Case Study Health Insurance Medicare Sales

The Medicare growth plan leadership actually approved

Regional U.S. health insurance provider · 4M+ members

Regulated Medicare compliance environment

Inbound + Outbound Sales volumes sized

The Challenge

Leadership set the enrollment target. Nobody had sized what it would take.

The insurer was entering a growth phase for its Medicare business with ambitious enrollment targets and a hard constraint: costs could not grow in proportion. Medicare sales run inside strict compliance requirements and complex enrollment processes, so simply adding agents wouldn't deliver the number. Staffing, training, call handling, and contact strategy all had to improve together, and executives wanted the financial case before funding any of it.

A regulated sales environment

Every tactic had to clear Medicare compliance and enrollment rules before it could count toward growth.

Every discipline in scope

Staffing, training, call handling, and contact strategy each carried part of the target, and none had been sized.

An unfunded investment

Executives needed a defensible ROI case before approving the hiring and training spend.

Our Approach

Size the operation the target actually requires.

01

Discipline Review

Reviewed sales processes, quality standards, call handling, and regulatory adherence against practices specific to Medicare enrollment and retention.

02

Strategic Roadmap

Co-created a prioritized tactic roadmap with stakeholders from sales, operations, and leadership, aimed at conversion, enrollment volume, and sales performance.

03

Staffing Model & Capacity Sizing

Sized the agents, team leads, and support roles required to hit the financial objectives and service levels for projected sales volumes.

04

ROI Model

Connected the proposed staffing, training, and operational improvements to projected revenue, giving leadership the financial case in their own terms.

The Results