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Author: Zach Wallens

API connectivity and the bentech ecosystem: A Q&A with Sun Life’s Ted Phillips

Posted on by Zach Wallens

By Zach Wallens, Director of Content and Communications, Ideon

The HR and benefits technology (bentech) ecosystem has exploded in recent years, with billions in venture capital investment driving innovation and new players in the space.

That’s left insurance carriers with a strategic and technology challenge: how do we partner and connect with dozens of bentechs, ensuring brokers and members have a great experience across the platforms they use today?

Ted Phillips, Sun Life’s AVP, Distribution Digital Center of Excellence, tackles these challenges every day. Ideon spoke with Ted about Sun Life’s tech partnership strategy, the value of “enhanced” API connectivity, and their new partnership with Ideon.

 The below interview has been condensed and edited for clarity.

 

IDEON: What’s your role at Sun Life?

TED PHILLIPS: I lead a team that’s responsible for the strategy and execution of our benefits technology (bentech) platform partnerships. We’re looking to create new partnerships, bring them to market, and grow premium through these relationships. Through Sun Life Link, we work with our accelerator team on building out API connectivity, and our data operations team, which takes the connectivity we build and operationalizes it.

Our ultimate objective is to make benefits easier to manage — to remove headaches that are often felt in managing ancillary products. We want to streamline benefits administration, billing, and everything in between.

 

How has your partnership strategy evolved recently?

We’ve transformed our partnership strategy for three reasons: First, there’s an expectation now—among members, brokers, and employers—that technology works seamlessly. It’s incumbent upon Sun Life to make sure the benefits experience is great for everyone and that we meet their expectations.

Second, technology has advanced quite dramatically over the past 2-3 years. APIs and enhanced connectivity are the hot topics of today. Most of the bentech ecosystem are working toward some level of enhanced API connectivity.

Third, the bentech ecosystem is far more complex and nuanced than a few years ago. Before, there were benefits administration platforms (BenAdmins), but now there are many more layers and segments within our ecosystem: HCM, proposal tools, quote-to-enroll, broker tech, resellers, and more.

 

What does that complexity mean for your team?

In 2019, the global investment in HR tech was $5B. In 2020, it was $17B. What that creates is a whole host of companies that are extremely valuable, like Ideon, and others that are just getting their idea off the ground. For us, the challenge is making the right decisions on which bentech platforms to partner with.

We’re always evaluating two things: which segments of the ecosystem do we want to work with, and how can we connect with them? Sun Life can’t take in every connection request we receive from bentech platforms. Middleware like Ideon allows us to multiply our team’s impact by increasing the number of platforms we can connect to.

 

Sun Life recently partnered with Ideon to enhance your data exchange capabilities with bentech platforms. How does better connectivity affect your clients?

It’s all about making benefits easier. APIs and enhanced connectivity enable us to streamline eligibility, benefits administration, enrollment, etc., and that saves hundreds of hours for our brokers and clients.

We find that when employer groups are on platforms, especially those with which we have enhanced connections, they have access to more Sun Life products and better benefits education experiences.  Also, with better connectivity, the enrollment and administration process is faster and more accurate, leading to fewer claims and billing issues.

 

Let’s talk more about that. How do APIs improve data accuracy?

Technology, including APIs and enhanced connectivity, allows us to identify errors and correct them before they become significant client issues.

It starts with making sure benefits products are set up correctly on platforms. We then use APIs to ensure enrollment eligibility is completed quickly and accurately, to make sure benefits are available when they’re needed.

As enhanced connectivity becomes commonplace, there will be tremendous value in having more accurate data connections. It’s not just about speed — accuracy is just as important.

 

Does this help Sun Life’s operational team, too?

Absolutely, there’s a big impact on carriers. The Ideon system creates better data accuracy — which may equate to fewer support calls, fewer billing issues, and fewer claim issues. That can have a huge effect on the industry: we’ll all be much better off if we aren’t using paper and email to solve and reconcile these data errors. With better connectivity, they might not be issues at all.

 

We’ve talked a lot about carrier-bentech partnerships. How else is the industry working together?

There’s beginning to be a collaborative mentality in the benefits industry. Data accuracy and data exchange are industry-wide challenges, and neither will be solved by one carrier alone.

LIMRA is a great example of industry participants and even competitors working together to solve these challenges. There’s a mentality amongst a group of individuals that we need to fix this as an industry. If we do, everyone will be better for it.

