Win-Backs

When a policy that's been in force for a while suddenly flips to cancelling, you want to know about it, and you want the member on the phone with your team fast. That's this campaign. The moment a policy moves to Future Cancel, and it's been more than 30 days since the policy's effective date, the AI starts calling. It tells the member their plan is showing as cancelled and gets them over to someone on your team who can sort it out.

The AI is basically the alarm bell. It doesn't know why the plan is cancelling and it never guesses or gives plan advice. Its whole job is to get the member to a licensed agent. It has a twin, Rapid Disenrollment Save, that catches the policies that drop in their first 30 days. More on the split below. For the full playbook on this use case, see Save Cancelling Members.

In the template picker, this one's called MA Win-Backs.

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 watches for policy status changes. When a policy moves to Future Cancel, careCycle skips anyone marked Deceased and checks that the policy's effective date was more than 30 days ago. If both check out, they're in.

Heads up: this one only starts on Future Cancel. Its twin, Rapid Disenrollment Save, starts on Future Cancel, Terminated, or Cancelled, but only within the first 30 days. Here's how that shakes out:

So a member can't land in both from the same status change. But there's a gap: somebody who's been on their plan for months and goes straight to Terminated or Cancelled (skipping Future Cancel) gets neither campaign. If you want those people too, add Terminated and Cancelled to this campaign's automation in the Automations tab, or add them yourself. Somebody who just started and is already dropping gets Rapid Disenrollment Save, which is a different conversation (something probably went wrong at onboarding). If you want both groups covered, turn on both campaigns.

The date check looks at the policy that changed, not any other policy the member has. If a member enrolled in a plan that hasn't started yet and it gets cancelled before it kicks in, the effective date is still in the future, so neither campaign picks it up. Same if the effective date is blank. You'd add those people yourself.

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 is this [First name]?

If someone else picks up, it doesn't get into details, it just asks when [First name] is around. Once the member confirms, the AI says who it is from [Agency], mentions the recorded line, and gives the reason in one go. It keeps it soft and says "health insurance plan" instead of the carrier name, along the lines of:

I'm calling on a recorded line 'cause your health insurance plan's uh showing as cancelled. Did you see our texts or anything?

Heads up: the AI says "showing as cancelled" even though the policy is technically in Future Cancel.

Then it goes straight to the fix:

Ok gotcha yeah so I just wanna make sure you don't lose your coverage. Is it okay if I transfer you to someone from the team who can get this sorted for you?

If they say yes, it says "Ok, one sec." and transfers the call to your team. If they're too busy, it offers to book a callback at a better time instead. If they don't want to book, it asks if they want your number.

Once the cancelled news lands, the AI doesn't repeat it. It's also ready for the stuff people say on these calls:

• "Why is it cancelling?" or "What should I do?" It's honest that it doesn't know the specifics, just that the system is showing it as cancelled, and that the team can sort it out.
• "Why can't you just fix it?" "Yeah no I'm really not the best for that. The team's got all the details though if you want 'em to take care of it now."
• "I already handled it." It frames the transfer as a quick double-check to make sure everything's squared away on your end too.
• Questions about their benefits. It checks the plan highlights or looks up the plan, answers just what they asked, and doesn't push.
• "Are you a robot?" It's straight with them: "yeah, I'm an AI," then "but I've got your account info right in front of me, and we're just trying to make sure your coverage doesn't drop."
• "Is this a scam?" It mentions their agent, your agency, and their carrier, and if they still don't buy it, gives them your number so they can call you directly to check.
• Confused or overwhelmed. It slows down but keeps steering toward the transfer, since your team is the one who can untangle it.

After hours

Same idea, same opener, but nobody's around to take a live transfer. This one also picks up when a member calls back after hours. So instead of transferring, it tells them the team's out and books a callback:

Ok gotcha yeah so the licensed agents are actually gone for the day, but I wanna make sure you don't lose your coverage. Let's just set up a time for someone from the team to call you back when they're in.

It pulls real times from your calendar (it asks for their zip code first if it doesn't have one) and lets them pick. If they don't want to book, it offers your number so they can call during business hours.

Appointment callbacks

When an appointment comes up, this employee makes the callback. It opens with "Hi is this [First name]?", mentions the recorded line, says it's the callback they had scheduled about their [Carrier] plan, checks that now still works, and grabs someone on your team. If now's bad, it books a new time. If they don't want to schedule at all, it lets them go, no pushing.

