Case Study: Leading US Health Insurance Provider achieves NAIC MAR compliance and streamlined GRC with MetricStream

Naic Mar Compliance Solution For A Health Insurance Provider

A leading state-based health insurer faced growing regulatory demands—NAIC Model Audit Rule (MAR), Medicare/Medicaid, HIPAA and other governance requirements—while relying on manual, paper- and spreadsheet-based processes. The lack of a single system to document risks and controls, limited visibility into internal control over financial reporting (ICFR), and insufficient periodic assessment put the organization at risk of non‑compliance and inefficient risk management.

The insurer implemented MetricStream’s Enterprise GRC Platform to replace free-form processes with an integrated, workflow-based risk and compliance system, deployed in a phased rollout with a five-week initial implementation. The solution automated control documentation and testing, provided role-based dashboards and reporting, improved visibility and corrective-action planning, supported ongoing NAIC MAR compliance, and standardized processes to reduce manual effort and costs.