 

Final question: Besides API connectivity, in what other areas is Sun Life investing in technology?

Sun Life is, first and foremost, an insurance company. But we have developed proprietary technology that provides a modern client experience. Sun Life Onboard, for example, is a digitally enhanced onboarding experience. Our Benefits Explorer tool helps educate members on benefits pre-enrollment and throughout the client lifecycle.

But it’s a balance. We also need to be where our clients are. As we’ve talked about, Sun Life has invested significantly in API-powered partnerships with bentechs in the market. Ideon is a big part of that.

We don’t think of these as separate buckets — in-house vs. external investment. We look at it holistically and invest accordingly. Ultimately, we want to make benefits easier to enroll, manage, and administer, on platforms and throughout the benefits ecosystem. We do it by developing technology and through partnerships with companies like Ideon.

 

Interested in learning more about Ideon? Check out our API middleware solution, connect with our sales team, or subscribe to our newsletter.

Why so many organizations still struggle with digital transformation

Posted on by Zach Wallens

If your organization is more deliberate than you think ideal when adopting new technology, you can take some cold comfort in the fact that it’s hardly unique. Transitions in general—and especially those that require great investments of time, money or other resources—have been challenging for humans since, well, humans became a thing. 

And that’s very much the case when technology is involved. “All too often, selling digital transformation within large organizations is an uphill battle,” wrote Ideon CEO and co-founder Michael Levin in a recent Forbes article.

The reasons for this are many, a great deal of them explored in behavioral economics. Essentially the study of human judgment and decision making, the field encompasses a deep and growing list of cognitive biases that influence decision making. Among the most powerful are aversion to loss,  aversion to regret and a preference for the status quo. In short, humans are biased towards keeping things the way they’ve been (because we’ve survived so far) and are often more afraid of feeling bad about an outcome than about the bad outcome itself. That’s as true for CTOs and CFOs today as it was for hunters and gatherers of the past. For good reason, too: For most of human history, time spent on regret (say, for taking the wrong turn in a forest) meant less time to address the resultant problem (say, the bear now chasing you). 

What does all this have to do with digital transformation? More than you’d think. It makes sense that companies dependent on analog processes are hesitant to embrace digital solutions. The status quo has worked, and most significant technological transformation requires significant investment, which presents the potential for significant regret if systems go south. There’s also the misunderstood but pervasive idea that technology equals layoffs, a loss most employees seek to avoid. But one need only consider the current U.S. economy to understand the complexity of this understanding. Even as technological change continues to sweep through industry, the labor market is as tight as it has been in decades.

The health insurance and employee benefits industry is one example of how technology can transform a business even as employment grows. In what was not too long ago a very manual process, consumers today routinely use digital apps and platforms to choose and manage their health insurance and voluntary benefits. These transitions are powered by APIs—including those developed by Ideon—that power data exchange between insurers, employers, brokers, and the growing ranks of insurtech companies. The overwhelming majority of that latter category didn’t even exist a decade ago. (And they’re hiring.) Not surprisingly, a look at the health insurance and employee benefits ecosystem suggests four strategies for propelling digital change:

1. Connecting digital reform to company priorities.
This increases organizational abilities and allows them to efficiently continue working toward their goals while adapting to technological developments. 

2. Maximizing employee engagement.
Employees will instinctively feel more comfortable with the technology being used when they are a part of the decision-making. 

3. Pump priming.
Selling a particular change for a particular organization is rarely as effective as also selling the benefits of technological change, broadly. People have a harder time resisting change when confronted by statistics, research, case studies, and other evidence proving the ROI of digital transformation in their and other industries.

4. Using cognitive biases for good.
The very biases that keep people from making change can be used to spark action if inaction is framed as the more dangerous option. When we choose not to decide we have still made a choice—and that can be a source of regret, too.

Internal evangelists selling and installing digital transformation within their organizations invariably do so through a combination of the above strategies. While rarely a simple task, if done well, it’s almost invariably rewarding.

Powerful from the start: How data integrations helped DocMe launch an innovative digital health app

Posted on by Zach Wallens

By Zach Wallens
Director of Content and Communications, Ideon

In this blog post, Ideon profiles one of our newest customers, DocMe, a digital health app based in New York.

It’s no secret that new technologies and companies are driving innovation in the healthcare industry. From mental health and virtual care to digital pharmacies, care navigation, and billing, digital health startups are popping up in all corners of the healthcare ecosystem.

That ecosystem, however, is getting crowded. The race for customers, funding, and publicity is more competitive than ever before.

