Coronavirus and Health Insurers

Social distancing and shelter in place strain the industry’s tech infrastructure

 By Dennis Negron

 As COVID-19 continues to spread throughout the U.S., health insurers are evolving to meet the needs of their membership. The changes required to manage this crisis will, in some cases, accelerate long term trends in health insurance distribution and member engagement already under way. The most disruptive consideration for decision-makers is how to adapt to Americans who continue to essentially “shelter in place” or at least avoid as many social encounters as possible.

 New York Governor Andrew Cuomo estimates the impact of the virus may last up to 9 months, which would require insurers to make significant changes to many processes that today rely on in-person interactions. Carriers without digital engagement infrastructure will be challenged to navigate this uncertain environment. Those that are prioritizing investments in technology will position themselves for success, and we at EnterMedicare have seen a big uptick in carriers reaching out for guidance on how to modernize infrastructure.

Regardless of the formal end-date of the crisis, the effects of social distancing and fear of physical harm will be felt for many months following shelter in place. Here are a few examples of how this crisis will impact the business of each and every health insurance carrier going forward.

  • Remote member enrollment becomes the norm, requiring advanced technology adoption for member engagement

The shift to technology-enabled sales has been progressing for several years. With beneficiaries shifting behavior sharply away from in person meetings, agents and carriers will need to adapt the form and substance of their appointments. Digital and online engagement represents the most reliable and scalable channel. This evolution in engagement format will be felt across product lines, but is particularly true in Medicare due to the health risks reported for 65+ populations.

  • Large scale agent recruitment and training events will move online

As we approach the first “social distancing” AEP, Medicare carriers will be forced to appoint, educate, train and onboard agents digitally. Technology presents a tremendous opportunity to scale these efforts and reach more agents more effectively, and allows for onboarding and appointment to become interactive. Carriers can go beyond basic information transition, and use the appointment process to understand unique broker needs and understand how to effectively segment and then service a diverse agent channel.

  • Increased digital sales will allow for more “know your customer” at intake

Carriers can capture more information on consumers upon enrollment. Digital policy submissions allow carriers to intake more data at the point of enrollment, and this data can be used to streamline onboarding, increase personalized care plans and drive more effective communications with members year-round.

  • Insurers will continue to improve targeted communications, especially during national health crises

Investments in digital will allow insurers to intake, sort and action consumer data more effectively. Understanding pre-existing conditions upon enrollment, and sorting this data into actionable communication plans allows carriers to provide poignant information to consumers during health emergencies. People with preexisting conditions that may be at higher risk can receive more detailed instructions on how to protect themselves, saving lives and building customer loyalty.

Dennis Negron is founder and CEO of EnterMedicare, a technology company that builds AI driven software for large health insurers. The company is backed by leading venture capitalists including investors such as former Google chairman Eric Schmidt and actor Will Smith. Prior to EnterMedicare, Dennis launched Oscar Health Insurance in California and spent six years with Citigroup. He holds an MBA from Stanford University and is based in Los Angeles.


Reach him at for additional perspective and solutions on these fast-moving market dynamics.