Mid-OEP Touch

A couple months into the new plan year is when the little problems show up: a card that never came, a doctor that doesn't take the plan, a prescription that suddenly costs more at the counter. This campaign calls every active member on February 15 to make sure everything's working, and gets anything that isn't over to their agent.

It's a pure service call. This happens during the Open Enrollment Period, so the AI never brings up switching plans, comparing plans, or any other plan as an option. Not even a hint. If the member brings it up, the AI notes it and gets them to their agent, who's licensed to have that conversation. It's one of the stops on the year-round Retention Journey.

In the messages below, anything in brackets fills in for each member: [First name], [AI name] (whatever you've named your AI employee), [Agency], [Agent name] (their assigned agent), [Agency phone], and [Carrier].

At a glance

How people get in

The campaign comes with an automation that fires on February 15 every year. On that day, everyone on your book with a policy status of Active, Placed, Pending, Pending Effectuation, or Pending Followup gets added. Once a year, everybody who matches.

You can also add people yourself anytime. See Add Customers to a Campaign.

What the AI says

The campaign comes with three AI employees: one for daytime calls, one for after hours, and one for appointment callbacks.

Daytime calls (the main one)

The call opens with:

Hey [First name], it's [AI name] calling from [Agency]. Did I catch you at an okay time?

Once they confirm, the AI says:

Oh great hey [First name] thanks, so uh [Agent name] asked me to give you a quick call and just make sure everything's been going alright with your plan this year.

Then the question that does most of the work:

Ok so you're a couple months into the new plan year now, has everything been working ok? Like your card and your doctors and everything?

Then prescriptions, since January is when drug costs change and a surprise at the pharmacy is the most common real problem:

Gotcha. And how about your prescriptions, everything filling ok at the pharmacy?

Last, it asks if there's anything they've been meaning to ask their agent about. If there is, it logs the details and offers a time with their agent, or a transfer if they want it handled now. It wraps up by reminding them they can call or text this number anytime, and that their agent is watching their plan through the year.

It skips any question the member already answered. And anything real (a drug name and what they paid, a doctor's name, a missing card) gets logged as an inquiry so your team can follow up.

It's also ready for the stuff people say on these calls:

• "Should I switch?" or "I saw this other plan on TV." It doesn't engage with the comparison at all: "Yeah that's a good one for [Agent name], they handle all that. Want me to have them give you a call?"
• "My prescription costs more than last year." It never explains why. It takes the drug name and what they paid, and routes it to their agent.
• "My doctor doesn't take my plan anymore." It doesn't confirm or deny network status. It notes the doctor's name and gets them to their agent.
• "I never got my card." It notes it so someone can chase the carrier.
• Unhappy with the plan. It lets them say the whole thing, notes the specifics, and offers time with their agent.
• "Are you a robot?" "I'm a virtual assistant, I help [Agent name] check in with clients."
• "Is this a sales call?" Nope, and it says so: nothing's being sold, nothing's changing, it's just a check-in.

After hours

Same call, same questions, but this one runs when nobody on your team is around to take the call live. If the member needs something, it takes down the details and makes sure their agent follows up.

Appointment callbacks

If someone booked a time, this employee makes the callback. It introduces itself, mentions the call is recorded, reminds them their agent had a callback scheduled about their [Carrier] plan, checks that now still works, and transfers them. If now's bad, it finds a new time on your calendar and books it. It follows the same rule: no talking about other plans.

The cadence

Day 1: Call

Text, a few minutes before the call:

Hey [First name], it's [AI name] with [Agency] - gonna give you a quick ring in a couple minutes to check in on your [Carrier] plan. Nothing urgent!

Voicemail if they don't pick up:

Hi [First name], it's [AI name] with [Agency]. Just a quick check-in now that you're a couple months into the plan year, making sure your card showed up okay and your doctors and prescriptions are going the way they should. There's nothing you need to do here. If anything's come up, give us a call at [Agency phone] and we'll get it sorted.

Day 1: Text (if we didn't reach them)

Sorry we missed you. Nothing urgent at all, we just wanted to see how things have been going with your [Carrier] plan since January. We'll try you again in a couple days.

Day 4: Call

Text, a few minutes before the call:

Missed you last time, so we're trying you again here in a few minutes. Still just a check-in on how the plan year's been going, nothing you need to do.

Voicemail if they don't pick up: the same one as Day 1.

Day 4: Text (if we didn't reach them)

Looks like we keep missing each other, and that's alright. Anytime something comes up with your [Carrier] plan, your card, your doctors, a prescription, just call us at [Agency phone] and we'll take care of it.

After that, the journey ends.

How each call works

• If they finish the check-in with the AI, they're done.
• If they book an appointment, get transferred, or the AI logs an inquiry, they're done too.
• If we can't reach them (no answer, "call me later," or the call drops right away), they get the follow-up text and move to the next call.
• If it's a bad number, or they ask not to be called, they're stopped right away.

Calls and texts only go out during your business hours and between 8 AM and 9 PM in the member's time zone.

Before you turn it on

• Set up your escalations in Employees > Escalations. Point Transfer Call at a transfer destination and Book Appointment at an appointment configuration. The campaign can't be activated until both point somewhere. Inquiries go to your Inbox and the Inquiries page automatically.
• Check your member data. The AI needs each member's first name, last name, assigned agent, carrier, and your agency name. People missing any of these get skipped, and so does anyone without a phone number or a time zone or state.
• Check your caller ID. Out of the box, this campaign calls from your agency's main number (the one your Receptionist answers), so make sure you have one. You can see this on the Phone Numbers tab: Use organization main number for outbound calls is switched on. Want it to call from its own number instead? Switch that off and add a number there (you can only change it while the campaign isn't active). See Managing Your Phone Numbers.
• Get SMS registration done so the texts can go out. See SMS and RCS Registration.
• Test it. See Test Your Campaign.
• Click Activate on the Overview tab before February 15.

Changing any of this

• What the AI says on calls: the Employees tab. See Edit Your AI with Employees. If you edit the script, keep the no-plan-talk rule in place.
• Texts, voicemails, and timing: the Pulse tab. Click any call or text step to edit it. See Pulse.
• Who gets in and on what date: the Automations tab. See Automations Explained.