Highlights
- An excellent customer experience is essential to building a successful self-funded health benefits plan for your company.
- Roundstone (as the captive solution) and Bywater (as the TPA) work together as an Integrated Health Plan, supporting both standard medical claims and larger stop-loss eligible claims for a one-stop shop that makes self-funding easy and seamless.
- With self-funding in the Roundstone Captive, you receive guidance every step of the way when building and implementing your employee health benefits plan.
Trying to communicate with customer support staff and being left on hold for hours can be a frustrating experience. When the customer service department does not understand you or your business needs, it can leave you feeling your time is not valued.
Jasmine Bibb, Director of Customer Experience at Roundstone and Bywater, keenly understands this and uses what she has learned from similar experiences in the health insurance industry to transform Bywater and Roundstone’s Customer Experience department into a space where all customers feel supported — every step of the way. A great customer experience is the cornerstone of an effective and successful self-funded health plan.
Customer Experience Is Everything to the Self-Insurance Journey
I sat down with Jasmine to talk about exactly what makes Roundstone stand out in the world of health insurance, particularly self-funded health insurance. Her answers show a focus on a personalized customer experience through dedicated customer care teams and a genuine desire to guide customers through their journey with Roundstone and Bywater. It’s that personalized touch that can be so critical to employee satisfaction with a self-insured plan that creates a remarkable experience for Roundstone’s clients and their benefit advisors.
For those who are considering self-funding as an alternative to being fully insured and those who are just starting their self-funding journey, the quality of support you receive throughout helps to ease any concerns and ensures a comfortable and easy ride.
What Is the Relationship Between Roundstone and Bywater?
First off, let’s clarify who’s who when we talk about Roundstone and Bywater.
Roundstone helps employers self-fund their employee health benefits through the Roundstone group medical captive, essentially sharing costs with other employers and leveraging stop-loss reinsurance for high-cost claims. The captive is the special sauce that reduces volatility and allows employers to participate in underwriting profits, instead of the carriers keeping all unspent premium dollars.
The group medical captive is an effective funding model for those who want to self-fund but are not large enough to rely on stop-loss alone. Roundstone also offers cost containment resources and expertise to help advisors and employers build toward a self-funding center of excellence.
Bywater is Roundstone’s in-house third-party administrator (TPA). In self-funding, a TPA processes healthcare claims and handles the administrative side of the plan. The role of a TPA is to handle the heavy lifting and create a seamless, trouble-free experience for the employer of a self-funded insurance plan. The TPA is the face of the plan to the employer, just like the carrier is for fully insured plans.
Roundstone (as the captive solution) and Bywater (as the TPA) work together as an Integrated Health Plan, supporting both standard medical claims and larger stop-loss eligible claims for a one-stop shop that makes self-funding easy and seamless. According to Jasmine, “While our customers have the freedom to choose their own TPA, many choose Bywater because they appreciate the integrated frontline customer service for all aspects of the health plan.”
Note that when we refer to just Roundstone in this conversation, we mean the combination of both Roundstone and Bywater, except where a topic is Bywater-specific.
How Do You Define a Great Customer Experience in Health Insurance?
According to Jasmine, in thinking about the Roundstone customer experience, she considers the following questions . . .
- Are we meeting our customers where they want to be met? (Reachability)
- Do we make it easy to purchase from and do business with us? (Convenience)
- Are we catering to the needs of our customers? (Personalization)
- Is the customer journey bogged down or straightforward? (Simplicity)
- Are we being consistent and ensuring we use every touchpoint available to us? (Flexibility)
“Admittedly we have an uphill battle,” says Jasmine. “I’ve never met a customer so inspired by the health insurance industry that they decided to get a tattoo of the affiliated business. Nor have I ever met a customer who was willing to prematurely spend money, to ensure they’ve reserved a front row seat, in preparation for a costly medical bill. Customers aren’t anxiously awaiting engagement with our industry. In most cases, customers interact (not engage) with the health insurance industry because they have to; it’s required.”
Many businesses in this industry compete primarily on the basis of customer experience. That means, it’s not about whose product is better or in some instances, who has the most competitive price point. The differentiator is the experience the customer has. We can attract new business based on our recommended solutions. However, converting a customer into a loyal customer is integrated in the actual experience we are delivering to our customers. Jasmine emphasizes that this philosophy permeates throughout Roundstone, no matter which department you work in: “We all impact our customers’ experience.”
Structure of the Customer Experience Organization at Roundstone
Throughout Roundstone, there are many teams that play a role in customer experience. Some of them, such as Regional Practice Leaders or Underwriting and Policy Administration, are part of Operations and Sales. What matters most is that these teams are collaborative and share Roundstone’s core values and customer-first mindset. For the purposes of our discussion today, we are focusing on the customer experience teams that report to Jasmine.
Jasmine clarifies what makes Roundstone’s approach special in the self-insurance world: “While all Roundstone customers have a dedicated care team, we also have specialized teams for different parts of the process.”
Our specialized teams include:
- Roundstone Implementation and Onboarding teams. These teams help employers design benefits plan documents, organize accounting processes, and understand what to expect from a self-insured health plan with Roundstone, using Bywater or another TPA.
- Bywater Service Center. The Bywater service center teams help plan members and providers understand their benefits and answer claims questions.
- Cost Containment Team. With a focus on proactive and reactive strategies to help reduce the costs of claims, this team’s area of expertise include data analytics, nursing, plan document optimization, claims, and underwriting. They use their expertise to find and evaluate the best cost containment solutions on the market and bring them to you.
- Relationship Management Team. These dedicated in-house teams provide employer and member-focused support and issue resolution for all Roundstone clients and their advisors, regardless of TPA. They also support the renewal process.