One way to stand out? Build intuitive, data-driven user experiences powered by third-party data integrations. New York-based DocMe, a brand new digital health app, is one example of an innovation-through-integration approach, leveraging several APIs to create a powerful interface for patients and providers.

Connecting the Dots

Founded in 2021 by private equity investor Tim Gollin, the original concept for DocMe was an app to help consumers shop for doctors, comparing availability, insurance coverage, and prices for specific procedures. Of course, there are existing services, such as ZocDoc, for booking medical appointments.

Gollin quickly realized that a connected patient experience—bringing together disparate data sets within a single platform—could truly differentiate DocMe from competitors. Leveraging third-party integrations, Gollin and his developers understood, would be far more efficient than chasing down data sets and building functionality from scratch.

DocMe streamlined its development by relying on specialized companies to provide data and services it incorporated into its app. “A lot of the data and connections we would have had to build ourselves in the past we can now get from vendors,” Gollin says. “We see ourselves as stringing together little bits of Tinker Toys to build a complete product.”

Indeed, DocMe integrates third-party technology for functions like electronic health records, payments processing, video conferencing, and provider identity verification. And it incorporates multiple sources of data about providers, procedure costs, and—with data from Ideon—insurance networks.

“Ideon provides me with the ability to show consumers which doctors are in their network without them having to go to their insurance company website,” Gollin says. “Doctors don’t even know what networks they are in. We’ve heard lots of stories where people get told on the phone the doctor is in their plan only to discover it’s not. Ideon has the definitive answer.”

This tight integration between services provides patients with an easier, more intuitive experience. Some examples:

  • DocMe promises patients that they’ll never have to enter medical information history more than once. 
  • When someone makes a doctor’s appointment, they not only see available times but also the specific services offered and the price they’ll pay according to the terms of their insurance plan.
  • When a patient books an appointment, DocMe will collect the amount not covered by insurance in advance. In other words, patients get a much more transparent market.

DocMe is continuing to add features to its product, integrating data more tightly to save users time. It will use Ideon’s card scanning technology, for example, to extract patients’ network information by simply snapping a photo of their insurance cards. 

DocMe is also preparing to roll out in Brazil, Italy, France, and the United Arab Emirates. Some might ask why a small company would spread its resources across different countries, each with its own health care system. Gollin answers that the work done to build integrated capabilities and smooth user experience into DocMe already gives it an advantage in other markets. “The goofy thing is the U.S. system is super complicated,” he says. “Everyplace else is significantly simpler.”

For more information about Ideon’s APIs for digital health and InsurTech platforms, click here.

BenAdmin Platforms Beware: Three potential data quality pitfalls—and how to avoid them

Posted on by Zach Wallens
By Zach Wallens, Ideon’s Communications Manager

The busy season is upon us yet again. And, yet again, health and benefits industry stakeholders are preparing for a mostly digital open-enrollment season in year two of the Covid-19 pandemic. Brokers are quoting the latest benefits products and formulating client proposals; employers are debating whether to stay the course or offer different health insurance and benefits in the coming year; and employees are familiarizing themselves with the digital tools that will guide their selections.

The focus for benefits administration (BenAdmin) platforms and other BenAdmin providers, as usual, is delivering high-level customer experiences through technology that eases the enrollment process rather than inhibits it. But given this emphasis on customer experience, there is another essential consideration for benefits technology vendors: data quality. Even the most user-friendly, feature-rich benefits software can earn a reputation as a front-end failure if data accuracy and quality are problematic during open enrollment.

The good news: BenAdmins have tools at their disposal to rectify—or, at least, minimize—data quality issues. 

The better news: BenAdmins need not rebuild their data infrastructure from the ground up to significantly improve quality. 

Rather, BenAdmins can lower their risk of data snafus by working with specialized vendors, whose solutions improve the speed and accuracy with which enrollment-related data is sent and received. With that in mind, here are three potential hazard areas that BenAdmins should keep an eye on—and how to avoid them.

1. Product-specific data. 

Employees need… 

  • An easy, streamlined way to review specific criteria they deem most important among the health plans offered by their employer. 
  • Confidence that they understand which plans meet their criteria, and will fit their budget. 
  • Help navigating the complexities of choosing not only health insurance, but also ancillary products (vision, dental, life and disability) that best suit their needs. 

