearly, several states needed a leading contact center provider with proven expertise in pioneering new, high-stakes implementations; managing complex government programs; rapid deployment; and delivering first call resolution and exceptional customer service.

During the summer of 2013, Faneuil opened a multi-channel contact center to help a state connect 1.1 million uninsured individuals and families with affordable health insurance coverage. Designed to serve as the initial point of contact for most customer inquiries regarding coverage, the Faneuil-operated contact center helps residents and small businesses understand the costs and benefits of multiple plan options; assists in determining eligibility, program selection and enrollment; and provides information regarding tax credits and billing. Considerable emphasis is placed on educating uninsured individuals about the advantages of enrolling in qualified plans that will provide health and wellness coverage for themselves and their families. Faneuil also serves as an initial point of contact for consumers seeking access to Medicaid and Children’s Health Insurance Programs (CHIP).

Faneuil completed site selection in the State’s capital city, stood up the new center, collaborated on the development of the training curriculum, and opened the new site for the continuation of staff training early in the summer of 2013. During a pilot launched nearly a month before the Open Enrollment, our staff began responding to general questions from callers regarding eligibility and enrollment.  When the enrollment window opened on October 1, 2013, calls were being processed by 80 in-state Customer Service Representatives (CSRs), with overflow managed by staff in Faneuil’s health insurance eligibility center in Martinsville, Va. In response to call volumes exceeding forecasts, Faneuil rapidly expanded in-state operations with the addition of a second center and 105 seats, and increased overflow support in Martinsville by another 95 seats—all by the first of December. In Jan. 2014, Faneuil provided temporary triage services from facilities in Hampton, Va., and Orlando, Fla., strengthening the program with an additional 220 CSRs and increasing total staffing to 500 CSRs operating from five networked, HIPAA-compliant centers. Hours of operation were also extended during Open Enrollment to expand customers’ access to center staff.

This partnership continues today. Bilingual CSRs fluent in English/Spanish and English/Vietnamese, Russian, Mandarin and Ethiopian, as well as those skilled in use of TTY services for the hearing and speech impaired, are on site, with a language line providing live translations for approximately 195 other languages. In addition to our contact center responsibilities, Faneuil also developed and implemented a Customer Relationship Management (CRM) database system for the State. The system is configured to fully integrate with Faneuil’s telephony platform, providing CSRs with “screen pops” in advance of each interaction so that customer data can be retrieved quickly.

Faneuil’s service to State HBE’s continues to grow. For example, one of the nation’s most populous states urgently requested call processing assistance during its second annual Open Enrollment period. Though the State operated its own customer care center, overflow support was required to ensure that all contacts were answered, applications were processed, and coverage was secured before the enrollment window closed.

Just seven weeks before Open Enrollment, Faneuil was notified of its selection as one of two vendors to provide this overflow support. As Faneuil had already been operating a network of HBE contact centers for more than a year, ramp-up for this project was significantly expedited.

Faneuil immediately began procurement and preparation of a facility in the State’s capital city; recruited, hired and trained an initial staff of 440 employees; installed infrastructure and deployed other critical elements to get the program up and running. Infrastructure for the initial deployment included the installation of connectivity and 520 workstations.  An additional 60 workstations were installed to provide additional capacity for production and support staff.

Expedited training of Faneuil’s Customer Service Representatives (CSRs) – which included CSRs who were bilingual in English and Spanish, Hmong, Mandarin, Vietnamese, Tagalog and Cantonese to assist the State’s multicultural residents – was delivered in collaboration with the State. The initial three-week training program included specifics of the HBE program and Faneuil’s training on contact center skills. Our new hires participated in instructor-led classroom sessions and computer-based lessons to comply with security and privacy regulations (including provisions of the Health Insurance Portability and Accountability Act), procedures for determining eligibility and enrolling participants in qualified healthcare plans, and navigation of the systems required to assist customers.  Extensive focus on soft skills, such as communicating clearly and being sensitive to the varying needs of a diverse customer population, was included in the curriculum.

Upon completion of training for the CSR group, and while system technology was being installed at Faneuil’s newly established facility, we began transporting our staff to the State’s own contact center about 140 miles away so our CSRs could begin working immediately to help manage call volumes and document processing. As overflow volumes continued to increase, Faneuil secured and opened a second site, procuring and installing an additional 160 workstations and 60 training stations. Between the two facilities, Faneuil provided the local technology infrastructure and desktop installation for more than 1,000 workstations operating seven days a week.

During the inaugural Open Enrollment period, completed March 31, 2014, Faneuil staff responded to 564,296 calls and processed 162,665 pieces of mail, fax, and email correspondence for our first State HBE client, which also retained us through contract extensions to provide contact center services for the 2014-2015 and 2015-2016 Open Enrollment periods.

At the peak of 2014-2015 Open Enrollment season, Faneuil CSRs processed monthly averages of more than 296,000 calls and nearly 10,300 chat sessions for our second State HBE client alone. Having successfully fulfilled our initial contract, Faneuil not only was awarded a new contract to manage overflow services for the 2015-2016 Open Enrollment period, but was made the sole vendor for overflow support.

By all measures, Faneuil performed expertly in navigating the complexities and challenges of implementing the Affordable Care Act nationwide. From our interactions with previously uninsured individuals and families, we know how profoundly their quality of life has been impacted by having access to health care. We are honored to have been so integrally involved in connecting tens of thousands of Americans with more affordable healthcare options.

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