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How to Provide a Better Shop and Enroll Member Experience

By Jason Gelsomino 08.18.22
Reading time: 4 minutes

Sales and marketing have historically not been a central focus in the payer space. The attention has concentrated on claims, adjudication, and the provider network. But one area of sales and marketing continues to be a vital tactic of every payer marketer’s strategy – shop and enroll.  

It is the role of the sales and marketing team to build interest with potential members and then tee them up for the shop and enroll experience. Except this is the point where many marketers are floundering. They are finding that they can get consumers in the health plan race but are having trouble getting them to cross the enrollment finish line.  

The problem is mainly based on the consumer experience. The issue goes back to the basic principles of consumerism in healthcare. Today’s consumers expect a more personalized and consistent experience when enrolling in a plan. And when they don’t get it, they move on to the competitor. 

The challenge is that most payers don’t have an effective shop and enroll solution in place from both a systemic and a technology perspective. And if they do have one, it most likely lacks the modern capabilities needed to make the payer a differentiator in the space. By adding the advantages of Salesforce Industries, payers will have a platform that enables them to provide the ultimate consumer shop and enroll experience. 

What is shop and enroll?

You may have heard shop and enroll referred to by the terms Configure-Price-Quote (CPQ) or quote-to-card experience. Think of shop and enroll like a shopping mall. It’s an online portal where members and potential members can browse, research, and enroll in a healthcare plan based on their specific criteria. For example, an individual versus a family plan, seeing what a deductible will be, or comparing the advantages of an HMO against a PPO. 

Even though the shop and enroll process is similar to what employees do for commercial enrollment, we’re not referring to employer-based plans because the goal is not to sell to a company’s employees. Shop and enroll is all about selling directly to a consumer through the marketplace or a commercial insurance payer. The primary purpose is to entice the consumer to log on to the portal, search for a plan, and enroll. 

Once the consumer has completed their research, the shop and enroll system takes them through the stages of the enrollment process. The consumer creates an individual account and enters a quoting flow. The soon-to-be member will:

  • Enter their demographics.
  • Fill out a medical questionnaire. 
  • Select their chosen medical and/or dental plan.
  • Receive a quote based on their parameters.
  • Get a plan summary to review.
  • And then they’re enrolled! 

This is the tipping point where a consumer converts to a member. The bonus is that members can continue to return to the same self-service portal to manage their healthcare plan and renew when needed.

Why should a payer consider Salesforce Industries for shop and enroll?

The major challenge we often see with payers trying to execute a shop and enroll system is dealing with the competition on the exchange. Back to that shopping mall analogy, consumers want to look at multiple stores before returning to the one that is right for them. And all those stores are competing for the consumer’s business. 

Salesforce Industries is the key to getting consumers to come to a payer’s “health plan store.” It provides a faster and smoother approach to shop and enroll that results in a direct and positive impact for the payer. The secret sauce of Salesforce Industries lies in its guided flow that helps improve the consumer experience and makes it super easy for them to take the enrollment process step by step.  

By using shop and enroll powered by Salesforce Industries, a payer can speed up quoting time by 40x and go from weeks to minutes. If a payer doesn’t have an electronic quoting system, then potential members would have the clunky process of having to pick up the phone or send an email and wait a while for the requested information. Having shop and enroll speeds up and streamlines the quote-to-order process because the online portal is available 24/7 with instant access to the necessary information. 

What are the key features of Salesforce for shop and enroll?

By leveraging shop and enroll powered by Salesforce Industries, organizations can transform how they manage the quoting, enrollment, benefits management, and renewal processes for healthcare payers.  

These are some ways that Salesforce combined with Salesforce Industries enhances the member experiences, optimizes operations, and provides a 360-degree view of the patient for the shop and enroll system. 

  • Health Cloud is essentially the hub of the shop and enroll model and where the contact center lives. Member advocates can see complete views of members’ clinical and non-clinical data as well as have centralized access to the available products, services, and prices. 
  • Community Cloud for Healthcare extends data and experiences to members, groups, brokers, and providers. It helps to tailor experiences for each user type using CRM data.
  • CRM Analytics for Healthcare leverages predictive analytics to gain actionable, AI-powered insights to support member health outcomes. Use it to spot trends, find answers, and create new best practices.
  • Salesforce Industries Quoting, Enrollment, and Renewals: These features use OmniScript to create the easy-to-use flows that guide users through the shop, enroll, and renew experience.

These are some of the other available Salesforce features that support a payer’s shop and enroll process from beginning to end: 

  • Benefits Catalog creates, launches, and configures benefit offerings with the declarative configuration for simplified management throughout the entire lifecycle.
  • Benefits Rating supports comprehensive rating methodologies, matrix-based table lookups, and calculations across product categories for all pricing scenarios.
  • Lead/Event Management provides compliant lead search and qualification as well as sales and education event management.
  • Telesales Management allows telesales agents to execute scripted call campaigns to new leads, prospects, and lost customers.
  • Benefits Marketplace provides a modern shop and quote experience with rule-based operations and guided decision support through any channel.
  • Benefits Renewal delivers a shopping engine that generates current, alternative, and recommended product selections to retain customers. 

Consolidate, streamline, and automate with Silverline

Members want a user-friendly experience as they shop for coverage that meets their needs, but outdated payer systems are complex and disjointed. Give your members confidence in their coverage choices with operational efficiencies for intuitive shopping and enrollment.  

Start building a connected healthcare system with Silverline. We’ll help you integrate data across business lines and product types so you can automate eligibility, personalize recommendations, and create workflows based on data-led insights. Learn more about how we can elevate your shop and enroll member experience.  

Ready to see real results? We can help.

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