API Middleware solutions can… 

  • Ensure data accuracy remains king, by aggregating plan and provider data directly from health plans and ancillary carriers. In doing so, they help BenAdmins maintain fidelity to their plan library and provider directory—plus the thousands of data points associated with each plan—without risking damage to employees’ health, financial well-being and goodwill. 
  • Shift the burden of data accuracy to the API vendor, enabling BenAdmins to confidently display product-specific information without fear of inadvertently misleading employees.

The Takeaway: The pathway to choosing the most appropriate health plan and ancillary benefits begins with employees having access to accurate, in-depth, comparable information about their options. Low-quality or outdated data, for example, can lead an employee into thinking that a plan covers their primary care physician, only to learn, post-enrollment, that the doctor recently dropped out-of-network. In third-party APIs, UX-focused BenAdmins have found a secret sauce for maintaining quality data. 

2. Group and member-level enrollment data. 

Employees need… 

  • Confidence that group and member information won’t fall prey to human error as it is manually keyed into enrollment apps. 
  • A seamless, delay-free receipt of their insurance card and, ultimately, use of their health insurance and benefits.

API Middleware solutions can… 

  • Connect carriers and BenAdmins and exchange accurate data between them (in fact, that’s their specialty). 
  • Enhance the quality of enrollment data by validating whether the submitted information meets carrier-defined business rules and other criteria, before the data even reaches the carrier. 
  • Allow BenAdmins to quickly and accurately identify and revise data issues, minimizing the chance of a lengthy enrollment delay for an employee.

The Takeaway: There will always be some risk of typos and other mistakes in enrollment data transferred from BenAdmins to carriers and benefits providers. After all, enrollment still involves some degree of human data entry. But for BenAdmins, the objective should be minimizing the amount of errors that reach carrier systems. API middleware partners can do that. 

3. Plan, class, and division mapping. 

Employees need… 

  • Confidence they will get enrolled in the correct plans with the correct carriers
  • BenAdmins with streamlined operations based on correct plan maps.

API Middleware solutions can… 

  • Enhance BenAdmins’ mapping capability to ensure groups and employees are enrolled in the right plans for the right coverage periods. 
  • Offer unique visibility into what’s under the hood at carriers and BenAdmins, making it easier to configure complex group setups when an employer has multiple plans, classes, and divisions.

The Takeaway: As with many things related to health insurance and benefits, what should be simple often is not. Where a group or employee may believe that they are enrolled in “Carrier PPO 123,” the carrier might identify that plan, internally, as “Carrier PPO NY ABC.” Or the same plan could have different IDs depending on the state or employee classification. This can generate massive confusion and even instances where employees or groups get enrolled in the wrong plan. Some larger businesses with numerous classes and divisions of employees might offer upwards of, say, 10 medical plans and several ancillary plans. Carrier-connectivity partners can help BenAdmin vendors relieve this pressure. 

And that’s no small thing. At a time when fully-digital, employee-facing enrollment capabilities are nearly universal, maintaining highly accurate data can be a true differentiator. Thankfully, there are partners, such as Ideon, that have considerable experience helping BenAdmins enhance their data quality without much development effort and investment.

 

Interested in learning more about middleware solutions? Download our guide on outsourcing carrier connectivity.

Seven ways benefit administration platforms can provide year-round value

Posted on by Zach Wallens

Most benefits administration (BenAdmin) platforms only have genuine access to employees during open enrollment. This small window of engagement is frustrating to BenAdmin leaders, but it need not be. That’s because they already have the building blocks necessary for creating year-round member interactions: existing relationships with employers and information about their employees. 

By smartly leveraging those relationships and that data, BenAdmin platforms can become a 24/7/365 gateway to the myriad of providers of health, retirement, and other programs an employer offers. Not only will that enhance the value BenAdmins deliver to employers, it will further differentiate them from their competition as well. 

Here is just a sampling of the enhanced services that can turn BenAdmin platforms into year-round destinations:

Centralized Portals for single point of access to HSA, FSA, HRA, 401k and other accounts. With these, employees can log onto a BenAdmin site or app and access to all of their health plans, retirement, and flexible spending information. 

Accumulators. A single up-to-date view of the important running totals from all member’s benefit plans, such as deductibles, out-of-pocket maximums, and flexible spending account (FSA) balances.

Provider Search. One interface to find any sort of provider. Since the BenAdmin knows the plans in which each employee is enrolled, it can limit the display of providers to those that are in-network.

