ebenefits network implementation training for infinisource february 2014
TRANSCRIPT
eBenefits NetworkImplementation Training for Infinisource
February 2014
Today’s Topics
●What is eBenefits Network?o Overviewo Key capabilitieso Carrierso How it workso Set-up & production processeso Small group enrollment (SGE) supporto Open Enrollment (OE) support
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WHAT IS EBENEFITS NETWORK?
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What is eBN?
iSolved
Employee Enrollment Data
Medical
Others
401k, FSA
Life
Dental
eBN
Cloud-based Automated Employee enrollment data exchange
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• Secure end-to-end data exchange; HIPAA privacy compliance
• Large carrier network (over 300 health & non-health today)
• Supports all carrier data formats
• Supports hosted and on-premise deployments
• Automatic scheduling and file transmission
• On-going EDI/file management (including OE support)
• Initial and on-going customer and carrier communications
Key Capabilities
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Carrier Network (April 2013)
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24Hour Flex Citi Street Great West Medical Mutual RxN'GOACS Clear Benefits Inc. Great-West Health Care MedTrak Scott & WhiteAdmin Pro Advantage Colonial Group Health Meritain SecurianAdminResources & Consulting Colonial Group Resources Merrill Lynch Select HealthADP CommunityCare Guardian MES Vision Self-Funding AdminAdvanced Benefits Strategies Comp Benefits Hart FMLA MetLife Sentinel BenefitsAdvantica Conexis Hartford MGIS ShenandoahAetna ConnectiCare Harvard Pilgrim Money Manager SHL/HPN (UHC)AFLAC Connecticut General Health Alliance Mountain States Admin SierraAllegiance Consult A Doc Health Mgmt Systems America Murfee Meadows Southern HealthAllied Administrators Core-Flex Health Net Mutual of America SpecteraAllied Benefit Systems CoreSource Health Partners Mutual of Omaha SpecteraAmeriBen Coventry Health Care Health Plan of Nevada MVP Healthcare SRCAmerican Specialty Health Creative Benefits Healthcare Mgmt Admin MVP Select Care Standard InsuranceAmeriflex Custom Design HealthNet My Cafeteria Plan StarMount/Always CareAmeritas Datapath Healthsmart National Benefit Services SterlingAnthem Davis Vision HealthyRoads National Vision Admin NVA SummacareAscensus Dearborn Financial HFS Benefits NCAS SunLifeAssurant DeCare Dental Highmark Nexcaliber Superior VisionAvesis Delta Dental Hirsh Financial NGS American T. Rowe PriceAward Incentive Group Dental Care Plus HMA Optum Health TASCBB&T Dental Select Homeland Healthcare Oxford TelaDocBCBS Direct Dental Horizon BCBS Pacific Benefits The Advantage GroupBenecard Discovery Benefits HR Simplified PayFlex The Loomis CompanyBenefit Coordinators Diverisfied Benefits Services Humana PBS The ODS CompaniesBenefit Resource Empire BCBS Hyatt Legal PCMI TuftsBenefitFocus Employee Benefit Mgmt (EBMS) IGOE Personal Choice Accounts UCCIBenefits Strategies Employee Benefits Corporation Independence Admin PNC Advisors UFCW National HealthBeneflex Employee Benefits Solution Independence Blue Cross Preferred Health Systems UMRBeniversal Employer Dental Services Infinisource Preferred One Underwriters Services CorpBlue Advantage ESI ING Premera Unicare (Wellpoint)Blue Care Network EyeMed Vision Care Insurance Mgmt Admin Premier Access United Benefits (FBMC)Blue Choice Fidelity Integrated Benefits Admin PrePaid Legal Services United ConcordiaBlue Cross First Choice Health iVision Presbyterian Health Plan United HealthcareBlue Grass First Continental Life FCL JAD Benefits PrimePay Unum (Unum Provident)Blue Shield Flex Plan Services Job Trax Principal Financial Vantage Financial Group IncBMI KS Flex System JSL Administrators Principal Life VeritasBright Horizons FlexCorp Kaiser Permanente Priority Health Vision Benefits of AmericaCal Choice Plus Flores Associates KMG America ProBenefits Vision Plan of AmericaCareFirst Florida Combined Life KSPH Professional Benefits Services ViveraeCareMark FMH Benefits Lifewise Assurance Company Progressive Benefit Solutions VSPCBIZ Genesis Benefits Lincoln Financial Prudential WageWorksCeridian Genworth Lincoln National Life Regence WDSChard Snyder Georgia Bankers Assoc MedBen Reliance Standard Wellmark BCBSCharles Schwab Gilsbar Medica (UHC) Rocky Mountain Admin WellpointCIGNA Grace/Mayer Medical Eye Services Rx Benefits Wells Fargo
Western Health AdvantageWorkable Solutions
How eBN Workscustomers (iSolved Users) Benefit Carriers
Employee enrollment
data
eBN Web Service
eBN Cloud Server Carrier File-out
Extract employee enrollment data
From iSolved system
Transmit to cloud server
Data mapping,translation & validation
Virtual connectionsScheduled, triggered, on-demand
Workflow & business rules
Standard data formats (HIPAA 834,
etc.)
Carrier-specific data formats
All file typesSecure and Private
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eBN End-to-End Process
Testing(eBN)
Production(eBN)
• Generate data set
• customer Data Analysis
• Carrier Business Rules
• customer-carrier data mapping configuration
• Complete Data Transformation
• customer Test File
• Carrier Testing
• Data Reconciliation (customer & carrier)
• Transmission Schedules
• Monitoring transmissions
• Manage data Discrepancies
• Performance analytics
Carrier Set-Up Regular Processing
Data Mapping
(eBN)
• Define plans
• Enter data
• Validate database
Prepare customer DB
(customer/Infinisource)
Pre Set-Up
8-10 weeks (estimate)
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Multiple test cycles may be required,Based on qualify to customer’s data
Implementation Process
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Infinisource Process
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• All tasks have been incorporated into Salesforce in the respective sections (Payroll IS, Benefits IS, etc)
• A new section has been created for the eBenefits coordinator (Lance)
• Included in this section will be a status fields that anyone will be able to view in order to see the status of the connections
• The Implementation Leader playbook has all of the necessary templates
Small Group Enrollment (SGE) Support●What is SGE Support?
o Intended for use with carriers that do not support EDI inputs from employers due to small enrollment sizes.
o Instead the carriers may accept alternative inputs from these “small group” employers
Manual data entry via carrier-provided secure Web portal (becoming more common)
o For SGE customers whose carriers support Web portal or spreadsheet inputs, eBN…
Automatically extracts the enrollment data from the iSolved system
Performs the manual data entry into the carrier portal on behalf of the employer
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How SGE Support Works in eBN
1. Enrollment data automatically extracted from iSolved per the schedule.
2. Changes Report generated by comparing current data to last. This identifies all adds/changes/terminations.
3. Work Order triggered to the eBN data entry team.
4. eBN staff log in to carrier portal (using employer-authorized log in credentials) and manually enter the changes.
5. Email sent to employer confirming that the changes were successfully entered.
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QUESTIONS?
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For More Information…
Caroline Guirguis, Account [email protected]
Tom Tillman, Business [email protected]