Asked & Answered: What group benefits carriers should know about LDEx

If you’re in the group benefits industry, you’ve probably heard the term LDEx, i.e., LIMRA Data Exchange Standards. Whether you’re actively adapting your systems to accept LDEx-formatted enrollment data or have only seen the term in passing, there’s a lot happening around this opportunity and, of course, a lot for carriers to consider.

LDEx won’t immediately solve all of our industry’s data exchange challenges, but it’s a step in the right direction. MetLife, Guardian, Sun Life, Aflac, and other industry leaders are members of the LIMRA committee tasked with developing the LDEx, reflecting its transformative potential. Some carriers, however, have a myriad of questions. 

Ideon, also a committee member, created this primer to answer basic questions about the standards and offer suggestions for leveraging them with minimal effort and expense.

What is LDEx?

The LIMRA Data Exchange (LDEx) Standards® are a set of rules—for terminology, formatting, content, and delivery—that facilitate digital communication between benefits administration (BenAdmin) platforms and insurance carriers. They are meant to replace various ad-hoc formats, such as EDI 834, for transmitting data about employee enrollment and eligibility in group benefit plans.

What are the benefits of LDEx for carriers?

If implemented broadly, LDEx will substantially reduce the complexity and expense of receiving enrollment information from BenAdmin platforms. Without LDEx, carriers typically spend weeks to months setting up and testing variations of EDI connections for each new group they enroll. If the industry uses LDEx, there will be greater consistency and accuracy throughout the integration and testing process, reducing the resources carriers must allocate to adding and managing groups.

As industry adoption increases, carriers will be able to connect more easily to benefits platforms and other insurance technology providers, dramatically improving the user experience for members who want to manage their eligibility through those platforms. 

Ultimately, brokers, HR teams, and members will find that enrolling and modifying group benefits will be faster and more accurate. In today’s competitive environment, this is a business imperative for insurance carriers. Increasingly, brokers and BenAdmin platforms are steering their group clients to insurance carriers that make the enrollment experience as easy and automated as possible, across the software they use today.

Who created LDEx?

LDEx is sponsored by LIMRA, a non-profit consulting group and trade association that works primarily with the life insurance industry. The standards were developed by a steering committee composed of 40 executives from group benefits carriers and insurance technology companies. 

What capabilities does LDEx provide?

The initial standards, released in January 2020, covered a wide range of benefits, including dental, vision, disability, critical illness, and life products. More recently, it has been expanded to include medical plans, flexible spending and health reimbursement accounts, paid family leave, and employee assistance programs.

The LDEx standard covers information about benefit enrollment, eligibility, and member changes. It also allows carriers to communicate data issues and coverage confirmations back to the BenAdmin provider.

The standards are designed to communicate transactions using structured XML files, a flat file format that’s common in the insurance industry. There are also near-term plans for LDEx to support REST APIs, which would allow for faster processing and better, automated error checking.

LIMRA is working on additional standards to support electronic communication of benefit plan designs and quotes.

What must carriers do to use LDEx?

The standards can be downloaded for free from LIMRA. Carriers must modify their existing enrollment systems to accept data in the new formats—or they can use separate data transformation software to convert each LDEx file they receive into the format their system uses. 

How can carriers ease the burden of adopting LDEx?

Although LDEx will ultimately save time and money for carriers, adopting the standards can add development expenses for carriers already spreading limited technology resources across many priorities. Some carriers, however, are finding ways to adopt LDEx without devoting resources to development.

Ideon’s middleware solution enables carriers to accept LDEx files from numerous BenAdmins, with minimal development effort and capital costs, and no need to modify their current system and format. It’s not just a quick fix—it’s a long-term strategic move to enhance your connectivity with BenAdmins and set yourself up for scalability and adaptability in the future. Ideon radically reduces the time and effort needed to set up and administer group benefits, while delivering faster and more accurate information for employers and members. Reach out to us for more information.

Asked & Answered: What benefits administration platforms should know about LDEx

If you work for an HR or benefits administration (BenAdmin) platform, you might have heard the term LDEx, i.e., LIMRA Data Exchange Standards. Whether you’re actively adapting your systems to transmit LDEx-formatted enrollment data or have only seen the term in passing, there’s a lot happening around this opportunity and, of course, a lot for you to consider.

LDEx won’t immediately solve all of our industry’s data exchange challenges, but it’s a step in the right direction. ADP, Benefitfocus, benefitexpress, Businessolver, PlanSource, Selerix, Paycom, and other industry leaders are members of the LIMRA committee tasked with developing the LDEx, reflecting its transformative potential. Some BenAdmins, however, have a myriad of questions. 

