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HEALTHCARE

Streamlined Benefit Plans Drive Cost Efficiency for Vantage Health Plan


The Challenge

Vantage Health Plan Inc. prides itself on providing highly flexible plan designs that combine variable per diems, multiple out-of-pocket maximum values and a wide range of deductible options. However, maintaining almost 200 benefit plans was a labor-intensive and lengthy process that the health plan wanted to eliminate. The team at Vantage had prior experience working in the Federally Facilitated Marketplace, where the TriZetto QNXT™ core administration system applies cost sharing reduction (CSR) functionality to health benefit plans offered on health insurance exchanges. The team approached the QNXT solution experts at Cognizant to help streamline Vantage’s processes and find solutions to cut down the number of benefit plans it needs to create and maintain.


Our Approach

With valuable insights from the Vantage team, Cognizant designed and implemented enhanced CSR features to streamline the plan building processes associated with its non-exchange business. Using a single plan to cater to multiple cost sharing variants, we helped Vantage lower the number of benefit plans it maintains by 93%. In addition, by reducing the amount of time required to create a benefit plan by 80%, the health plan was able to free up experienced staff and deploy them to higher value tasks such as conducting audits to boost accuracy.

Vantage Leverages QNXT’s CSR Capabilities

Together, Cognizant and Vantage Health Plan tapped into the full potential of the QNXT benefit system and effectively used its CSR capabilities to streamline benefit plan design and implementation while driving more rapid implementations of sponsor/plan annual renewals and additions.

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93%

reduction in the number of benefit plans

80%

saved in benefit plan creation time

Improved

implementation of sponsor/plan annual renewals and additions


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