If they don't pick up, it leaves this voicemail:

Hi [First name], this is [AI name] from [Agency]. Just giving you a call about your upcoming appointment with us. Give me a shout back. Thanks. Bye.

The cadence

This one moves fast on purpose. Two calls on each of the first two days, then spaced out over the rest of the week.

Day 1: Call

Text, a few minutes before the call:

Hey [First name], this is [Agency] - we've got something urgent about your healthcare plan. Giving you a call right now.

Voicemail if they don't pick up:

Hey [First name]. This is [AI name] from [Agency] I, uh, I work with [Agent name]. We um, we just got a notification that your plan with [Carrier] is canceling and I wanted to make sure you knew that this means you might be losing all of your benefits that we set you up with. Oh and uh, you're also at risk of not being able to see your doctors in network. So yeah I wanted to give you a call to see if you knew about all this. Please give me a call back as soon as you get the chance. Thanks. Bye bye.

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

Hey [First name], we just tried calling about an urgent issue with your plan. Trying again in a few hours - or call us at [Agency phone].

Day 1, about an hour later: Call

No voicemail.

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

Hey [First name], that was us again. Your plan really does need attention. Call [Agency phone] when you get a chance.

Day 2: Call

Text, a few minutes before the call:

Hey [First name], it's [Agency] - still trying to connect about your [Carrier] coverage. Calling you now.

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

Day 2: Text (if we didn't reach them)

[First name], we've been trying to reach you about your [Carrier] plan... this is getting urgent. Call us at [Agency phone], we can still help.

Day 2, about three hours later: Call

No voicemail.

Day 2: Text (if we didn't reach them)

[First name], your plan is set to cancel soon. We really need to talk please call [Agency phone] - we'll try again tomorrow too.

Day 3: Call

No voicemail.

Day 3: Text (if we didn't reach them)

[First name], we'll try again in a couple days but please call [Agency phone] before then. Your healthcare coverage is at real risk.

Day 5: Call

Text, a few minutes before the call:

[First name], it's [Agency] checking back in - your [Carrier] plan situation still needs to be fixed. Calling you.

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

Day 5: Text (if we didn't reach them)

[First name], we're going to try one more time but please just call [Agency phone]. The team can help, but we're running out of time.

Day 7: Call

Text, a few minutes before the call:

[First name] - last call from us. Your plan is being cancelled. Please pick up.

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

Day 7: Text (if we didn't reach them)

[First name], we've been trying to reach you for over a week - your healthcare plan is being cancelled. Call [Agency phone] before it's too late. Our team is ready to help.

After that, the journey ends.

The Pulse also has a wrap-up text on two of the outcomes. On the first call, after a transfer:

Glad we got you connected with the team, [First name]. If you need anything else please give us a call - [Agency phone].

And when the AI talked to them but didn't transfer:

Hey [First name], just making sure you have our number - [Agency phone]. Your healthcare plan really does need attention, please don't put this off.

On the later calls, both of those outcomes point at a step named "SMS", and there are two steps with that name, so check the Pulse tab to confirm which text you want them to get.

How each call works

• If they get transferred, book an appointment, or the AI logs an inquiry, they're done. The journey ends right there. Booking an appointment ends all of that member's active campaigns.
• If they talk to the AI but don't take the next step, they're done too.
• If they say they're not interested, they're stopped.
• If we can't reach them (no answer, voicemail, "call me later" without booking, 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. So if a same-day retry lands outside that window, it waits until you're open again.

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, carrier, and assigned agent, plus your agency name and phone number. People missing any of these get skipped, and so does anyone without a phone number or a time zone or state.
• Make sure your policy statuses stay current. This campaign only fires when a status changes in careCycle, so your policy data has to keep flowing in.
• 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. Then add anyone who's already in Future Cancel, since the automation won't go back for them.

Changing any of this

• What the AI says on calls: the Employees tab. See Edit Your AI with Employees.
• Texts, voicemails, and timing: the Pulse tab. Click any call or text step to edit it. See Pulse.
• Who gets in: the Automations tab. That's where the Future Cancel trigger and the 30-day effective date rule live, and where you'd add Terminated or Cancelled if you want those too. See Automations Explained.