From Zero to One: Designing the Future of Workforce Benefits

Creating a startup within a 150 year old B2B2C financial services company to revolutionize employee benefits and the claims process.

Industry

Financial Services

Industry

Financial Services

Role

UX Designer

Role

UX Designer

Background

Background

Background

Pacific Life has been operating in the life insurance and annuities industry since 1868 - over 150 years.

In 2022 the company announced its plan to expand into the workforce benefits space, a completely new line of business. To achieve an ambitious August 2023 launch date, Pacific Life created a startup environment within the company to go from zero to one in a single year.

About the Project

I was part of a four-designer team that created three portals for each of our main users: the brokers who sell our benefits, the employers who offer them, and the employees who use them.

Following the release of the portals, the first big value-add feature was adding a way to submit claims in the employee portal.





Our event-based approach to claims is a major departure from the industry standard, and completely revolutionizes the employee experience.

The Problem

The Problem

The Problem

Current state in the industry of employee supplemental health claims is confusing, repetitive, and paper-based—adding stress to an already difficult time. Employees have to figure out which of their benefits apply and then submit claims for each one separately, making it easy to miss out on benefits.





We wanted to do it differently.

Claim Forms from a Competitor

The Solution

The Solution

The Solution

A process based on what happened, not what products you have.

Employees answer questions about what’s going on, and we submit all applicable claims on their behalf - no combing through policy documents or repeating information.





This process allows for straight-through processing on simple claims, meaning less work for the business and faster payments for employees.

Submit a Claim

Please choose a claim type to begin.

With Pacific Life’s event-based claims approach, we guide you through the process to gather information, automatically creating all claims you may be eligible for.

Learn how claims work

Wellness Claim

Get rewarded for routine checkups and preventive care that help keep you healthy.

Pregnancy

This option is for pregnancy and can be submitted before or after birth.

Illness

An illness is a disease, sickness, or condition that affects a body’s normal function.

Injury

An injury is physical harm or damage caused to the body from an accident, fall, hit, etc.

Loss of Life

This option is for the loss of a loved one.

Looking for other claims?

Dental

Most dental claims are automatically filed by your provider. You can view past claims in your dental portal.

View dental claims

Need to file an out-of-network claim?

Download out-of-network dental form

Vision

Most vision claims are automatically filed by your provider. You can view past claims in your vision portal and file an out-of-network claim if needed.

View vision claims

9:41

Submit a Claim

Please choose a claim type to begin.

With Pacific Life’s event-based claims approach, we guide you through the process to gather information, automatically creating all claims you may be eligible for.

Learn how claims work

Wellness Claim

Get rewarded for routine checkups and preventive care that help keep you healthy.

Pregnancy

This option is for pregnancy and can be submitted before or after birth.

Illness

An illness is a disease, sickness, or condition that affects a body’s normal function.

Injury

An injury is physical harm or damage caused to the body from an accident, fall, hit, etc.

Loss of Life

This option is for the loss of a loved one.

Looking for other claims?

Dental

Most dental claims are automatically filed by your provider. You can view past claims in your dental portal.

View dental claims

Need to file an out-of-network claim?

Download out-of-network dental form

Vision

Most vision claims are automatically filed by your provider. You can view past claims in your vision portal and file an out-of-network claim if needed.

View vision claims

9:41

The Impact

The Impact

The Impact

9.7 CSAT

Satisfaction score for people with claims approved

9.7 CSAT

Satisfaction score for people with claims approved

9.7 CSAT

Satisfaction score for people with claims approved

8.5 CSAT

Satisfaction score for people with claims denied

8.5 CSAT

Satisfaction score for people with claims denied

8.5 CSAT

Satisfaction score for people with claims denied

80%

Straight-through processing on Wellness claims

80%

Straight-through processing on Wellness claims

80%

Straight-through processing on Wellness claims

24%

Reduction in calls to customer service since the launch of online claims

24%

Reduction in calls to customer service since the launch of online claims

24%

Reduction in calls to customer service since the launch of online claims

My Role

My Role

My Role

As one of two designers dedicated to this project, I co-owned the design process end-to-end.

Together we drove alignment across product, compliance, marketing, and subject matter experts, ensuring our designs balanced usability, regulatory requirements, and business goals.

Initial Research

Initial Research

Initial Research

Project kickoff — off to a rocky start

In our first stakeholder meeting, the product owner shared a process map following business logic rather than user-centered information architecture. When we suggested aligning to users’ mental models, we learned the backend was already built without design input. This showed how involving design early can prevent rework.





Given just three weeks to define all backend data and deliver low-fidelity designs for the claims process, our challenge was clear: how might we create a simple, intuitive intake flow that captures all required data?

Process map of user flows in LucidChart

Refining the user flow

With a tight deadline, we worked closely with stakeholders to improve the process map, organizing sections more intuitively and covering the full employee experience.

High-level user flow of entire claims process

Focused User Flow - Claims Intake Process

Low-Fidelity Exploration

Low-Fidelity Exploration

Low-Fidelity Exploration

We prioritized mobile-first design because employees, unlike Pacific Life's existing users, are more likely to use phones than desktops. With Pacific Life targeting small to medium-sized businesses, many employees may not have access to a computer, making phone accessibility essential.

Our first draft had over 115 screens in 5 user flows for each of the different event types.

