How a U.S. Payer Delivered 75% Throughput During AEP, Surpassing Benchmarks with AI Workforce Support

timer 3 min read

Doubled Medicare Sales, Exceeded AEP Targets

The Client

A leading national healthcare payer managing high-volume ACA marketplace enrollments during AEP. Each year, the organization must prepare its operations to guide thousands of consumers through plan selection, eligibility inquiries, and enrollment completion within a limited enrollment window, making throughput a critical performance metric.

The Challenge

The client needed to ramp its domestic marketplace workforce of Spanish-speaking agents within a three-month period for non-licensed enrollment support. This compressed hiring timeline put AEP throughput at risk, as new agents needed to reach proficiency quickly to meet enrollment demand while avoiding falling below benchmark performance.

The Solution

Everise deployed an AI workforce support to improve agent readiness through simulation-based training and real-time performance optimization.

The Result

EverAI.Simulator accelerated proficiency at scale, driving AEP throughput beyond the 69% benchmark.

The program reached 75% AEP throughput, surpassing the 69% benchmark during the enrollment cycle. AI workforce support through EverAI.Simulator enabled faster agent readiness via simulation-based training and real-time coaching, which improved throughput during peak demand.