By
Cheryl Gibson
Health plans today face extraordinary pressure to reduce administrative cost, improve efficiency, while delivering an improved member experience. Members expect fast, digital-first interactions. Regulatory demands grow more complex. And legacy approaches (also known as doing “business as usual”, are becoming untenable.
The potential gains from modernizing are substantial. According to McKinsey, AI and automation could reduce administrative costs by $150 million to $300 million for every $10 billion of payer revenue, while also boosting revenue by up to $1.24 billion.
Across the industry, digital transformation is accelerating. A 2024 survey of digital health decision-makers found that 75% have increased spending on digital health solutions in the past two years, driven by consumer demand, outcomes, and cost savings.
In this blog, we will focus on the one distinct process that impacts all payers… quoting. We will show how payers can rethink the quoting process in three simple phases. With this approach, quoting becomes a strategic engine for growth, accuracy, and agility.
The Current Challenges with Payer Quoting
Health plans often wrestle with disjointed quoting processes. These processes are typically trapped in manual work, fragmented tools, or outdated platforms that barely communicate with one another. That fragmentation slows everything from quoting, approvals, and downstream processes.
High manual labor and error risk
Sales/Account Management, Underwriters, and operations staff spend too much time shifting spreadsheets, reconciling versions, and chasing missing data. As complexity grows (more plans, options, compliance rules), error rates creep up.
Slow quote-to-card cycle
When the quoting process is disconnected from enrollment, billing, and core systems, passing information along can involve multiple handoffs and manual intervention—dragging the overall timeline.
Data silos and weak integration
Legacy or homegrown systems often don’t share data in real time. That means the quoting process can remain in isolation from critical changes within the healthcare industry. Changes in product infrastructure, claims adjudication automation and the ability to “bill what was sold” can limit responsiveness and lend itself to dissatisfaction..
Limited insight into quote performance
Many payers lack visibility into why particular quotes fail, conversion rates, product viability, or how quoting activity aligns with profitability. Without dashboards and metrics, decisions are based on gut or hindsight rather than forward-looking data.
Scalability constraints
A quoting architecture designed for standard plan designs breaks under volume, complexity, or new market launches. Adapting to new plans, regulations, or distribution models becomes risky and resource-intensive.
Corporate Insight published a benchmarking study of 23 payers across 240 desktop and mobile functions to measure the digital experience. The findings underscored the vast disparity in how well payers deliver digital capabilities to members, brokers, and employers.
Fixing quoting can unlock downstream gains. But in order to do that well, you need a deliberate, phased approach.
Phase 1: Foundational Quoting
The journey starts with building a solid foundation. This phase establishes a single source of truth, applies compliance guardrails, and introduces automation that streamlines quoting from the ground up.
Product and Benefit Catalog Setup
A centralized product and benefit catalog is the cornerstone of Phase 1. By capturing plans, riders, and pricing attributes in one repository, payers eliminate the confusion of scattered spreadsheets. Version control ensures start and end dates are tracked, regulatory changes are reflected, and prior authorization requirements are consistently applied.
Salesforce Quote-to-Card Foundation
Once the catalog is in place, Salesforce can be configured to support both simple and complex quoting scenarios. A rules engine enforces eligibility, underwriting, and compliance requirements, reducing errors and keeping quotes aligned with regulations.
Workflow Automation
Guided workflows move quotes through each step—proposal, enrollment, and beyond—while tracking SLAs for turnaround time. This reduces bottlenecks and creates predictability across the process.
Document Automation
Plan-level data feeds directly into proposals, contracts, rate sheets, and SBCs. With e-signature capabilities, documents are finalized faster, and outputs can be shared with member and provider portals for greater transparency.
Dashboards and Reporting
Decision-makers gain visibility into the quoting pipeline through real-time dashboards. Metrics such as close ratios and win/loss reasons provide clarity on what’s working and where improvements are needed.
By the end of Phase 1, quoting moves from a fragmented, manual process to a centralized system with clear workflows and guardrails. This foundation sets the stage for payers to integrate with core platforms and unlock greater efficiency in Phase 2.
Phase 2: Operational Efficiency & Integrations
With a strong quoting foundation in place, the next step is to connect processes, reduce manual work, and accelerate the quote-to-card journey. Phase 2 focuses on automation and integration with the core platforms payers rely on every day.
Census and Enrollment Automation
Quoting often begins with census data from employers or brokers. Instead of rekeying information, Salesforce can import census files using standard templates or EDI feeds. Validation rules check eligibility and accuracy, reducing errors and eliminating wasted cycles.
System Integrations
A true quote-to-card process requires more than standalone quoting. At this stage, Salesforce integrates with enrollment, claims, billing, and rating platforms. Finalized quotes can flow automatically to downstream departments like Implementations, minimizing manual handoffs and ensuring consistency across systems.
Renewals Made Simple
Renewals are a major source of administrative burden. In this phase, renewals are automated once the current year is finalized. Workflows can also handle mid-year plan changes, adjusting benefit offerings and updating downstream processes seamlessly. What once required manual intervention becomes a repeatable, efficient process.
Broker and Employer Portals
Self-service is another key lever for efficiency. By enabling brokers and employers to generate quotes, submit enrollment information, and track real-time status updates through a portal, payers reduce the workload on internal teams while improving the experience for external partners.
Streamlined Operational Workflows
Internally, handoffs between sales, underwriting, and implementation teams are automated. Approvals are embedded into workflows, and status updates remain visible across teams. The result is greater transparency, less back-and-forth, and faster turnaround times.
