The employer group (EG) business of a national health plan offers a diversified portfolio of health insurance products such as medical, dental and vision across both small and large group segments.


The health plan made investments in expanding capabilities to accelerate growth with large employers and emphasize cross-selling of ancillary products, while maintaining its market share in the small group segment. To retain its members and redesign its sales model to improve overall sales economics, the health plan partnered with ZS. 

The challenge

The health plan’s sales model had not undergone a thorough evaluation for several years, despite overall changes in the organization’s membership composition and strategic priorities moving forward. Nationally, the structure across segments and markets included multiple overlapping roles driven by localized decision-making that compounded over the years.


Given future growth objectives and the impact of COVID-19, the client engaged ZS to evaluate ways to improve the efficiency, effectiveness and agility of its sales model to sustain growth in a hybrid post-COVID-19 selling environment. 

The solution

  • Define objectives: ZS interviewed sales leaders and conducted a workshop to define key objectives that the future sales model should achieve—improving sales economics, increasing sales in growth segments, and improving standardization and role clarity.
  • Design future sales model: ZS worked collaboratively with the client’s sales and executive leadership teams on a solution that maintained some flexibility at a local level, but commonality nationally. The output preserved field presence in all geographies while remaining aligned with the client’s growth priorities by segment and product types. ZS also created a responsibility matrix aimed at reducing role pollution by defining the lead and support roles across segments and products. Additionally, ZS conducted a series of blinded and unblinded broker interviews to pressure test sales model changes and collect feedback on the client’s performance.
  • Determine productivity expectations and estimate headcount: ZS analyzed historical sales results to establish future productivity benchmarks for frontline sales and retention roles. Using these productivity benchmarks, ZS provided headcount recommendations across frontline, sales manager and support roles based on future growth expectations and workload balance.
  • Create business case and seek signoff: ZS made a detailed business case with implications on cost of sales and productivity to support the recommendations that helped secure buy-in from all stakeholders across the organization, including sales leaders, operations, finance and human resources.

The impact

  • Improved sales economics: Introduced a new flexible sales model that could save up to 10% in administrative costs on an annualized basis.
  • Increased productivity: Improved focus and standardization of roles via clear lines of responsibility and production benchmarks, laying the groundwork for 10-30% improvements in productivity.
  • Enhanced leadership structure: Established a leadership structure that enabled local leaders to spend more time on strategic thinking and long-term growth planning, providing a path to scaling.