Health Insurance · Bilingual ACA
Every channel on one system, every renewal worked, every policy on the book accounted for.
A South Florida agency running ACA health, life, and tax lines was answering WhatsApp by hand on one phone, tracking clients in spreadsheets, dialing renewals one at a time, and finding out a client had been moved to another agent only when someone got around to the monthly check. We rebuilt the operation around a single CRM and an AI layer on the phones, WhatsApp, and follow-up. The first open-enrollment season after go-live looked very different.
What was breaking
The agency was growing on the strength of a bilingual, referral-heavy book, but the operation underneath had not kept up. Every channel was run by hand, and the busiest weeks of the year, open enrollment, were exactly when the manual approach fell apart.
- WhatsApp Business handled by hand on one phone number. Conversations were never preserved, nothing was logged anywhere, and there was no way to follow up at scale.
- Client data spread across a stack of Google Sheets, with no single source of truth across the health, life, and tax lines and no checks on what was being entered.
- Renewals during the ACA open-enrollment window done by agents dialing manually, one client at a time, so throughput was capped exactly when volume peaked.
- Inbound calls went to voicemail after hours. No bilingual greeting, no routing, no callback. Those callers were simply lost.
- Multichannel follow-up (calls, voicemail, SMS, email, WhatsApp) done ad hoc or not at all, with nothing to catch a client whose income changed or who moved.
- AOR, EACD, and RCCD forms filled out by hand, one client at a time.
- When a client's policy was moved to another agent, a once-a-month manual review was the only thing that ever surfaced it, so up to a full month of commission was gone before anyone could act.
What we built
One CRM wired to every channel, with an AI layer sitting on top of the phone, WhatsApp, and follow-up. The renewal calling piece is an agent-assist dialer: it qualifies and warm-transfers, it does not bulk-dial.
Multichannel follow-up automation
An AI layer reaches clients across phone, voicemail drop, SMS, email, and WhatsApp on a defined cadence: it confirms their information, catches changes in income, address, or household, surfaces plan-specific details like covered medications and services, helps them find in-network doctors, and books medical appointments. Every touch is logged to the CRM, so a client who moved or whose income changed no longer falls through.
AI renewal-call assistant ("dialer 2.0")
During open enrollment it calls clients due to renew, asks if they have a few minutes, and warm-transfers the ready ones straight to a licensed agent, so each agent works 2 to 3 times more renewals in the same window. Bilingual English and Spanish from day one. It collects what an agent needs to quote (income, household size, immigration status, ZIP, address) and can optionally be voice-cloned so it sounds like the team. This is agent-assist, not bulk dialing: the system qualifies and hands off, it does not blast a list.
WhatsApp Business automation, on the same number
AI answers FAQs instantly, sends value messages and follow-ups, auto-creates client groups, sends personalized voice notes, and sends Meta-approved bulk templates safely, with number warm-up and template compliance so the line does not get banned. Existing conversations are migrated and preserved on the way in, and everything mirrors into the CRM.
Custom CRM build, plus team training
One CRM wired to every channel, with reputation management, automated AOR and EACD form generation, lead segmentation, dead-data reactivation campaigns, sales funnels, a website and landing pages, and social auto-posting. Separate workspaces keep health, life, and tax cleanly apart, and the data has quality controls on it instead of being whatever someone typed into a sheet. Delivered with hands-on training so the team can run it.
Bilingual inbound line
Answers every call instantly, detects English versus Spanish, captures name, email, and phone, routes to the right department, and books a callback automatically when agents are busy, so after-hours and overflow callers stop going to voicemail. After-hours capture went from nothing to all of it.
Agent-of-record protection
The system watches the book for policies being moved to another agent. Before, the only thing that ever caught it was a manual review run roughly once a month, which meant the agency could be out a full month of commission on a policy before anyone even knew it was gone, and often longer before it could be corrected. Now, the moment a policy is reassigned off the agency's book, the team gets an automatic alert and can move on it the same day, while there is still time to fix it.
Rollout was phased over fifteen weeks: WhatsApp and the CRM first, then the renewal and inbound-call systems, then the custom bots and cross-sell automations, then consolidation and handoff, with three months of support included.
After the first open-enrollment season
Ninety days after go-live, with one full ACA open-enrollment period behind the new system, the numbers had moved across every channel we touched.
What shipped: a single CRM with separate workspaces per line of business, a multichannel follow-up engine, the agent-assist renewal dialer, WhatsApp automation on the existing number, a bilingual inbound line, and agent-of-record protection, all logging to the same system, with the team trained to run it.
Client identity and internal system IDs are withheld. Figures are drawn from this engagement and vary by deployment, scope, and how much of the roadmap actually gets shipped.
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