California workers can expect a lot less hassle when enrolling for healthcare benefits this year thanks to a sweeping digital modernization initiative.
This project, called Health Enrollment Self-Service Capabilities (HESC), digitized California’s health insurance enrollment process for the state’s more than 1.5 million public employees, retirees, and their families. It will eliminate the need for manual paperwork by departments and simplify changes submitted by employees. The California Public Employees’ Retirement System (CalPERS) expects to save thousands of hours in staff time thanks to the project, and reduce its environmental footprint dramatically.
Officials at CalPERS promoted the benefits of the digitization effort by nominating the project for this year’s National Association of State Chief Information Officers (NASCIO) State IT Recognition Awards.
“Nearly all of CalPERS 1.5 million health members will be able to make health plan changes, anytime they need, online, in only a few clicks,” said Rob Jarzombek, CalPERS Chief of the Health Plan Research & Administration Division, in the state’s NASCIO nomination. “The resulting reduction in paperwork by members and [agency] employers, as well as the reduction in mailed hardcopy letters, will be substantial.”
Jarzombek said the state had to confront its outdated paper forms and documentation challenges that were wasting time and resources for staff. During the year state employees have different life events, such as marriage or a change of address, that often require health enrollment changes. The process for this demanded employees request changes via paper forms, then for supervisors and human resources staff to manually upload a file to the state approving the request.
“This has historically been a very cumbersome and manual-driven process and we’ve heard from employers that it can be especially challenging to keep up with the volume of transactions during open enrollment,” Jarzombek said, adding that CalPERS open enrollment period, which runs from Sept. 19 to Oct. 14, is usually when 50-60 percent of the transactions take place.
Yet, while putting everything online might seem simple in principle, the complexity of state IT systems and policies called for Herculean effort from state technologists and administrators. Because of the sheer scale of the project, Jarzombek said it had to be broken down into three phases and involved input from a slate of agencies. The phases were designed to stagger enrollment submissions, starting with new state contractors in July 2021, widening to already enrolled state employees in early December 2021, and finally opening up to every state employee last July. Jarzombek said CalPERS Health Account Management Division (HAMD) led each phase from start to finish.
“Throughout the project, we met with representatives from various state and public agencies to ensure they have an opportunity to provide input on the design of this new functionality as one of the primary users,” Jarzombek said.
Going forward, CalPERS said its user surveys have shown near unanimous support for the project. The state’s contracting agencies reported an 87 percent overall member satisfaction rating. And for members overall, the system received a 70 percent satisfaction rating with 100 percent of users saying they’d recommend the system to colleagues.
Jarzombek said a defining attribute of the project was its benefits for both employees and administrators.
For employees, the project provides fast, 24/7 online access to manage health enrollments, does away with paper forms, and allows for easy management of supporting documentation — no more tracking down paper documents.
For administrators, the project provides timely electronic notifications regarding progress of employee transactions, open enrollment streamlining, and easy viewing and management of transactions and supporting documents. This reduces manual intervention and makes it easier for employers to keep track of everything.
As a next step, Jarzombek said they’ll be gathering more survey feedback from members and administrators to identify new opportunities to enhance the state’s health enrollment.
Image: Coolcaesar at English Wikipedia