Topic: Enrollment
The Future of Benefits Administration Platforms: Centralizing the Employee Experience
Basic health insurance ✅
401(k) ✅
Paid time off ✅
Employee benefits, once mostly a collection of must-check boxes, have transformed into multifaceted rewards programs, customizable to meet the needs of each employee and a key differentiator in recruitment and retention. Ancillary benefits such as pet insurance, gym memberships, and financial assistance programs are becoming the norm, fueling higher expectations for what employees receive, beyond compensation, from their employers. The enhancement and personalization of employee benefits, however, has caused a ripple effect throughout the world of benefits administration (BenAdmin) platforms.
The ways in which BenAdmins have adapted to this new dynamic offer a predictive glimpse into the future of this crucial sector. Just the basics—health insurance enrollment, management of paid time off (PTO), etc.—will no longer cut it. Instead, forward-thinking BenAdmins are preparing for the future: all-in-one platforms that integrate all elements of the employee experience into a centralized system.
From payroll, dental insurance and 401(k)s to FSAs, wellness programs, retirement plans, stock options and student loan repayment, BenAdmins of the future will consolidate all relevant information within one central platform. Those who succeed will not only be incredibly agile—easily adding the hottest non-core benefits of the day—they will be perceived as incredibly agile, representing a major differentiator. They will possess personalized data and insights to share with employees so they can make more-informed decisions about health and benefits products.
So what is the future of benefits administration? In a word, unified. A single system to rule them all. No employee—and, for that matter, no broker or employer—wants one system of record for health insurance, another to manage stock options, and still another to review HSA balances and employee assistance programs (EAP).
Although tying all of these components together into a single platform will become an essential differentiator between BenAdmins, certain features are gaining in popularity and will ultimately be expected by employees. Here are three trending features that will be an important part of all future BenAdmin platforms:
- Healthcare concierge services help employees navigate the complexities of our healthcare system, from recommending providers and facilities based on quality and cost, to minimizing healthcare spend by redirecting employees to, for example, an in-network urgent care facility.
- BenAdmins of the future must consider employee wellness a vital piece of the benefits package. Mental health assistance, financial wellness programs, and telehealth services should be easily accessible and integrated into the centralized employee experience.
- Personalized ancillary benefits provide employees with the opportunity to select the non-core benefits that best fit their needs and interests. Some might prefer a gym membership and pet insurance to an HSA, and others may deem student loan assistance a prerequisite for any job offer. More choices, more benefits, more customization—that’s a key pillar of the future of benefits administration.
The future of benefits administration is truly limitless, but it can only reach its unified, all-in-one potential if, on the back-end, BenAdmins have agility and connectivity. Agility because, inevitably, new benefits options—perhaps even entirely new benefits categories—will become popular as younger employees enter the workforce and expect benefits packages to align with their interests. To remain competitive, BenAdmins will need a scalable method to integrate these benefits quickly and efficiently.
Connectivity enables BenAdmins to exchange group and employee-level data with carriers and other benefits providers, such as telehealth, gyms and wellness companies. BenAdmin connectivity is the first step in bringing the full employee benefits experience onto one platform, allowing employees to enroll in and manage benefits across a variety of carriers, lines of coverage, and products. Historically, carrier and benefit provider connectivity has been technically and operationally challenging for BenAdmins. But today, APIs offer BenAdmins a lifeline to simplified, flexible and scalable connectivity with multiple parties.
To learn more about how APIs can streamline connectivity in the benefits ecosystem and prepare BenAdmin platforms for the future, contact Ideon for a consultation.
Lightening up the year-end blackout period for employee benefits
Ideon ends the hassle of changing current-year plan details during open enrollment.
By Dan Langevin, co-founder and chief technology officer of Ideon
Towards the end of every fall, as 1/1 renewal dates loom, insurance carriers, brokers and members work diligently to ensure that upcoming plan elections go off without a hitch. Meanwhile, life goes on in the current plan year, and life events that affect enrollment need to be addressed. Simultaneously managing the current plan year changes and the upcoming elections is often a tricky ordeal.