Ideon, also a committee member, created this primer to answer basic questions about the standards and offer suggestions for leveraging them with minimal effort and expense.

What is LDEx?

The LIMRA Data Exchange (LDEx) Standards® are a set of rules—for terminology, formatting, content, and delivery—that facilitate digital communication between BenAdmin platforms and group benefits carriers. They are meant to replace various ad-hoc formats, such as EDI 834, for transmitting data about employee enrollment and eligibility in group benefit plans.

What are the advantages of LDEx for HR and benefits platforms?

If implemented broadly, LDEx will substantially reduce the complexity and expense of integrating with carrier systems and sending enrollment data in carrier-specific formats.

As BenAdmins know all too well, the lack of consistency has, traditionally, caused significant operational challenges and group-onboarding delays. BenAdmins typically spend weeks to months setting up and testing carrier connections. But if both carrier and BenAdmin platform use LDEx, there will be greater uniformity and accuracy throughout the integration and testing process, reducing the resources BenAdmins must allocate to adding and managing groups.

As industry adoption increases, BenAdmins will be able to connect and transmit data to carriers more efficiently. Ultimately, brokers, HR teams, and members will find that enrolling and modifying group benefits will be faster and more accurate if their BenAdmin uses LDEx. In today’s hyper-competitive environment, this is a business imperative: BenAdmins need to make the enrollment experience as easy and automated as possible, across as many insurance carriers and product lines as possible.

Who created LDEx?

LDEx is sponsored by LIMRA, a non-profit consulting group and trade association that works primarily with the life insurance industry. The standards were developed by a steering committee composed of 40 executives from group benefits carriers and BenAdmin platforms.

What capabilities does LDEx provide?

The initial standards, released in January 2020, covered a wide range of benefits, including dental, vision, disability, critical illness, and life products. More recently, it has been expanded to include medical plans, flexible spending and health reimbursement accounts, paid family leave, and employee assistance programs.

The LDEx standard is carrier-agnostic and covers information about benefits elections, coverage changes, terminations, non-coverage demographic changes, and eligibility management. It also allows carriers to communicate data issues and coverage confirmations back to the BenAdmin provider.

The standards are designed to communicate transactions using structured XML files, a flat file format that’s common in the insurance industry. There are also near-term plans for LDEx to support for REST APIs, which allow for faster processing and better, automated error checking.

LIMRA is working on extensions to support electronic communication of benefit plan designs and quotes.

What must benefits platforms do to use LDEx?

The standards can be downloaded for free from LIMRA. In general, BenAdmins can implement them the same way they would configure their systems for any other data exchange format.

It remains to be seen how much consistency there will be among carriers adopting the LDEx standard. One cautionary tale: EDI 834. This standard remains the status quo format for most medical plans, but over time carriers have developed their own variations, so BenAdmins have had to modify and test their data formats for each dialect of the standard. 

Will carriers do the same with LDEx? Time will tell. In the meantime, there are tactics BenAdmins can implement to leverage LDEx to the fullest extent possible while leaving room to adapt if necessary.

How can benefits platforms ease the burden of adopting LDEx?

Although LDEx will ultimately save time and money for BenAdmin platforms while enabling a smoother user experience, some remain hesitant. After all, wouldn’t adopting the standard require devoting significant resources to development and testing the format—while still building and maintaining the carrier connections?

Not quite.

Ideon’s middleware solution enables benefits administration platforms to send LDEx-formatted data to any carrier, regardless of whether the carrier is set up for LDEx. Ideon handles the translation into LDEx or whatever format is best for the carrier. It’s not just a quick fix—it’s a long-term strategic move to enhance your carrier connectivity and set yourself up for scalability and adaptability in the future. Ideon radically reduces the time and effort needed to set up and administer group benefits, while delivering faster and more accurate information for employers and members.

For more information, please reach out to us here or send us an email at sales@ideonapi.com

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Employee Spotlight: Keriann Iovino

At Ideon, we’re proud to have such a talented, diverse team leading the charge for a better and more connected health insurance and employee benefits industry. Our ongoing Employee Spotlight series showcases the people behind our product and unveils what life is like at Ideon. Next up… Keriann Iovino, our People Operations Coordinator.

Name: Keriann Iovino

Title: People Operations Coordinator

Department: People Team

Location: New York

 

Work

How long have you worked at Ideon? 

Just shy of 5 years!

