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Automation in insurance is rapidly moving from a back-office function to a core strategic advantage. The affinity insurance ecosystem is expanding into new verticals, incorporating new partners, and facing increasingly complex data requirements. This growth necessitates modernization. The organizations preparing for 2026 are already modernizing their operations, starting with automated data workflows to manage this complexity.

Why Automation in Insurance Is Now a Strategic Imperative

The affinity space is characterized by rising operational complexity: more distribution channels, more partners, and more data touchpoints. This environment makes manual workflows a significant liability, as they create delays, errors, and unnecessary IT burden.

Conversely, efficient data automation in the insurance industry directly improves distribution performance, enhances client experience, and boosts partner satisfaction. The benefits of automation in the insurance industry extend from reducing risk to speeding up key financial processes. To illustrate what's possible, let's look at real-world examples from PIMA member, Milliman Connect, a technology partner in the affinity insurance market.

Case Study #1: How Automation Helped a TPA Accelerate a Complex Merger

A large, independent third-party administrator (TPA) acquired a competitor and needed to quickly merge their systems, personnel, and technology. The challenge was immediate: the eligibility, enrollment, claims, and pre-authorization of file formats from the acquired organization were incompatible with the TPA's more modern systems. 

The IT department was under a tight timeline and had to decide between reallocating internal resources to build a custom file conversion solution or seeking outside support. Manual routing and conversion would have strained internal IT resources at a sensitive time, risking delays in realizing the acquisition's value.

The Automation-Driven Solution

The TPA routed files through Milliman’s Connect platform. This cloud-based solution introduced automated file routing, conversion, and data standardization. The data was converted into a standard format and automatically transmitted to both the legacy and modern platforms simultaneously. Crucially, this was achieved without the need for custom software development or additional internal personnel.

The Results

The project demonstrated the power of process automation in the insurance industry. Outsourcing the file conversion transition fully to Milliman Connect accelerated the acquisition timeline. The financial results were substantial:

• Significant Cost Savings: Year one savings were projected to be well over $1.5M in personnel and infrastructure costs alone.

• Ongoing Annual Savings: The resulting architecture led to the elimination of unnecessary IT infrastructure, with additional yearly savings projected in the $800K–$1.2M range as IT was no longer responsible for file issues.

• Internal Focus: Internal resources were freed from the conversion project to continue with more valuable strategic projects.

This example highlights the strategic value of sophisticated data transformation, which is far beyond simple robotic process automation in insurance.

Case Study #2: How Enrollment Automation Reduced IT Costs by 40%

A national insurance program manager and advisor handled a growing volume of group medical, dental, vision, life, and disability data. Although the firm had an existing carrier integration partner, it became overwhelmed with the necessary work of receiving, cleaning, and deploying enrollment data back to carriers, especially as the business expanded. The firm also struggled to perform reconciliation and to efficiently manage and validate changes in the growing data volume.

Automated Data Workflows Solve the Bottleneck

The program manager implemented Milliman Connect’s platform to automate the transfer of data between benefits administrators and carriers. This solution introduced new, automated data workflows for the organization:

• Automated Processing: The system securely imported enrollment data, cleaned it, tested it, and then securely uploaded it to each carrier in the specific format that carrier required.

• Data Enhancement: Milliman Connect imports, digitizes, transforms, and enriches output data, simplifying workflows and unifying organizations accurately, efficiently, and safely.

• Faster Integration: The solution was deployed quickly, introducing file and data transfer requirements in less than a week.

This systematic, intelligent automation approach turned an operational bottleneck into a streamlined process.

The Results

The automation resulted in massive operational and financial improvements, demonstrating a significant return on investment:

• 40% Reduction in IT Expenditures: The insurance program manager cut its IT spending by 40% thanks to the efficiencies gained.

• Improved Accuracy: The firm saw improved enrollment and commission accuracy.

• Enhanced Financials: The automated processes enhanced client persistency ratios and increased the speed of commission payments.

• Risk Mitigation: Moving data operations to the automated platform significantly reduced the firm's risks.

Preparing for 2026: How Affinity Leaders Can Embrace Automation Now

These case studies reveal a clear path forward where automation in insurance enables growth by transforming data chaos into scalable, reliable workflows using existing infrastructure.

Automation is enabling:

• Faster onboarding of partners and employer groups.

• More efficient carrier communication.

• Cleaner data, fewer manual interventions, and higher accuracy.

• More scalable distribution relationships.

With these new features in mind, affinity leaders must shift their mindset to view automation in the insurance industry as sales and distribution enablement. To prepare for 2026, organizations should:

• Standardize enrollment and eligibility data specifications.

• Introduce automated workflows for file preparation, validation, and transmission.

• Evaluate third-party partners for integration and data-transformation capabilities.

• Recognize that the benefits of automation in the insurance industry include significant financial savings and acceleration of strategic projects.

Ultimately, automation in insurance is rapidly becoming the operational backbone of modern affinity programs. By adopting automated data workflows, organizations can conquer the complexity of growth and integration, turning data management from a struggle into a competitive advantage. 

Continuous learning, collaboration, and visibility across peers, like through PIMA, will accelerate the innovation needed to master this new operational landscape.

Engage with PIMA to explore how automation and operational modernization will shape 2026 and power the next phase of your affinity growth.