GR: Can you give our Members an example of an organization you worked with where the application of the Business Architecture practice made a difference for them?
SL: A few years ago, I worked as a Business Architecture consultant for a health insurance provider. The insurance business, and health insurance is no different, is driven by rules. For example, if you’re in X insurance plan, then you have access to X benefits, you pay X amount in a premium, X amount is your copay, X amount is the maximum limit of what the insurer pays. And, under certain circumstances, you may also have these other benefits such as if you’re a woman, then you may have maternity related benefits. And, we may cover X procedures, but only with pre-approval, and if your doctor is in our network then we may cover more, otherwise we cover less.