Cost Estimator. A tool that enables a member to enter a procedure or drug and see their out-of-pocket cost under their plan. This tool could also let members compare their effective costs at different hospitals, using the price transparency disclosures that the federal government has mandated. 

Benefits Marketplace. A year-round array of voluntary benefits, programs and offers available through the employer such as gym memberships, pet insurance, identity protection, and student loan assistance. The most relevant offers can be surfaced when members get married, have children or experience other qualifying life events.

Healthcare Concierge. Many BenAdmin providers offer sophisticated decision support to help members select plans. This assistance can be extended year-round in regards to selecting providers, lowering costs, and even booking appointments. Concierge services can be offered via human support, automated bots, or in combination.

Wellness Programs.  There are myriad ways to offer members the information, support, and encouragement to make healthier choices about eating, exercising, stopping smoking, managing chronic conditions, and dealing with mental health. These can deploy tools including self-assessments, coaching, gamification, rewards, and integration with mobile devices. 

Concierge and wellness programs can involve significant investments in content and support staff. BenAdmin providers, accordingly, may look to partners for these services rather than building them in-house. But all the other services on this list are essentially extensions of the capabilities that BenAdmins already have—connecting data from benefit providers, employers, and employees. Still, by using this information to offer convenience, utility, and insights, BenAdmin providers can engage members and prove value to employers 12 months of the year.

Build vs. Buy: The Case for Enhancing Carrier Connectivity to Improve Enrollment Experiences

Posted on by Zach Wallens
By Zach Wallens, Communications Manager at Ideon

One-stop-shop HR and benefits administration (BenAdmin) platforms, which integrate all elements of the employee experience into a centralized system, are the future of the benefits industry. From health insurance and dental coverage to telehealth and gym memberships, those BenAdmins that offer the most-popular employee benefits on one platform will boast the best user experience and, as a result, a significant advantage over rivals. In fact, some forward-thinking BenAdmins are already preparing for this all-in-one future, laying a foundation to scale aggressively and add new benefits at a moment’s notice.

But this trend raises an important question: How, from a technical standpoint, will BenAdmins add all of these benefits products—from numerous insurance carriers and other providers—to their platforms?

The answer, as most BenAdmin executives know, is digital connectivity. BenAdmin platforms have long identified connectivity with carriers as a technological necessity—and competitive differentiator—for success in today’s digital-first age. Connectivity enables BenAdmins to present up-to-date product information, enroll employees in benefits digitally, and transfer group and employee-specific information to carriers and other providers. It is a pivotal component of any modern BenAdmin experience.

But while digital connectivity is universally accepted as integral to any tech-forward BenAdmin’s UX strategy, a consensus has yet to develop on the issue of building or buying a solution for developing and maintaining carrier connections. Many BenAdmins elected to utilize their existing technology team to build integrations to carrier systems because this was, until recently, their only option.

This go-it-alone “build” approach, however, has been technically and operationally challenging for BenAdmins. Establishing and sustaining relationships with hundreds of carriers and providers—each with unique systems and formats to which BenAdmins have had to conform—is a process that is both time-consuming and labor-intensive. Moreover, integrating to each carrier’s core systems, one by one, involves tremendous development resources.

These drawbacks are prompting many BenAdmins to consider a new digital connectivity strategy: the “buy” approach. Indeed, a growing number have determined that buying connectivity on a mass scale, through a carrier connectivity partner such as Ideon, is a more effective use of resources than building those bridges themselves.

In this scenario, BenAdmins integrate with a single partner’s API, and it’s that partner’s responsibility to manage the connections and exchange of data—often in real time—with carriers and benefit providers.

These BenAdmins are outsourcing carrier connectivity to specialists in just that skill, resulting in massive efficiency gains, a quicker path to scalability, and better experiences for end users—employers, HR teams, and employees. Such forward-thinking benefits platforms have decided that it makes more business sense to invest in a turnkey solution that is built, managed and regularly improved by industry-specific digital connectivity experts than to devote time, money and labor to create multiple carrier integrations themselves.

Instead, these BenAdmins are taking the savings achieved from outsourcing connectivity and investing them in the development of improved experiences for their customers’ employees. Data-driven plan selection, personalized decision support, integrated telehealth services, and robust ancillary offerings are just a few of the tech-enabled experiences that employees expect from their BenAdmin. These are features that require ongoing iteration and improvement, and represent far better destinations for operational capital.

Buying is the new frontier of BenAdmin-to-Carrier connectivity, a forward-facing reallocation of resources that goes a long way towards enhancing their competitive advantage.