Designing Reusable Digital Building Blocks for Health Insurance Sales Platforms: A Metadata-Driven Architecture for Product and Quote Configuration

Abstract

Health insurance sales applications need to deal with continuously evolving products, benefit designs, eligibility requirements, pricing rules, approval policies and regulatory requirements. The typical approaches tend to be coded into bespoke application logic, causing the duplication of functionality and an increasing maintenance burden when new products and markets enter the picture. This article suggests an architecture for building reusable digital building blocks to support health insurance sales and quoting systems. The model contains configurable components for common recurring tasks such as employer information collection, census processing, benefit selection, plan configuration, quote generation, routing for approval, forms, and downstream integration. The user experience is separated from product and business rules by a metadata-driven configuration layer, enabling the introduction of product and validation changes without significant redevelopment of the user experience. Reusable integration interfaces are standardized services that link front-end applications to policy, enrollment, pricing, document-generation and administrative systems. The framework suggests that enterprise insurance applications will continue to transition from monolithic enterprise process implementations to libraries of reusable domain capabilities, which will deliver greater consistency in enterprise applications across products and markets, will lessen the need for enterprise application duplication, and will enable composable enterprise applications. Based on a synthesis of 29 sources published 1972 to 2018, break-even occurs at six products, with a 37.2% reduction of cumulative effort at 12 products, and a 69.1% reduction in mean change lead time.