Low-Fidelity Testing

Low-Fidelity Testing

Low-Fidelity Testing

Methodology

  • Moderated, 60-minute, qualitative interviews with a clickable prototype

Goals

  • Comparing Terminology

  • Assessing Usability

Results

Results

Results

Terminology

“Drafts” vs “Not Submitted”

The Claims Team and Legal and Compliance were committed to "Not Submitted," but Design won this battle with compelling data showing 100% of employees clearly understood "Drafts," while several felt confused by "Not Submitted."

"Wellness" vs "Preventive Care"

While users showed a slight preference for "Preventive Care," both terms were well understood. Given the business's strong preference for "Wellness" and the lack of significant usability impact, we aligned with the business terminology.

"Hospital Stay" vs "Hospital Admission"

While "Hospital Stay" felt more succinct to the design team, being clear about hospital admission turned out to be key to user comprehension.

"Hospital Stay" vs "Hospital Admission"

While "Hospital Stay" felt more succinct to the design team, being clear about hospital admission turned out to be key to user comprehension.

Usability

Users found the process simple, clear, and faster than expected. What we thought might frustrate users was seen as valuable and necessary.

Testers also identified where extra help text would be most useful.

Iteration Needed

66% of users thought it was unclear for "Terminal" to be an option under type of illness and thought it should be its own question.

We also received several new business requirements to incorporate into the flow, so we conducted a second round of low-fidelity testing before moving on to higher fidelity.

Low-Fidelity Testing Round 2

Low-Fidelity Testing Round 2

Low-Fidelity Testing Round 2

Results & Further Iteration

Our second round of testing yielded mixed results. While some of the flow became clearer even with the additions from the business, most of our iterations still were causing problems.

For example, the update to the terminal diagnosis question was jarring for users. In our next iteration we added additional context about the relevant benefit and introduced more sensitive language.

High-Fidelity Design

High-Fidelity Design

High-Fidelity Design

After two rounds of testing and iteration, we delivered comprehensive low-fidelity screens for all flows, enabling the backend team to finalize data mapping and APIs.

We then transitioned to high fidelity visuals.

Question Template

We started with UI templates of the different types of questions so the front-end team could build out the components while we designed the remaining screens.

High-Fidelity Testing

High-Fidelity Testing

High-Fidelity Testing

Since we tested the low-fidelity flow multiple times and were on a tight timeline, we conducted limited guerrilla testing for our high fidelity screens with 30-minute qualitative interviews using a clickable prototype.

Results

Our updates to questions about sensitive topics drastically improved users' clarity and comfort. Overall, users felt the process was clear and simple.

Final Delivery

Final Delivery

Final Delivery

Selected screens from final high fidelity flow

Outcomes

Outcomes

Outcomes

Event-based claims released on time, simplifying the process for both employees submitting claims and specialists reviewing them.

More importantly, this project redefined the role of design at Pacific Life. While conducting research internally, we found misalignments between siloed teams. By uncovering and resolving conflicting information early, we prevented costly downstream issues.

In doing so, we demonstrated the strategic value of UX. This shifted Pacific Life’s perception of design as essential to feature prioritization and a trusted voice in shaping user-centered business strategy.

Quantitative Impact
78%

Percent of claims submitted online versus other channels

78%

Percent of claims submitted online versus other channels

78%

Percent of claims submitted online versus other channels

9.7 CSAT

Satisfaction score for people with claims approved

9.7 CSAT

Satisfaction score for people with claims approved

9.7 CSAT

Satisfaction score for people with claims approved

8.5 CSAT

Satisfaction score for people with claims denied

8.5 CSAT

Satisfaction score for people with claims denied

8.5 CSAT

Satisfaction score for people with claims denied

80%

Straight-through processing on Wellness claims

80%

Straight-through processing on Wellness claims

80%

Straight-through processing on Wellness claims

24%

Reduction in calls to customer service since the launch of online claims

24%

Reduction in calls to customer service since the launch of online claims

24%

Reduction in calls to customer service since the launch of online claims

Qualitative Impact
Seamless Omni-Channel Experience

Employees and call center reps now share the same view for smoother handoffs

Seamless Omni-Channel Experience

Employees and call center reps now share the same view for smoother handoffs

Seamless Omni-Channel Experience

Employees and call center reps now share the same view for smoother handoffs

Cross-Team Collaboration

Fostered alignment with business, technology, compliance, and design to reduce rework

Cross-Team Collaboration

Fostered alignment with business, technology, compliance, and design to reduce rework

Cross-Team Collaboration

Fostered alignment with business, technology, compliance, and design to reduce rework

Elevated Role of Design

Design is now included in strategic decision-making, ensuring user needs shape feature prioritization

Elevated Role of Design

Design is now included in strategic decision-making, ensuring user needs shape feature prioritization

Elevated Role of Design

Design is now included in strategic decision-making, ensuring user needs shape feature prioritization

Learnings

Learnings

Learnings

01
Early design involvement is critical

Starting at the discovery stage prevents complexity and costly rework, and can help ensure cross team alignment.

02
Progress over perfection

Shipping an MVP with known gaps still created a leap forward compared to the industry’s paper-based standard.

03
UX can catalyze organizational change

This project helped shift the company mindset toward earlier design collaboration on future initiatives.