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AEP Support Services

Member Enrollment and Management Services

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Annual Enrollment Period

  • Improved Operational Efficiency
  • High Membership Retention
  • Enhanced Regulatory Compliance
  • Reduced Cost to Serve
  • Improved Member Experience
  • High Manpower Utilization

The Annual Enrollment Period (AEP) is the busiest time for a Medicare Advantage Health Plans. Due to the limited time window and the competition to engage and enroll members, health plans witness a seasonal peak in the demand for sales and enrollment staff, tapering down by the end of the year or first quarter. During the AEP, health plans face resource constraints, application errors backlogs, error-prone manual activities and increased member grievances.

Wipro assists during AEP (and beyond) with its In-house Member Enrollment and Member Management services. It helps to quickly ramp up teams and address the increased demands of AEP season.

Wipro hires, trains, and manages enrollment representatives, who work as an extension of internal team of health plan. It supports end-to-end Membership business process spanning Eligibility, Enrollment, Billing, Reconciliation and Member Customer Service. As an extension to the existing team, Wipro's AEP Support services are offered with either AEP Staffing Model - AEP support leaving existing Client's Platform or Member360 AEP Module - AEP support leveraging Wipro hosted Member360 solutions.

With successful AEP management for last 6+ years, Wipro contributes to Financial Accuracy, Payment Accuracy & SLAs with 30% increase operational efficiency along with automated billing reconciliation.

Successful AEP Management for last 6+ years


Improved Service Levels


Increase in Operational Efficiency


Medicare Lives Supported

Health Plan AEP Challenges

High Cost

Operational Inefficiencies resulting to High operating expenses​

Missed SLA

High volume influxes in AEP (about 60% spike over BAU volumes) resulting to misses in TAT​

Manpower Shortage

Staff Hiring & Training Challenges​

Non - Compliance

Bandwidth Constraint of skilled resources considering increased focus on meeting CMS compliance and reporting requirements​

Reconciliation Errors

Oversight in Financial and Membership reconciliation for complex enrollment resulting to errors​

Member Dissatisfaction

Low Member satisfaction and experience​

Wipro Solution

AEP Staffing Model

Our dedicated Business Intelligence Team supports staffing analysis based on historical data unique to each client, placing the right staffing span for each client. Sudden spikes are managed with our signed-up factory model utilizing trained resources pooled and aligned for clients using common platform and states

Member360 AEP Module

Our deep and long-standing relationship with CMS for 30+ years as a trusted contractor has enabled us to offer an integrated automation solution in Wipro's Member360 platform by receiving MBD and being the largest submitter of enrollment volume, including RAPS and EDPS. 


Operational Costs


Reduced Errors
during AEP

Wipro Value Drivers

End-to-end Membership BPO Services Eligibility, Enrollment, Billing, Sales / Broker Management and Member Customer Service

Medicare Enrollment Products & Services Academy & COE to enable ready-to-be-deployed staff ​

Global Shared Services Delivery Model with cross-trained Membership Staff​

Core-Flex Staffing Model to address Seasonality and provide staffing and operational flexibility​

Existing relationship & governance framework to drive continuous value​​

Enhanced focus on regulatory compliance & reporting​


Zero-Delay in processing applications and fulfilling SLAs during AEP

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