For health insurance enrollment call centers, the Open Enrollment Period (OEP) is one of the most demanding times of the year. And preparation is everything. Success depends on how well teams handle the surge in call volume, tight deadlines, and complex compliance requirements.
In this high stakes period, agents focus on helping consumers select the right health plan, while managers work to keep acquisition costs down, protect caller ID reputation, and encourage the kind of positive experience that leads to increased health plan enrollments.
The best-prepared call centers enter OEP with trained teams, a steady flow of fresh, high-intent leads, and modern technologies that help them get the most out of those leads and improve performance while navigating strict regulations such as the Telephone Consumer Protection Act (TCPA) and health insurance privacy rules.
CPA: The true measure of enrollment efficiency
In health insurance enrollment, efficiency is paramount for call centers. And it isn’t measured by the number or length of calls, but by how many quality enrollments result from the resources invested.
Cost Per Acquisition (CPA) is the metric that connects daily activity to business outcomes. A low CPA indicates that a center is connecting with high-intent leads, minimizing wasted dials, and adhering to regulations governing the manner and frequency of consumer contact.
Conversely, an inflated CPA occurs when call centers prioritize raw volume over lead quality and agent utilization. High CPA erodes margins and frustrates both agents and consumers.
Focusing on CPA aligns dialing strategy, staffing, and compliance practices with the real goal: delivering affordable and compliant enrollments.
The key to lowering CPA is planning ahead, which, for many lead generation and enrollment call centers, means implementing substantive changes before OEP begins.
Prioritizing the changes that matter
The most impactful changes are practical rather than flashy. Alignment across sales/enrollment, operations, and compliance/QA minimizes errors and ensures smoother handoffs. Real-time dashboards enable managers to identify and resolve issues quickly, while optimizing the efforts that are driving success. Centralized consent and suppression lists ensure outreach complies with regulations such as the TCPA and CMS guidelines, while respecting consumer privacy.
The key for health insurance enrollment call centers is prioritization:
- Handle high-intent leads first
- Equip agents with accurate, current data
- Implement smart automated outreach cadences and optimize them based on results.
Prioritization supports enrollment goals and builds trust that lasts beyond the enrollment season.
The common pitfalls that impact enrollment
A common pitfall for call centers during OEP is chasing volume over quality. When agents spend time on leads that aren’t ready or can’t be reached, cost per acquisition rises and potential revenue is lost.
Another serious problem is overlooking compliance. Failing to adhere to rules around consumer consent, call frequency, time-of-day restrictions, or data privacy exposes call centers to legal risk and undermines consumer trust.
Siloed teams – where sales/enrollment, operations, and compliance don’t coordinate – also drag down performance. The most successful centers identify the friction points that truly impact enrollment and address them systematically, rather than focusing on vanity metrics that don’t move results.
Technology that drives smarter enrollment
Data and automation are transforming how enrollment and lead generation call centers prepare for Open Enrollment.Teams that haven’t invested in these capabilities recently will start OEP at a disadvantage.
A modern technology toolkit typically includes:
- Powerful dialer-based platform with key features like speed-to-lead functionality to increase success rates, answering machine detection to avoid wasted agent time and omnichannel outreach capabilities.
- Automated phone number management that improves caller reputation and contact rates, selects the optimal caller ID in real time and lowers CPA by reducing blocked or unanswered calls, especially those flagged as spam.
- Workflow automation that structures call cadences and coordinates outreach across channels so no lead is over-dialed while still receiving timely, well-paced follow-ups
- Intelligent call routing that connects consumers with the right agent quickly, improving both conversion potential and agent efficiency.
- Real-time dashboards that track contact rates, lead status, and agent performance, helping managers make strategic decisions and quick course corrections.
- Built-in compliance safeguards, including real-time DNC and Reassigned Numbers Database (RND) scrubbing and centralized consent management, to ensure outreach aligns with TCPA and privacy rules, while maintaining consumer trust.
Together, these technologies improve efficiency and remove friction so agents can focus on the conversations that lead to successful enrollments.
Guiding performance through the right metrics
For any outbound call center, contact rate is the north star of metrics. Without live connections, enrollment campaigns underperform and fail to meet goals.
But contact rate is not the only measure that matters. Successful teams monitor a range of metrics that provide real-time insight and enable quick adjustments:
- Cost per acquisition (CPA) – Measures how efficiently leads convert. Tracking CPA throughout OEP helps teams spot when contact or conversion efficiency starts to slip.
- Abandonment rate – Ideally kept under 3% to avoid frustrating consumers and losing opportunities.
- Agent wait time – Should stay within 20–30 seconds, to keep agents productive
- Lead freshness/Speed-to-lead – Engaging leads within 48 hours of generation sharply improves connection and conversion rates.
- Compliance adherence – Monitors consent status, and Do Not Call (DNC) violations to ensure outreach adheres to TCPA and CMS rules
- Enrollment rate – Indicates how often agents complete an enrollment, a key measure of call effectiveness and consumer experience.
These metrics, together, help leaders gauge efficiency, maintain compliance, and fine-tune performance throughout the enrollment period, guiding continuous improvement rather than waiting for results after the fact.
Putting it all together
The path to strong OEP performance is to start early and take a holistic approach.
Adding more agents or buying more leads are just pieces of the puzzle, but they don’t address the multifaceted challenge of open enrollment. Securing enough phone numbers well in advance, training new hires before peak weeks, and building a plan to keep lead data fresh throughout enrollment are equally important.
Teams must be aligned around meaningful metrics, such as CPA and contact rate, rather than vanity measures like total dials.
Success during the critical period of open enrollment hinges on making small, disciplined improvements over time. These changes can make the difference between hitting enrollment goals or falling short.
Nima Hakimi has led the company since its start-up days in 2006 as an innovator of outbound contact center software solutions. Under his leadership, Convoso continues to expand into new growth markets, and to develop future forward products that enhance the performance and efficiency of success-driven companies. As an active industry leader, Nima is in demand for speaking and advisory engagements, where he shares his knowledge and experience about best practices, compliance, and strategies for sales and lead generation teams. Nima is a board member of R.E.A.C.H. (Responsible Enterprises Against Consumer Harassment) and advises on how contact centers in the lead generation ecosystem can be compliant as well as profitable.
This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.
