APIs: The Key to Insurance Ecosystems

Application programming interfaces offer health insurance brokers an efficient and modern way to manage data and processes.

A man leaning on a windowsill in front of a large window while looking at his phone

It may be hard to imagine now, but there was a time not too long ago when individuals had to balance a checkbook to determine their available cash flow. Nowadays, consumers know better, having come to expect the modern experience of logging into an app or online account to see their current, pending and investment balances in real time.

Today, the health insurance and employee benefits industries are seeing a similar shift in mindset. Consumer expectations for how they research, select and procure most products today have reached new levels of sophistication, due in part to third-party experiences developed by digital leaders such as Amazon and Netflix.

With a wave of change in employee expectations, employers have placed a higher value on benefits programs to satisfy rising workforce needs and compete for scarce talent post-pandemic. All industry stakeholders — brokers, general agents, insurers, benefits providers and tech platforms — have abruptly found themselves functioning virtually. They strive for more intelligent, digitally enabled ways to do business and remain relevant. The insurance industry faces a great opportunity and significant risk as it changes in response to powerful demographic, societal and technological forces.

The healthcare industry, despite being a multibillion-dollar market, is known for its complexities and slow pace when it comes to technology adoption. Health insurance brokers, in particular, face challenges with managing data and processes among carriers, brokers, employers and the millions of employees they represent. For example, setting up a new plan requires brokers to gather information from various sources and enter it manually into their systems. This process can take hours or even days and is prone to human error. Furthermore, verifying eligibility, claims processing and communicating with carrier partners and customers often involves cumbersome and inefficient back-and-forth email transactions.

For one employer group to enroll with a carrier, it could take hundreds of hours of interactions spanning request for proposal (RFP) and quoting to plan consulting and routine service. This process includes the email transmission of millions of data points trapped inside PDFs, creating opportunities for quality control, lost time and errors.

A Better Way

Carriers typically have complex legacy systems that can be time-consuming and costly to update or replace and face significant regulatory pressures. If new solutions are ineffective or improperly implemented, the financial and reputational consequences could be disastrous. The lack of flexibility has prevented large-scale change and innovation within the healthcare ecosystem. In contrast, nearly every other industry has evolved at a pace and scale that at least meets consumer expectations.

Fortunately, application programming interfaces (APIs) offer a modern solution to integrate different systems and streamline processes, allowing health insurance brokers to save time, improve accuracy and enhance communications to improve the overall customer experience. An API is a set of protocols allowing different software applications to communicate. This means that data can be shared seamlessly between other systems, eliminating the need for manual data entry and reducing the likelihood of errors. With APIs, health insurance brokers can integrate their systems with carrier partners' systems, enabling real-time data transfer and automation of various processes.

One of the key benefits of APIs is the amount of time they can save for health insurance brokers. Brokers can free up thousands of hours each year by eliminating manual data entry and back-and-forth email transactions. As a result, brokers can focus on higher-value tasks such as building customer relationships, providing better service and growing their business. APIs also reduce the time it takes to set up new plans and verify eligibility, enabling brokers to respond to customers' needs faster and more efficiently.

See also: Building Your Digital Sales Arsenal

APIs can also help minimize the likelihood of human error in data entry. When data is entered manually, there is always the risk of typos, missing information or incorrect data. This can lead to delays, re-quotes and even legal issues. APIs, however, enable real-time data transfer and automatic data validation, ensuring that the information is accurate and up-to-date. This can improve the overall quality of service and reduce the likelihood of errors, elevating the customer experience.

Furthermore, APIs can enhance overall communication efficiency. With APIs, health insurance brokers can communicate with carrier partners and customers in real time, enabling faster responses. For example, when a customer submits a claim, the API can automatically transfer the data to the carrier partner's system, which can be processed quickly and efficiently, reducing the time it takes for the claim to be processed and allowing customers to receive their reimbursement faster.

Bridging the Human and Digital Touch

While the healthcare industry has made significant strides in new offerings and solutions, such as patient virtual reality and aggregated health data apps, the lingering effects of the pandemic continue to expose the lack of industry-wide data standards and customer interfaces. These challenges emphasize how true digital reinvention requires a strategic combination of data, a robust set of APIs to integrate data sets across organizations and domains and people with the consulting chops necessary to work meaningfully with the results.

Overall, APIs offer health insurance brokers an efficient and modern way to manage data and processes, saving time, improving accuracy and enhancing communication efficiencies. By integrating their systems with carrier partners' systems, brokers can streamline operations and improve the overall quality of service. This can lead to a better customer experience and enable brokers to grow their business by focusing on higher-value tasks. In today's fast-paced world, where customers expect instant gratification, APIs can help health insurance brokers keep up with the changing times and stay competitive in a challenging market.

Julie Cape

Profile picture for user JulieCape

Julie Cape

Julie Cape is the executive vice president of client services and SMB markets at OneDigital.

She oversees OneDigital’s select enterprise teams, which account for over 28,000 clients. Prior to joining Digital in 2007 as director of sales, Cape worked for a professional employer organization and a payroll/benefits agency.

She graduated from Indiana University with a major in criminal justice and planned on going to law school, but, after getting a taste of employee benefits during her first job out of college, Cape knew benefits was her true passion and never went back to school. Cape is licensed to sell life, accident, health and long-term care insurance.

Read More