> Click here for the full white paper.
Each fall, millions of Americans enter the annual open enrollment period, a critical window when individuals and employers make choices about health coverage. According to latest data from Centers for Medicare & Medicaid Services (CMS), approximately 24.2 million consumers selected or were automatically re-enrolled in health insurance coverage through the individual marketplaces during the 2025 open enrollment period.
For U.S. health insurers, this period is both an opportunity and a stress test. It represents the single busiest time of year for member acquisition, plan renewals, and data exchange with employers, government marketplaces, and healthcare providers. Behind the scenes, however, success depends on data. Accuracy, integration, speed, and security determine whether insurers deliver a smooth experience or face costly errors, dissatisfied members, and regulatory scrutiny. Outlined below are the top eight data challenges insurers face during open enrollment, recommendations for resolving them, and ways Paradigm can help turn these challenges into long-term strategic advantage.
Challenge 1: Fragmented & Siloed Data Systems
Insurers today often operate across a patchwork of legacy policy administration systems, CRM platforms, employer-benefits portals, and government/ACA marketplace interfaces. Because these systems rarely communicate seamlessly, enrollment data becomes fractured and inconsistent. The result is duplicate member records, conflicting eligibility data, and delays in coverage activation.
In the 2025 open enrollment period for the marketplaces, about 5.36 million plan selections were made, including nearly 988,000 new consumers. That volume of transactions and the multiple entry points (employer file, broker portal, member self-service, etc.) amplifies the risk of misalignment across systems.
The Fix: Carriers should invest in creating a “single source of truth” for member data, either by consolidating platforms or deploying modern data integration and master data management (MDM) solutions that harmonize systems and eliminate fragmentation…