A Long Standing Journey Of Technology Transformation
The Context
Argus Dental and Vision was a regional player in the Group Dental and Vision Insurance industry before being acquired by Aflac in 2020. Following this acquisition, Aflac significantly expanded it’s market reach. Within a short timespan, they had onboarded more employers and employees, expanded their provider network, increased daily claims processing and formed new broker partnerships to drive the sale of Aflac’s Dental and Vision products.
The Business Need
With the rapid growth in mind, Aflac D&V set out to overhaul their technology landscape, ensuring an industry-leading experience for all stakeholders while mitigating the operational challenges that arose during this expansion.
Productivity
- Automation of repetitive tasks
- Streamlining of operations through integrated systems
- Accelerated processing of data & transactions
Scalability
- Ease of scaling processes
- Flexibility to add new functionalities as the business grows
- Ability to enter new markets with minimal additional overheads
Competitive Advantage
- Ability to keep up with industry standards and trends
- Ecosystem to offer new and improved products/services
- Enhanced customer experience and satisfaction
Security and Compliance
- Improved data security measures spanning encryption & firewalls
- Protection against cyber threats and data breaches
Innovation and Growth
- Development of new business models and revenue streams
Our Approach to Transformation
As we defined the roadmap for the systems and processes to be developed, we carefully considered some key factors to not just ensure an enhanced experience for both internal and external stakeholders, but also a smooth and undisrupted transition from the existing business processes and systems to the new ones.
The Journey
Year 01
Year 01
Foundational Setup :
Defined the Technology Stack, Design Patterns, and Infrastructure for Integration, Portals, and APIs.
Key Considerations :
Performance, Scalability, Flexibility, Future-Proofing, and Development Speed.
Initiatives :
- Deployed Docgen for generating welcome packets in production
- Initiated the Development of API layer with Base Entity definitions
- Designed the DI framework, incorporating Mule and Business Rules components
- Made DI framework production-ready for one eligibility source and 2 group sources
- Completed Member Portal for CG groups
- Completed Provider Portal for CG and MA group members
Key Achievements
- Developed and deployed the initial system in just 2 months, setting the foundation for rapid innovation
- Transitioned to event-based document generation with EIS and Kafka, expanding to 8 document types across 3 business lines and generating over 2.3 million documents to date
- Integrated APIs with 11 different data sources from the start, ensuring seamless connectivity
- Built ABS’s first modern Member Portal in 2 months
- Optimized claims processing, reducing turnaround time for greater transparency
Year 02
Year 02
Initiatives :
- Completed the design and development of Employer and Broker portal
- Expanded DI to support additional eligibility sources and formats
- Developed DI Portal
Key Achievements
Integration Portal
- Designed and built the Aflac integration platform in 3 months supporting :
- 50+ Enrollment Vendors
- 5 Clearing Houses
- 2 Group Vendors
- 3 Billing Systems and 1 Payment System
- Implemented comprehensive end-to-end auditing and step-by-step tracking
- Enabled configuration with multiple file formats including Flat files, CSV, EDI (834, 837, 835, 277, 999), XML, Spreadsheets
- Optimized resource usage for processing large files efficiently
- Ensured comprehensive reporting and transaction tracking for groups, members, and claims
- Offered Detailed UI showcasing transformation, enrichment, and validation steps
- Achieved a benchmark of under 1 second for page load time, even with high transaction volume
Employer Portal
- Developed in 2 months enabling tailored views for external brokers and corporate Aflac agents, ensuring a personalized experience
- Enabling Employers to directly terminate members, streamlining administrative tasks, manage invoices and set up one-time or recurring payments with ease
Year 03
Year 03
Initiatives :
- Initiated and completed comprehensive EIS Integration discussions and designs, covering DI, Portals, & Docgen
- Successfully onboarded new groups to EIS while enabling parallel operations across multiple claims systems
- Designed and developed Aldera to EIS conversion, including claims integration with Aflac clearing houses
- Enabled Dental and Vision claims submission via the Provider Portal
- Migrated ~500K MA members to EIS
- Finalized the Health Plan Portal design and development
Key Achievements
Integration Portal
- Migrated 18K groups and 120K members from Aldera to EIS using the DI platform
- Achieved a 0% Drop Rate, ensuring all groups and members were accounted for
- Built the Health Plan Portal in 3 weeks
- Enabled MA health plan partners to view membership, claims, and prior authorization data
Year 04
Year 04
Initiatives :
- Ensured Efficient Handling of 500K+ Members and Millions of claims spanning 10 years
- Perfected application enhancements and performance optimization
- Indexed all EIS data to improve performance and reduce dependency
- Stabilized integrations with EIS
Through our long-standing partnership with Aflac, we are dedicated to continuously improving experiences, streamlining workflows, and evolving systems to keep pace with their changing needs. By leveraging innovation and technology, we support Aflac in achieving operational excellence and driving the realization of their business goals.
If you can introduce your business vision to us,
We can realize it with speed & perfection