Presentation Title Presentation Title Second Line

AuthorTitle

LEANLandmark Enrollment Application Navigator

©2016 Pegasystems Inc.

Joe TreichelOptum IT SponsorCarolina RayarOptum IT Delivery ManagerTrent OlsonUnitedHealthcare Owner

Who is Optum?

Helping people live healthier lives

Health Benefits

Named one of world’s Most Admired Companies in Insurance and Managed Care by Fortune in 2011–2015

$157.1BFY15 revenue

Ranked 14thof the Fortune 500

$67.6B+ FY15 revenue 100,000+ employees

OptumHealth OptumInsight OptumRx

Our business landscape:

Helping to make the health system work better for everyone

Health Services

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Optum Success with Pega®

Projects generating over

60%auto processing of work

Projects exceeding

9xoperational improvement

Projects above

$275 millionin net benefit

Projects with 50% rate of return 32 applications in production and more in the pipeline

25average number of active projects

120+ projects completed in 4 years

10average opportunity pipeline

25k+internal users

100k+ external users

157best practices, standards,

and how-to’s

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expert services

53

reusable assets

Pega® Registered Business Partner

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Why LEAN?

Why build a Sales Agent-facing enrollment tool?Last year during the Medicare Annual Enrollment Period, over half of the applications submitted were by paper.Electronic applications are faster, provide better data, and are less expensive to process.UnitedHealthcare needed a mobile enrollment tool that enables their sales agents to meet consumers in a variety of locations; homes, restaurants, retail locations, community meetings, etc.

Fewer application errors Reduced expense Increased sales

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What is LEAN?

Landmark Electronic Application Navigator (LEAN)• New electronic enrollment application for UnitedHealthcare,

built on a Pega platform • Accessed from a mobile app (using a tablet device) or a computer

Faster• All Medicare

Advantage/ Part D plans available

• One-stop shop

Easier• Streamlined application• No more

signature pads!

Better• Built-in safeguards• Ability to view

applications

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PC Laptop

LEAN: Support and Compatibility

BrowsersDevices

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UnitedHealthcare Sales and Distribution Challenges

Challenges Implications / ImpactsPrevious application was cumbersome for field agents to use, especially the signature pad anddevice compatibility

• Poor usability• Negatively influences agents’ choice of which carrier to offer

Four separate code bases implement the rules for online, offline, eModel, and telesales code to present applicable questions and answers for the selected plan

• Inconsistency to agents and enrollee• Maintenance burden• Cost of ownership

Previous application did not support all products, which leaves paper applications as the only option

• Results in manual entry and enrollment into multiple enrollment systems, negatively impacting quality and cost

Data capture validation quality is poor • Enrollment is the origination of input and poor quality reduces claim auto adjudication rates among other data quality impacts

• Leads to downstream member dissatisfaction and negative impact on Star Ratings

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Success Factors

• Sales agent ride along– Operational walkthrough with agents– Consumers

• Pilot (proof of concept)• Optum / UnitedHealthcare collaboration

– Senior leader engagement– UnitedHealth Group culture (integrity, compassion, relationships, innovation, performance)

• Iterative agile methodology– Playbacks

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Optum Technology Solution

• Consolidate enrollment rules for all products, all containedin one source

• Pega technology advantages– One application design executes on multiple platforms

• All leading browsers (i.e., Chrome, Firefox, IE, Safari)• iOS and Android

– Responsive UI• Insulates developer from complexity of HTML5/CSS3 to support transition

between landscape and portrait display– Strength in integrating rules with the overall application design including

navigation, presentation, and processing– Manages offline complexity with little or no developer involvement

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Optum Technology Delivery Challenges

• New to mobile development– Optum catching up in this space– App store submittals

• High involvement with IRM and mobile security• More DMZ environments needed in lower levels (Dev, QA)

– Can’t get a true test of an external-facing app within firewall– Cell signals in office building poor (Coffee Shop Testing)

• Bleeding edge of vendor software (Pega PRPC 7.1.8)• 7,000 concurrent users - performance testing

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LEAN Adoption

Statistics

Over 80,000 applications taken since implementation

Over 10,000 unique selling agents

Significant training and marketing execution

Positive feedback from sales agents that LEAN is intuitive and easy-to-use

No major outages during AEP

35% Decrease in agent time to complete an application

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Promotional Video

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DEMO

UnitedHealthcare®: 2016 Pega® Business Impact Award Winner

June 5, 2016, PegaWORLD

Differentiated valueAward given to companies who have deployed a Pega application AND achieved staggering results via quantifiable business returns in the area of Customer Service, Sales and Onboarding, Marketing, Operations or Pega 7 Platform

Solution• New electronic enrollment

application for UnitedHealthcare, built on Pega platform

• Accessed from mobile app via tablet or computer

• Optum and Pega partner to roll out mobile Sales Agent Enrollment app for UnitedHealthcare clients

Results• Tool focused on individual

Medicare and Retirement plans and has over 7,000 agents trained on using the tool, processing more than 1,000 applications per day on agents’ mobile tablets

• Time to value demonstrating a “best in class” user experience

Landmark Electronic Application Navigator (LEAN)

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Q&A