Tufts Health Plan Case Study – Partner since the early 1980s

About Tufts Health Plan

Tufts Health Plan, founded in 1979, is a not-for-profit health maintenance organization (HMO) that provides top-ranked health care coverage to individuals and employer groups throughout a six-state region.

Situation

Tufts Health Plan was looking to create a non-group website with an online quoting capability for consumers to compare and shop Tufts Health Plan for individual and family health insurance plans.

Solution - Why Tufts Health Plan Chose Mosaic

Tufts Health Plan called upon Mosaic Insurance Exchange to help them develop and execute technology solutions for their small group and non-group insurance markets.


Todd Lienhard, Manager of Tufts Health Plan Client Services, explains: “When we launched our non-group solution, it was determined that Mosaic Insurance Exchange was the best fit for the new solution we needed because of the customer experience, long-standing experience in the industry, the standard of excellence of their enrolling and billing systems, as well as their presence in the marketplace and pricing.”

Key services Mosaic Insurance Exchange provides Tufts Health Plan are:

  • Enrollment – With goals of accuracy and timeliness at the forefront, Mosaic Insurance Exchange handles the quoting, online enrollment and plan/policy-rating functions for Tufts Health Plan. This includes a weekly enrollment feed integrated into Tufts Health Plan’s system with very little enrollment reconciliation needed between the 2 companies.

  • E-billing – One of the most beneficial services that Mosaic Insurance Exchange provides for Tufts Health Plan is an electronic billing and payment capability.

  • EDI Submission – The EDI files are simple and load directly and efficiently into Tufts Health Plan’s system, allowing for increased accuracy in forms.

  • Customer Service Support – Mosaic Insurance Exchange’s call center support is robust, and the account management is set up in a way that is conducive to Tufts Health Plan’s business efforts. Mosaic Insurance Exchange experts are readily available for renewal questions for individuals as well as on the group side for brokers and employers.

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