1. Autonomy in the digital management of collectives.
With the constant increase in the number of options and services for different types of groups, companies that have to manage these services are faced with complex and inefficient processes. In this post we will analyze how the management of these groups can be digitized, focusing on the analysis of healthcare groups. The concepts used are also applicable to other environments, for example the management of groups with life insurance or the management of car fleets.
Next, we are going to describe the experience of managing groups with company health insurance. We will do so on the basis of the integration of three operational modules involved in the platform:
- Insurance Company Back-Office
- The Private Area of the group or company
- The Private Area of the employee/beneficiary of service or insurance company
The fundamental idea is to design the solution to enhance the self-management of the group by the company or those responsible for the management of the group, with minimal intervention by the back office department of the insurance company. This is essential in the administrative management of the registration and deregistration of employees in the group, in the authorization of services and in the ability to provide information on services or insurance coverage. All this without having to expressly request it from the insurance company, that is, without depending on it.
The autonomy given to the managers of the group to be able to carry out administrative procedures without depending on the company is only the first step to consolidate these processes. The optimum is to improve and enhance the ability to integrate this management within the company’s own portals or applications. This is an increasingly marked trend in large companies, where the employee portal is a centralized gateway to provide services of all kinds in better conditions than those that the employee can find on their own.
2. How to manage a new registration in a group
To concretize and fix the concepts of the model we are going to describe a simple task: how the enrollment of an employee and his family in the corporate health insurance of a company would be managed. There are basically three operational modes for this task:
1. From the insurance company, appealing to the Company’s back office.
This is the traditional operation and is still predominant today. In this case, the company’s department responsible for managing the registration, normally Human Resources, informs the company, usually by e-mail or phone call, of the person’s incorporation into the group.
2. From a manager of the group.
In this case, the Human Resources department or the person responsible for the group is given access to the Group Management Area to carry out the procedure. This area may be integrated with the company’s internal management applications.
3. By the employee himself/herself.
By registering and accessing their Private Area. A registration request will be made, which may have to be previously authorized or authorized a posteriori by Human Resources also from the system itself.
This simplified schematic shows the high-level flows that represent this example.
3. Design of the applications of the digital collective management platform
From the point of view of the design of the applications and web services in which the system must be developed, the example task described is implemented in the same way for the Company’s back office as for the company’s Group Manager. A web service invoked from a company application or a landing or web portal is used. On the other hand, when this function is left in the hands of the employee, it is usual to carry out a validation or authorization process of the request by the company. This is usual in all those cases in which the company assumes all or part of the cost of the service. To do this, a workflow must be implemented that:
- It starts with the employee’s request.
- It goes to the company’s collective manager for approval and/or rejection.
- It ends when the insurance company that provides the service has been registered in the group.
This authorization or validation process can be supported by an authorizing center with rules established in the system to perform the validation automatically under certain pre-established assumptions. This process will free the managers of part of their work, making the operation much more efficient.
Beyond the example we have developed for the registration of an employee in a given policy or service, this system can be used to address other tasks such as:
- Termination of beneficiaries.
- Modification of data.
- Authorization of medical services.
- Product improvements.
- Purchase of services.
- Information documentation/certificates.
- Videoconsultations and issuance of prescriptions.
As a general design philosophy, systems should be constructed in such a way that certain tasks, especially the most common ones, are designed to be reused:
- From the company’s back office.
- From the collective’s portal.
- From an employee’s Private Area.
By using web services-based architectures, these can be invoked from corporate applications, facilitating their integration. Otherwise, they can be implemented in specific web or landing pages, white-labeled or not, for the group or for the employee.
4. Flexible Compensation Plans
This tool is becoming essential to assist in the management of the flexible compensation plans that companies are increasingly providing to their employees. As the number of services available to the employee grows, the complexity of their management and the number of resources that the company has to dedicate to this function increases. In these cases, the digitalization and self-management provided by the system makes it possible to replace manual and human-mediated procedures. In this way, people will be able to dedicate or limit themselves to the resolution of incidents and exceptional tasks.