Jasmine explains that relationship managers handle each of the very different stages of the self-funding journey and deal with the day-to-day issues that a customer (employer or advisor) may experience in a self-funded plan. They ensure customers receive personal care and timely, accurate, and responsive service backed by key performance metrics that lead to high member satisfaction.
An Extension of Your HR Team
“Roundstone and Bywater customer service teams work with customers at every level, from employees to HR managers and team leaders,” Jasmine said. “We help everyday consumers understand their benefits when something goes wrong and they need to file a claim.”
As Jasmine explains, her teams help customers understand standard health plan elements like deductibles and HSAs, so they know their benefits and responsibilities.
“Roundstone also helps HR personnel from smaller companies realize the opportunity that self-funding presents,” she continued. “Ultimately our goal is to equip HR professionals and the everyday consumer with the tools needed to better understand health insurance and recognize when advocacy is needed. We like to think of ourselves as an extension of our client’s HR team. Oftentimes, the client segment size we’re servicing combines HR functionality under one department or one person. I’ve never met an HR professional who set out with the goal of entering HR to become a health insurance subject matter expert. This is why we believe our role in creating a good experience and building a solid relationship with our clients is so important.”
“We also work with advisors to find the ideal plan solutions for their customers,” she added. “The advisors are integral to everyone’s success.”
What are Roundstone’s Customer Experience Principles and Foundational Values?
“The one Golden Rule that defines and drives all we do is being employer-focused. Being employer-focused means that we are always aligned with the best interests of our clients,” said Jasmine.
“We are focused on pulling together advisors and other solution providers into one seamless experience. We treat people the way we like to be treated.”
Jasmine emphasizes to her customer care teams that health insurance is complicated. Most of us as healthcare consumers can attest to at least one baffling moment with a medical bill. ”It’s our job to make it easy to understand self-insurance. It doesn’t have to be so hard,” she asserts.
How Does Roundstone Train Customer Service Teams?
Jasmine shares that she has each new team member do a DiSC assessment to understand their personality type and what works well for them. It helps ensure they are in the right spot to help customers most effectively. The DiSC assessment helps the team member better understand their strengths as well as areas of opportunity. The assessment also helps them become more aware of personality profiles associated with their clients and, in turn, the expectations those individuals may have for service levels and information sharing.
Roundstone/Bywater also holds monthly professional development sessions to discuss the best ways to help customers — even when staff don’t have control over an outcome. It’s all about communication, empathy, and transparency.
“It’s crucial that every customer service professional on our team understands the integral part they play in our success,” Jasmine says.
She emphasizes how this philosophy aligns everyone around the same goal:
“Service center agents can sometimes see themselves as simply answering the phone. I don’t always think they realize just how significant they are to the work that we do. We always help them understand that they are professionals who contribute to our retention goals.
“They are a critical component of our 95% customer retention rate that validates the success of the Roundstone Captive.”
How Does Roundstone Customer Experience Measure Success?
“Measuring customer service performance is critical for analyzing member satisfaction of any self-funded health plan,” Jasmine said. “Assessing key metrics can help support staff make informed changes to how customers (both B2B and B2C) expect and/or want to be treated. That impacts how the team approaches strategy revisions and future initiatives. A great example would be the approach taken with the service center team.”
Jasmine aims for her staff to resolve any issues on the first call. She uses common metrics to evaluate her team’s effectiveness. Here’s a sample of some key performance metrics that keep the teams on track.
Call Audit Metrics
- How quickly were the calls answered? At least 95% of all calls must be answered in under two minutes.
- How long was the member on hold?
- Did they need to call the member back?
- How well did the customer support staff respond to the call?
- Did they ask the correct HIPAA questions?
- Was the agent’s tone professional and courteous?
- Was the information they obtained correct?
Relationship Management Metrics
- What is the customer renewal rate? A high renewal rate is a good indicator of customer satisfaction.
- What is the response time for emails? How long was the issue open? Issues should be fully resolved in under a week.
Onboarding Metrics
- How long does the onboarding process take? The entire process should take no longer than 30 days, including paperwork, plans, and billing.
Jasmine also prioritizes customer feedback to inform her assessment of her team’s efficacy. She sends surveys to customers at the end of the 30-day onboarding process for the Roundstone Captive and again after the client has been with us for six months. The survey addresses all elements of the customer journey, including questions about their experience and points to improve.
Roundstone Customer Experience In Action: A Self-Funding Success Story
A story that really touched Jasmine was an incident in which a Bywater agent was speaking with a member who had questions about her health benefits. The member had called because her provider stated that she had an outstanding balance for a previous appointment. When the member inquired as to why, the provider stated that her insurance had not rendered payment for the service. The member called Bywater for an explanation regarding the claim and expressed her concern about being sent to collections for an item her insurance should have covered.
The agent was unable to locate the claim in the system. She called the provider and was able to determine the claim was sent to the wrong address and helped redirect the provider to the appropriate address for submission. The agent then reached out to the claims dept to ensure the claim made it to Bywater and requested an exception be made to expedite it through the review and payment process to ensure there were no further issues. Once completed, the agent called the member back as a follow-up to provide education and resolution.
Jasmine points out that healthcare plans can be complex and frustrating, but they are also deeply personal. These stories illustrate her commitment — and that of the entire Roundstone team — to positive customer experiences and compassionate, personalized support. This greatly enhances the experience of a self-funded insurance plan.
Get the Best Customer Experience by Self-Insuring with Roundstone
If you’re thinking of switching to self-funding, the Roundstone Captive offers high-level customer service to support you through your journey. With dedicated customer care teams and knowledgeable, friendly employees who understand the ins and outs of self-funding, you have the guidance necessary to implement a self-funded employee health plan for your business.
Speak with us today to learn more about the benefits of self-funding in a group captive and how Roundstone gives you personalized support all along the way.
