Open Enrollment Preparation Guide

ISI Language Solutions is a leading provider of language access solutions for health plans and their providers. By providing industry specific solutions for over 37 years, ISI has developed a deeply rooted understanding of our clients’ processes, business objectives, and annual calendar-based workflows.

ISI possesses a wealth of experience and knowledge as it relates to health plans, language services and Open Enrollment (a.k.a., annual enrollment period or AEP). As you and your colleagues prepare for this critical time, consider the guidelines below.

Identify Targets 

  • Review market demographics and identify key non-English speaking markets, which can vary widely from state to state. Roughly 75% of U.S. Hispanics speak Spanish at home and 1/3 say they’re not proficient in English. Communicating with potential members in languages and formats that they can understand is vital to ensuring success.
  • Identify the uninsured population. The uninsured represent 30.1M individuals, or roughly 11% of the non-subsidy eligible population. Data shows that just one in three Hispanics is insured.

Ethnic minorities represent $3.6T in purchasing power. Hispanics account for more than half, spending $10B on health, wellness, prescription drugs and OTC products.

Review Resources 

  • Review the details of last year’s AEP campaign. Were deadlines met? Budgets adhered to? Most importantly, were members satisfied? Did enrollment increase? Were all standards of compliance met? Thorough reviews and evaluations can improve and simplify processes for next year. Check out ISI’s blog post from 2019 to learn more about conducting this type of review.
  • Audit member-facing functions in 5 key areas: claims, marketing, membership, customer care and pharmacy. Client facing communications include websites, marketing brochures, social media, summaries of benefits, enrollment materials, welcome and sales kits, forms, member letters and calls. Identify any of the file requirements or guidelines that have changed since the previous year.
  • Assess your supplier relationships to ensure that you have the right partners supporting you. Your language service provider should be able to assist you with translations across all of your requested languages, in any of your supported file formats. Transmission and connectivity should be seamless. As a standard, they should have multiple eyes reviewing each of your translation projects to ensure the best results. They should also support you and your team with customer service, training and ongoing account management with data and real-time reporting on progress.

Prep & Schedule

  • Establish or update style guides, glossaries, and translation memories. These tools help to ensure consistency across projects and will improve efficiency over time.
  • Establish timelines for document creation, revisions, editing, translations and reviews to synchronize with the insurance industry’s annual calendar.
  • Understand and plan for alternate formats (including Braille, Large Print and Audio) to ensure regulatory compliance with the Americans with Disabilities Act (ADA). If you receive federal funds or support federal programs like Medicaid or Medicare, you’ll also want to ensure that your website and other communications technology are accessible to all and in line with Section 508 of the 1973 Rehabilitation Act.

Interested in learning more about planning for Open Enrollment? Contact us!