Open Enrollment
Every call answered. Every medication checked. Every enrollment completed — even at 2 AM on deadline day.
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Frequently Asked Questions
How does the Associate handle medication lookups? +
The Associate navigates a locality-specific drug formulary — including tier classifications, prior authorization requirements, quantity limits, and step therapy protocols. It uses fuzzy matching and phonetic interpretation to handle complex pharmaceutical names spoken over the phone. When a caller lists their medications, the Associate checks each one against the formulary and provides personalized plan guidance.
Can it handle calls for someone other than the caller? +
Yes. The Associate supports proxy enrollment — a family member or caregiver calling on behalf of someone else. It also handles tandem enrollment for multiple people in the same household during a single call.
What happens outside of open enrollment season? +
After the enrollment window closes, the Associate shifts to qualifying life events — job loss, marriage, new dependents, relocation — that create special enrollment eligibility. It also handles general inquiries, CSR routing, and message-taking year-round.
Does the Associate replace licensed agents? +
No. It handles intake, qualification, and formulary navigation — the administrative work that consumes licensed agent time during peak season. Complex enrollments, plan comparisons requiring professional judgment, and final enrollment confirmations route to your licensed staff with full context.
Open Enrollment Doesn't Wait. Neither Should Your Callers.
Every missed call during OE is a member who might not enroll. We partner with you to ensure every caller gets through — day, night, weekend, deadline day.