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GroupHEALTH Benefit Solutions

Transforming Customer Experience Across a Complex Benefits Organization

Mapping the complete client lifecycle across three customer types, identifying systemic breakdowns, and driving improvements from data infrastructure to first-claim experience

Product Design CX Strategy Product Marketing Journey Mapping

The Challenge

A $950M benefits provider serving 450,000+ Canadians had fragmented systems, distributed teams, and no unified view of how clients and plan members actually experienced their products.

450K+
Canadians covered
7K+
Client organizations
3
Customer types served
$950M+
Annual premium

Mapping the System Before Changing It

As I learned the organization over my first six months, I mapped how work actually flowed across sales, underwriting, claims, and renewal. The journey map became a high-traffic wall mural where teams saw how their decisions created friction elsewhere.

Client Lifecycle Journey: Prospecting → Renewal

Recreated from memory (original was a high-traffic wall mural)

← Scroll to explore full lifecycle →

New Business Development

Cold calling to book sales conversations

  • High turnover due to pace of cold calling
  • Quotas and commission bonuses
  • Success required belief in product differentiation

Sales Conversation

Review current plan, pitch GroupHEALTH

  • Educate clients on renewal windows vs contracts
  • Licensed to sell benefits plans
!

Quoting & Underwriting

Collect client data, calculate risk, prepare quote

  • Sales sometimes overpromised what UW could deliver
  • Timeline confusion between teams and clients
  • Back-and-forth via email to finesse costs
  • UW caught between sales and client expectations
!

Plan Setup

Code plan into WEBS platform

  • Data re-collected (names, contacts, salaries, classes)
  • Printout → manual re-keying into system
  • 80% employee data completion required to proceed
  • Often waiting on clients to provide complete info
!

Enrollment Window

~2 weeks, often delayed

Late = manual, miss optional CI

!

Account Setup

"Didn't I already sign up?"

Temp passwords, GH vs ClaimSecure confusion, resets

Ongoing Usage

Members use benefits

CS supports Plan Admins, claims handled

!

Claims Processing

First-claim confusion

Explanation of benefits unclear, ClaimSecure complaints

!

Renewal Prep

Staff overtime, time-sensitive

Hard to gauge plan "health", systems tied manually

Renewal Decision

Negotiate or flat increase

Renew or terminate

Smooth stage
!
Friction point

Systemic Patterns Identified

🔗
People as System Glue
Fragmented systems were tied together by people which was incredibly tedious and inefficient
⚖️
Sales/Underwriting Misalignment
Sales and underwriting were misaligned when they should have been equipped to better help one another
Post-Purchase Uncertainty
Unnecessary client confusion at multiple steps contributed to post-purchase uncertainty
💬
Journey-Blind Communication
Client and plan member communication was often complex and did not always consider the entire journey
🔄
"Why Do I Have to Repeat Myself?"
Data did not flow between steps internally the same way a client perceived it should
📋
Insurance-Heavy Language
Plan member communication regarding claims and coverage was complex and insurance-language-heavy

Client Lifecycle Data Redesign

Led one of three org-wide process redesigns. Mapped how data moved from prospecting through renewal, identified redundancies, defined ideal state.

System of Record
My work became the foundation for a unified data model showing clients what they'd already submitted and automating handoffs
Progressive Disclosure
Additional fields appeared only when needed (staff positions, salary bands) without re-asking for basics
Automated Setup
Data flowed automatically to plan setup, eliminating manual re-entry and associated errors

Explanation of Benefits (EOB) Redesign

First-claim processing was make-or-break. When plan members didn't understand their EOB, they complained to employers who questioned their purchase decision.

Plain Language
Removed jargon, explained what an EOB is, made claim codes understandable
Information Architecture
Moved codes from footer to inline under each claim. Proximity over mental assembly.
Visual Design
Color and hierarchy made paid/denied/partial visually distinct at a glance

Impact: Reduced support calls, improved plan member satisfaction with first-claim processing

Plan Member Education Resources

Created plain-language resources to reduce onboarding confusion and give plan members early access to learn the app before they received credentials.

Using the App guide screenshot
Using the App Guide
Early-access walkthrough showing plan members how to use the app before onboarding. Reduced "I already signed up" confusion.
View live site →
Benefits coordination page screenshot
Benefits Coordination
Plain-language explanation of coordination of benefits — replaced insurance jargon with actual human language.
View live site →

Marketing Strategy Shift

After Pragmatic Institute training, I shifted GroupHEALTH's sales approach from product-led (listing features) to problem-led (addressing client needs). Created needs-based marketing assets that became foundational to prospecting.

Mental Health Isn't Optional flyover
Mental Health Flyover — Problem framing: whole-person health vs. isolated coverage features
Download PDF →
Disability Prevention Benefits Everyone flyover
Disability Flyover — Emergency kit metaphor: preparedness over product features
Download PDF →
Prescription Medication flyover
Prescription Flyover — Cost containment framed as partnership, not limitation
Download PDF →
Benefits plans should run like utilities: stable, predictable, and quietly reliable. The experience around them (sales, setup, claims) is where we make an impact.
— GroupHEALTH philosophy on customer expectations

Key Metaphors Developed

First Aid Kit
Match health events to plan components. Leads with scenarios, not products.
Emergency Kit
Disability coverage as preparedness. You don't want to use it, but you need to know what's in it.

What Changed

Data Infrastructure
Informed system of record initiative that streamlined client onboarding and eliminated redundant data collection
First-Claim Experience
EOB redesign reduced support calls and improved satisfaction at critical trust-building moment
Sales Approach
Marketing assets shifted prospecting conversations from feature lists to problem-solving
Feedback Loops
Launched plan member surveys and onboarding sessions (80-95% satisfaction)

The work operated at multiple levels: tactical fixes (EOB layout), strategic initiatives (data infrastructure), and organizational change (how GroupHEALTH talked about its value).