Client case studies | Innovative approach leads to resourceful solution

PwC helps insurer meet healthcare reform requirement.

A large insurer was working hard to fulfill their exceeding complex statement of benefit (SBC) requirements within a tight time frame. The insurer turned to PwC to help with the thousands of SBCs it needed to produce so that they would be accurate, compliant, and ready for clients by the government’s deadline. PwC’s Virtual Business Office (VBO) was ideally suited to this task.

After the insurer decided to engage us to produce its SBCs, we formulated an action plan, staffed 60 people in our VBO, and developed a 280-item checklist that reflected the federal government’s SBC content and format requirements. During the multi-week engagement, we reviewed hundreds of SBCs a day, more than ten thousand in total. In the end, the insurer had its SBCs prepared in time for the first open enrollment period.

The ability of our VBO to process a tremendous volume of SBCs within a tight time frame allowed the insurer to meet a major health reform requirement by the government’s deadline.

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