BS&F's Municipal Insurance: From Social Challenge to Innovative Tool

Frits Korthals Altes and Patrick Eppink from Turner assisted BS&F’s CEO Ronald van Lier in the development of Gezondverzekerd.nl. It’s the story of a consultancy firm that devised a smart IT solution for applying for health insurance. “You shouldn’t try to innovate everything on your own.”

1. What was the challenge for which you engaged Turner, and why was it necessary? What was complex or ‘wicked’ about it?

BS&F, originally an advisory firm, acted as a knowledge partner in the fields of healthcare and social security. “We assist municipalities in keeping low-income individuals physically, mentally, and financially healthy while making the implementation of these measures accessible and efficient,” says Ronald van Lier, CEO of BS&F. “We have developed various products and services, including the Municipal Insurance: a collective health insurance for low-income individuals. Almost all municipalities in the Netherlands offer this insurance, with around 642,000 people benefiting from it.”

The Municipal Insurance is a unique product aimed at ensuring a good insurance position for low-income individuals, thereby preventing healthcare avoidance and mitigating larger societal problems. The insurances are administered by well-known health insurers, with the municipality providing additional coverage and financing so that low-income individuals do not incur extra costs or deductibles. However, to qualify for the Municipal Insurance, individuals must provide various pieces of information, which can lead to complications. “We noticed that applying for the Municipal Insurance involves a lot of administrative hassle, both for the individuals and municipalities,” says Van Lier.

Van Lier decided to engage Turner to further digitize the process. While the application could now be done digitally, applicants still had to provide proof of their income, including physical bank statements. Additionally, officials had six weeks to assess the application. “The question was whether the income and asset test could be automated,” says senior advisor Frits Korthals Altes. “Previously, applicants had to, figuratively speaking, bring their shoebox of paperwork to the counter. The official would make copies of the relevant information, highlight it, and finally enter the data into an Excel file. Very cumbersome. With BS&F’s software, applicants can now provide all relevant data to the municipality using DigiD.”

What made the launch complex is that BS&F was originally an advisory firm, Korthals Altes explains. “With the launch of this product, BS&F also became a software provider. This not only requires a completely different approach but also entails a different revenue model. You have to invest significantly in software development and recoup those costs through a licensing model. Moreover, you have to deal with users who call every day with questions about the product and expect an immediate response. So, they also had to set up services like a helpdesk. This had a significant impact on BS&F’s internal operations.

2. What led to the breakthrough? In terms of content, change management, and/or project management?

Together with Frits Korthals Altes and Patrick Eppink, Ronald van Lier opted for a platform strategy. “The danger in the execution phase that follows is that there are many ways to Rome,” says Van Lier. “Before you know it, you start exploring them all together, and nothing happens except talking. I trust Frits and know what he is capable of, so he did that for us in a short period. He, along with the users, developed the ideal customer journey, devised all processes, made contracts, ensured connections with all relevant parties, such as the Tax Authorities, the Employee Insurance Agency, the Cadastre, and the RDW. He also supervised the team that built the platform. Thanks to his efforts, we launched this tool as an additional feature on Gezondverzekerd.nl in a short time.”

The most significant breakthrough is undoubtedly the conscious choice to collaborate with partners who already had partial solutions, clarifies Korthals Altes. “I always say: don’t try to innovate everything on your own. It’s better to investigate who is part of your ecosystem and who you can collaborate with. Various parties in the chain have smart solutions, which we strung together. Why would you want to do that trick again if it already exists?”

The Tax Authorities or the Employee Insurance Agency do not have the option to share their data with a commercial party. For this reason, BS&F teamed up with another company, Ockto. “We let the applicant log in with their DigiD on the relevant website; underwater, we then retrieve the necessary data and process it into a legality advisory.

"You shouldn't try to innovate everything on your own. It's better to investigate who is part of your ecosystem and who you can collaborate with. Various parties in the chain have smart solutions, which we strung together."

3. How was the execution achieved?

During execution, all attention was focused on bringing together existing smart solutions. As Korthals Altes says, you can’t develop a complete and complex IT solution in half a year. Therefore, execution mainly involved connecting existing systems and addressing any legal hurdles. Ronald van Lier fully trusted Turner’s two advisors in this regard. “Frits always comes up with the smartest solutions, and Patrick doesn’t sugarcoat things but always aims for a ten. We not only collaborated pleasantly, but it was also very efficient. Because we trusted each other, we could make rapid progress. When you hire consultants as a smaller organization, it’s relatively costly, so you want to make quick progress and know that you’ll recoup your investment.”

In addition to Ockto, Korthals Altes also brought on board a software developer, a data provider, and an expert in gross-net calculations. “Tax legislation is terribly complex, so you need someone who can perform these calculations very well. There are companies that do this for pension funds and payroll processors and know everything about it. You definitely shouldn’t want to do that yourself. So, we focused on governance and architecture and told the other parties involved how they should collaborate. As an advisor, I involve myself at all levels, from the boardroom to the engine room. I maintained contact with Ronald van Lier, but I also brought the technicians together when they had a problem.”

4. Are there benefits for all stakeholders? For customers, shareholders, employees, management, and society?

The Municipal Insurance is a product with high societal value. “Did you know that out of the 6.8 billion euros we spend on Assistance and Special Assistance in the Netherlands, about 1.7 billion goes to administrative costs alone?” says Van Lier. “There are 342 municipalities in the Netherlands, each with their own implementation organization. We create one smart digital solution for all municipalities and can also customize it for local regulations and preferences. This way, municipalities have budget left over to support vulnerable residents. Additionally, we make it easy for residents. There are 1.5 million people in this group. That means many people who are entitled to extra assistance are not yet using it.”

The target group, including low-income individuals and those slightly above, often exhibit short-term behavior, adds Korthals Altes. “They often choose a health insurance with a high deductible because it costs less,” he says. “Stress, financial problems, a poor living environment, all these factors reinforce each other. Thus, healthcare avoidance occurs: they don’t go to the doctor or dentist because it could cost them a lot of money. If there’s a health insurance where the municipality takes on part of the risk, and people are better insured, societal costs will decrease in the long run. It can help people escape poverty. In short, it’s an important instrument for municipalities, not only because people stay healthier but also from a debt prevention perspective.” And if this is accompanied by a reduction in administrative burdens, both for the municipality and the residents themselves, that’s only a good thing, according to Korthals Altes.

5. What was the most significant dilemma, and how did you deal with it?

The main dilemma in developing the digitized Municipal Insurance was timing, says Korthals Altes. “The Municipal Insurance is a seasonal product; you sell it once a year for six weeks. So we were under immense pressure to go live before the campaign season began. We knew our solution wasn’t perfect yet, and there was still much room for improvement, but we had to enter the market. Otherwise, we would have to wait a year.”

In that sense, BS&F’s SaaS platform for municipalities was truly a minimal viable product, as it is called in professional jargon: the product had the minimum requirements to be deployed effectively. “It was quite a challenging period,” says Korthals Altes. “We also saw this with the introduction of the energy surcharge. Politics discussed it for six months, and once the decision was made, it had to be implemented within two months. That was another time squeeze. But that’s part of innovating. It doesn’t happen perfectly right away. It helps enormously to go to market with a minimal viable product and truly involve the users, let them experience it, and continuously improve the product based on that. After all, it’s all about the user.”

BS&F Ronald van Lier

Ronald van Lier
CEO BS&F

Frits Korthals Altes

Turner Director of Digital Transformation and Innovation

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