What do you enjoy about Ideon’s company culture?

I love the transparency and the people I work with every day.

How has Ideon helped you grow professionally?

Management at Ideon wants to see everyone succeed. Although I was hired as an Office Coordinator in our NYC headquarters, I was always interested in the People/HR field. Ideon’s Head of People, Emily Joseph, and our Chief of Staff, Tory Bensen, were supportive in helping me more closely align my responsibilities with my interests, eventually transitioning me into the People Operations Coordinator role that I’m in today. 

What do you like most about your job and working at Ideon?

I get to meet every new Ideon employee, ushering them through the interview and onboarding process. Our team is amazing and it’s been especially rewarding over the past 12 months, getting an opportunity to meet so many new faces, all from different backgrounds and locations!

What attracted you to Ideon’s mission?

In the past, I’ve worked in the medical field and saw how confusing and messy health insurance can be. When I came across Ideon, I was immediately drawn to its mission to solve these challenges at the industry-wide level. I wanted to be a part of a company making a big impact. 

 

Life

Favorite activity when you’re not working? 

Besides relaxing with my family, I love crafting! I like to make shirts and tote bags.

Favorite place you’ve traveled?

Curacao was by far my favorite place that I’ve traveled to.

Interesting fact about yourself… Go!

I was once in a Mac Miller music video!

Interested in joining our team? Check out Ideon’s careers page.

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Vericred Releases Annual Map of ICHRA-friendly States

**NOTE: Ideon is the company formerly known as Vericred. Vericred began operating as Ideon on May 18, 2022.**

2022 ACA health plan data shows that in nearly half of U.S. states, an ICHRA could be a cost effective solution for small employers seeking to give employees more plan options

December 16, 2021 – Vericred, the API platform powering digital quote-to-card experiences in health insurance and benefits, today announced it has released its annual map of states where insurance premiums are most friendly to Individual Coverage Health Reimbursement Arrangements (ICHRAs). Employers who choose to offer an ICHRA provide a monthly, tax-free stipend that employees put toward the premium of a plan they choose from the individual market. 

The Vericred 2022 ICHRA Map shows the counties and states where an employee using an ICHRA would likely find Affordable Care Act (ACA) individual premiums equal to, or less expensive than, ACA small group plan premiums, i.e., “ICHRA-friendly.” For each state, Vericred calculated the difference between the average (across all counties) lowest-cost Bronze plan in the ACA small group and individual markets. 

Key findings from the Vericred 2022 ICHRA Map include:

  • Nearly half of the U.S. is ICHRA-friendly — in 24 states, 2022 individual Bronze plan premiums are equal to or less expensive than small group plan premiums
  • The number of ICHRA-friendly states grew by 26% since 2021, when 19 states were considered ICHRA-friendly. In 2020, only 16 states were ICHRA-friendly 
  • The top five ICHRA-friendly states, are, in order, Ohio, Georgia, Indiana, South Carolina and Mississippi
  • The five least ICHRA-friendly states, which have a market where premiums in the ACA individual market are most expensive compared with the ACA small group market, are, in order, Alabama, Oklahoma, Illinois, Tennessee and West Virginia
  • Some states have flipped – Maryland was ICHRA-friendly last year, and is now not ICHRA-friendly. In 2021, Kansas was among the least ICHRA-friendly states; now it is no longer 

“Historically, individual market premiums have been more expensive than small group premiums. Our data shows this is changing, and fast. ICHRA is now an attractive, cost-effective option for employers seeking to offer employees health insurance for the first time, or for those offering coverage, to control their benefit costs,” said Michael W. Levin, CEO and co-founder of Vericred. “We expect this trend to continue in the coming year, and as a result, we anticipate that more employers will offer ICHRAs.”

Resources

About Vericred
Vericred is the way health insurance carriers and employee benefits providers connect with new technology partners to deliver seamless quote-to-card consumer experiences. We are not the websites or apps you use to choose a plan or find a doctor. We are the infrastructure. We are the ‘pipes’ that simplify the complex exchange of quoting, enrollment and eligibility data between carriers and the technology partners responsible for delivering health and employee benefits to hundreds of millions of Americans everyday. Our APIs transmit billions of data points between InsurTech and insurance carriers, powering digital distribution across the insurance industry. Visit www.vericred.com.

Interactive Map: 2022 ICHRA-Friendly States

This map displays the difference between the lowest-cost plans in the individual and small group ACA markets by county.

Vericred CEO shares his prediction regarding decision-support becoming more commonplace in 2022

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