By the end of Phase 2, payers have an interconnected quoting ecosystem. Processes that once relied on manual inputs are now automated, and data flows smoothly between systems. This shift reduces administrative effort, speeds up onboarding, and improves collaboration across internal and external stakeholders.
Phase 3: Advanced Analytics & Scalability
Once quoting is digitized and integrated, payers can unlock the next level of value: intelligence and scale. Phase 3 focuses on analytics, AI, and a scalable framework that supports growth and adapts to changing market conditions.
Advanced Analytics
Leadership needs more than basic pipeline visibility. Salesforce enables profitability dashboards segmented by line of business, along with risk scoring and year-over-year loss ratio trends. These insights help sales and account management teams identify which quotes are most likely to convert or renew, turning quoting into a proactive, data-driven process.
Large Group and Complex Segments
As payers move beyond individual and small group quoting, the solution must support complexity. Salesforce scales to handle custom benefit designs, tiered networks, and carve-out scenarios. Underwriters and actuaries can model different options directly within the system, reducing turnaround times for even the most complex cases.
Compliance and Audit Automation
Keeping up with annual filings and regulatory plan design changes is a heavy lift for most organizations. In this phase, compliance tasks are automated, with risk-based approval routing ensuring that the right checks are completed before a quote advances. This reduces compliance risk while freeing teams from repetitive tasks.
AI-Powered Enhancements
Artificial intelligence adds intelligence to efficiency. Features such as AI-guided quoting recommendations, natural language intake for census data, and sentiment analysis of broker and employer interactions take quoting to a new level. These enhancements not only save time but also strengthen relationships by making every interaction more informed.
Scalability Framework
A modern quoting solution must grow with the business. Salesforce provides a modular architecture that allows payers to onboard new products quickly, expand into new markets, and extend functionality to include areas like broker and internal agent commissions. This flexibility ensures the quoting process remains future-proof.
By the end of Phase 3, quoting is no longer a back-office function. It becomes a strategic enabler that provides insights, drives better decisions, and scales as the organization grows. With analytics, AI, and a flexible framework, payers are positioned to compete in a market where speed, compliance, and intelligence are non-negotiable.
The Business Outcomes of the 3-Phase Approach
Adopting Salesforce change management tools with a structured, phased approach delivers measurable business benefits. By aligning people, processes, and technology at each stage, organizations move past surface-level adoption to real transformation. The impact shows up in both operational performance and long-term strategic outcomes.
Stronger User Adoption and Engagement
When users feel supported and equipped, they are more likely to embrace new tools fully. The phased model ensures that:
- Teams receive training when they need it, not all at once
- Feedback loops allow improvements to be made along the way
- Confidence grows steadily, leading to higher usage rates
Organizations that invest in user adoption typically see greater ROI from their Salesforce initiatives.
Reduced Operational Risk
Change introduces uncertainty. A gradual rollout, supported by Salesforce change management tools, helps minimize disruptions by:
- Identifying potential roadblocks early
- Allowing adjustments before full-scale deployment
- Reducing the likelihood of costly mistakes
This risk management translates into smoother transitions and fewer setbacks.
Faster Realization of Value
Instead of waiting months or years to see the benefits of a new Salesforce system, the phased approach helps organizations capture value earlier. Leaders can:
- Measure small wins quickly
- Use data to refine strategies in real time
- Scale successful practices across the business
This accelerates time-to-value while keeping momentum high.
Long-Term Business Resilience
Beyond immediate gains, the 3-phase approach sets the stage for sustainable growth. Companies that follow this model are better prepared to:
- Adapt to new market conditions
- Support ongoing innovation within Salesforce
- Maintain alignment between technology investments and business goals
Ultimately, the phased framework doesn’t just deliver short-term wins. It builds a foundation for lasting business resilience.
Client Story: Digitizing quote requests to accelerate sales cycles
One Pennsylvania-based health insurer was struggling with inefficiencies in its Large Group quoting process. Sales teams relied on static Excel forms that often came back incomplete, leading to internal confusion and delays in building benefits. The lack of structure slowed down deal cycles and created unnecessary friction for both employees and prospects.
To solve this challenge, TELUS Digital implemented a dynamic quoting form within Salesforce using Health Cloud and OmniStudio. The new solution introduced:
- Conditional logic and data validation to ensure submissions were accurate the first time
- Version control and plan selection tied directly to prospects or customers
- Seamless integration with downstream processes, eliminating manual back-and-forth
The impact was immediate. Manual errors dropped , quoting accuracyimproved, and the client gained a scalable process that could evolve with their needs. Most importantly, the insurer’s own team was empowered to own the solution. After go-live, they were confident enough to build their own enhancements and data integrations—proof that the system was not only effective but sustainable.
Partner with TELUS Digital
Rolling out Salesforce effectively requires more than the technology itself. Success depends on having the right partner who understands how to balance technology with people, processes, and outcomes. TELUS Digital combines deep Salesforce expertise with a proven change management framework to help organizations maximize the value of their investment.
With TELUS Digital, companies gain:
- Specialized Salesforce knowledge that ensures solutions are tailored to industry-specific needs
- A structured, repeatable change management approach that drives user adoption and minimizes disruption
- Clear alignment to business outcomes so every stage of the project ties back to measurable results
- Long-term partnership and support to help organizations evolve with Salesforce and unlock new capabilities over time
Partner with TELUS Digital today to unlock the full potential of Salesforce and transform your quoting journey end to end.
