Turning Overload into Opportunity
Sendero
AI Solutions for Sendero’s Enrollment Boom
The Challenge
Sendero Health Plans experienced an unanticipated enrollment surge during the 2025 ACA Marketplace open enrollment period, doubling its membership from the previous year, and quadrupling it over the last two years. The growth in membership came with a massive leap in the number of calls to the Member Service team, which had been staffed based on member forecasting models. Limited by the number of staff and hours in a day, it was impossible to keep pace with the thousands of calls coming in daily. As a result of longer hold times, the health plan’s call-back queue grew into the thousands, with hundreds of call-backs being added to the queue each day, leaving members feeling frustrated and worried.
The Solution
Hahn quickly developed a strategic integrated communication strategy to relieve pressure on Sendero’s support systems while providing members with the information they needed. Hahn’s first priority was to decrease the number of phone inquiries for basic information that was available elsewhere, freeing up the Member Service team to focus on calls that were time-sensitive or more complex. Members were empowered to get the information and guidance they needed on the health plan’s website, featuring a newly updated FAQ page with clear guidance on common issues, alert messages to drive traffic to this page, a revised IVR script to streamline call routing, and pre-drafted email and social media templates to ensure consistent messaging, tone and voice across all channels.
Seeing an opportunity to improve efficiency, Hahn Labs ideated, built, tested, and launched a natural language AI Phone Assistant in just 48 hours to screen incoming calls as they came in. Using the new website content as its knowledgebase, the AI Assistant was designed to resolve member calls asking for basic information without involving a live agent. The AI Assistant automatically scaled to respond to call volume, and could recognize and switch to Spanish instantly.
When the AI Phone Assistant launched on Jan. 15, 2025, members started receiving instant responses and step-by-step guidance for retrieving an ID number, updating a primary care provider, or registering on the new portal. The AI Assistant was also active during after-hours and weekend calls to minimize call-back queue buildup.
The Results
The AI assistant answered more than 4,900 calls within the first week of deployment and more than 25,000 calls within the first month. The AI Assistant consistently resolved nearly 90% of calls, while the rest were escalated and added to the live agent call-back queue. Using an average call length of 5 minutes, the AI Assistant saved more than 1,875 hours of agent time in the first month–the equivalent of 12 additional full-time employees–with little to no time spent training and onboarding.
By implementing AI in a modular, human-in-the-loop fashion, Hahn helped address immediate needs, while also positioning Sendero for long-term scalability—ensuring future growth wouldn’t compromise customer care.