Supplemental OTC Benefit Programs Increase MA HMO & PPO Plan Enrollment

FORT LAUDERDALE, FL (BUSINESS WIRE)—Convey Health Solutions (Convey), a leading healthcare technology and services company, today announced completion of a study concluding that plans who offer an over-the-counter (OTC) supplemental benefit in the Medicare Advantage (MA) marketplace grow significantly faster than those plans who do not offer an OTC benefit. Convey utilized its Spotlight technology from Pareto Intelligence (Pareto) to aggregate 2020 CMS enrollment data. Convey’s data scientists subsequently analyzed the data to understand the correlation between the OTC benefit and MA membership growth.

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The analysis from Pareto’s Spotlight technology compared 2019 and 2020 enrollment and membership data for HMO and PPO plans having an OTC benefit to determine the impact on membership. The analysis excluded Special Needs Plans (SNPs), new health plans and plans that exited the market for 2020. Highlights of the analysis include:

      • Plans that offered OTC in 2020 experienced a 13.3% growth in their membership
      • Plans that did not offer OTC in 2020 experienced almost no growth (0.4% increase)
      • Plans that offered an annualized benefit of less than $200 yielded membership growth of 2.9%
      • Plans that offered an annualized benefit between $200—$300 yielded higher membership growth at 12.8%
      • Plans that offered an annualized benefit of greater than $300 yielded the highest membership growth at 23.2%

Although a variety of other conditions and benefits could influence plan membership performance, the data suggests strongly the OTC benefit improves membership growth. Convey and Pareto continue to evaluate 2020 Annual Enrollment Period (AEP) plan performance data and expect to deliver additional market intelligence in the coming months.

Convey is a market-leading provider of supplemental benefits administration solutions that monitors both CMS regulations and market trends in order to provide innovative solutions for its clients. Combined with the powerful analytics solutions from Pareto, Convey is prepared to respond to client’s needs.


For an interactive tour and further details about the 2020 AEP data, visit:  Please navigate to the “OTC Analysis” tab to see the complete details.


About Convey Health Solutions | Convey Health Solutions is a specialized healthcare technology and services company that is committed to providing clients with healthcare-specific, compliant member support solutions utilizing technology, engagement, and analytics. The Company’s administrative solutions for government-sponsored health plans help to optimize member interactions, ensure compliance, and support end-to-end Medicare processes. By combining its best-in-class, built-for-purpose technology platforms with dedicated and flexible business process solutions, Convey Health Solutions creates better business results and better healthcare consumer experiences on behalf of business customers and partners. The Company’s clients include some of the nation’s leading health insurance plans and pharmacy benefit management firms. Convey’s healthcare-focused teams help millions of Americans navigate the complex Medicare Advantage and Part D landscape. To learn more please visit

About Pareto Intelligence | Pareto Intelligence is a leading healthcare technology company modernizing the way health plans and providers succeed in value-based care. We deliver analytics, technology and advisory solutions to help our clients achieve complete and accurate revenue, communicate critical patient information seamlessly, activate clinical and claims data, and make more informed strategic decisions. Our solutions are supported by machine learning-enabled predictive models and proprietary algorithms that help our clients capture 5:1 to over 20:1 return on investment. Through this, Pareto demystifies complex healthcare data, and delivers actionable insights to improve outcomes.

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