USE CASE
Governing High-Volume Member Communications at Scale
Every year, health plans must deliver ANOCs, EOCs, SBs, SBCs, and other member-facing materials across Medicare, Medicaid, and commercial lines—often under immovable deadlines. As benefit designs grow more complex, manual processes can’t keep pace, increasing errors, delays, and costly errata.
Imagenet’s Plan Benefit Package Module ® (PBP) and Collateral Management Module ® (CM) replace fragmented production with governed, automated workflows—so plans can scale confidently and deliver audit-ready member communications on time.
THE CHALLENGE
Manual Member Communications Workflows Create Risk and Rework
Most health plans rely on disconnected, manual processes to manage high-volume member communications:
Benefit data lives across multiple systems and spreadsheets, increasing inconsistency.
Document creation requires repeated manual edits, increasing error risk.
Review and approval cycles lack version control and visibility.
Late-stage changes trigger rework and fire drills.
Translation, accessibility, and fulfillment are often handled as downstream add-ons.
For example, when benefit updates occur close to CMS deadlines, teams must scramble to revise ANOCs, EOCs, and SBs/SBCs across multiple formats. Without governed workflows, even small changes can cascade into missed deadlines, errata mailings, or compliance exposure.
These inefficiencies increase administrative burden, delay delivery, and put regulatory compliance at risk.
THE SOLUTION
Governed Automation Connects Benefit Data To Compliant Member Communications—End To End
Imagenet’s PBP and CM modules work together to automate member communications —from approved data through document delivery:
Centralized benefit intelligence (PBP): Plan benefit data is consolidated into a governed source of truth, with rules-driven logic aligned to CMS models and requirements.
Automated document generation (CM): ANOCs, EOCs, SBs, SBCs, and other member materials are dynamically generated directly from approved benefit data—eliminating manual rekeying and duplication across documents.
Built-in governance and controls: Versioning, approvals, audit trails, and documented rules ensure outputs remain accurate, compliant, and defensible.
Integrated accessibility and language support: Translation and 508 remediation are embedded into workflows and timelines — not handled as last-minute steps.
Scalable fulfillment: Secure print and mail with end-to-end tracking ensures materials move from approval to mailbox with full visibility.
Together, PBP and CM transform member communications into a repeatable, compliant, and scalable operation.
REAL-WORLD IMPACT
Health Plans Deliver Faster, Cleaner, Audit-Ready Communications at Scale
Organizations using Imagenet’s PBP and CM modules achieve measurable results:
Thousands of compliant member documents produced accurately.
Reduced errata mailings and rework.
On-time delivery, even under tight CMS and ACA deadlines.
Streamlined review cycles with full traceability and accountability.
One leading Medicare Advantage and Commercial Group plan produced more than 46,000 member documents across 480 unique plans using Imagenet’s PBP and CM modules—covering Individual & Family (on- and off-exchange) and Small and Large Group plans—while maintaining full compliance and meeting regulatory timelines.
Operational Applications
CMS-required member communications: ANOCs, EOCs, SBs/SOBs, SBCs
Medicaid materials: Member handbooks and state-specific communications
Commercial lines: ACA-regulated SBCs and benefit summaries
Accessibility and reach: Translation, 508 remediation, and alternate formats
Fulfillment: Secure print and mail with end-to-end tracking
Ready to Modernize Member Communications?
Discover how Imagenet’s PBP and CM modules help health plans automate member communications with confidence—reducing administrative burden while staying compliant at scale.