The fact is, most carrier systems struggle to manage coverage across plan years—regardless of the carrier’s backend data ingestion system (EDI 834, API or a custom format). When you consider that enrollment elections for the next plan year begin at least a month before the effective date and that changes can continue to be made retroactively for 60 days, cross-plan-year changes can actually be a problem for three months a year.
To this point, the “state of the art” solution has been manual one-off processes. Carriers require specialized, custom formats (different from their regular EDI 834, API requests or flat files) or specially timed delivery of changes for the prior plan year that differs from the regular file delivery day. In practice, most brokers and operations teams at BenAdmin platforms handle these changes manually, by contacting the carrier or by entering the data into the carrier’s portal. This isn’t exactly ideal. Nor is it ideal for the carriers, as their cost-saving automation is bogged down by so many extra manual touches.
This is a major systemic shortcoming. How can we realize full digital connectivity if for 25% of the year we require a separate manual process to handle basic changes?
Eventually, the underlying limitation will be resolved. Carriers will upgrade their internal systems, data models and processes to seamlessly handle cross-plan-year changes. But, as with many things technology-related at large national carriers, the investment required to accomplish that will be large and the timeline long. The market wants a solution today.
Enter Ideon’s Blackout Period Change Management. We have worked diligently with our carrier partners to develop cross-plan-year, change-management processes that eliminate the need for one-off manual changes. The result: the effective elimination of Blackout Periods.
From the BenTech platform or broker’s perspective, data is sent to Ideon’s APIs per standard operating procedure. Our data model has the concept of different plan years baked in. The differences between how transactions are handled with each carrier are entirely transparent. It “just works.”
From the carrier’s perspective, cross-plan-year changes remain less than ideal. Most carriers need to do some level of system acrobatics to process them. That can mean tasks as manual as employees processing a custom Excel doc with every requested change. That said, knowing that they are getting clean data in a consistent format from multiple BenTech platforms gives them back some of the leverage they reap from automation the other nine months of the year. Further, as the carrier upgrades the efficiency of their internal systems (to standard file feeds or, ultimately, to APIs), it will have a partner who understands the idiosyncrasies of cross-plan-year changes and can help to develop a technical integration and business process.
This fall, we piloted our Blackout Period Change Management process with a large customer that covered tens of thousands of lives across hundreds of groups and four carrier partners. The feedback from all sides was extremely positive. That success has made us that much more excited for a broad rollout across all of our carrier and BenTech partners.
Ideon’s mission is to make insurance and employee-benefit data flow freely between member-facing tech platforms and insurance companies. We know that APIs will be a big part of that solution. In the short term, though, we will also provide innovative, tech-enabled business processes that bridge the gap between where we think we should be and the realities of what exists in the ecosystem today.
Contact us to learn more!
Vericred Launches Health Insurance and Employee Benefits Enrollment APIs, Announces Key Relationships
**NOTE: Ideon is the company formerly known as Vericred. Vericred began operating as Ideon on May 18, 2022.**
Beam, CaliforniaChoice, Kaiser Permanente and Oscar partner with Vericred to create a de facto standard for California group enrollment and member management
September 15, 2020 09:00 AM Eastern Daylight Time
NEW YORK–(BUSINESS WIRE)–Vericred today unveiled a new suite of enrollment and member management APIs, ushering in a new era of digital connectivity between health insurance and employee benefit carriers and InsurTech companies. Vericred’s API Platform enables the simple and seamless exchange of quoting, enrollment and eligibility data between carriers and technology companies such as tech-enabled brokers, BenAdmins, HCMs and HRIS solutions. This news is paired with the announcement of groundbreaking enrollment relationships with Beam, CaliforniaChoice, Kaiser Permanente and Oscar.
“The digital transformation of health insurance and employee benefits is being held back by lack of connectivity and industry standards, resulting in incredible inefficiencies and poor consumer experiences,” said Michael W. Levin, Vericred’s co-founder and CEO. “Our enrollment and member management capability democratizes this connectivity and enables industry-wide digital quote-to-card experiences for carriers, general agents, brokers, employers and employees.”
Vericred’s new suite of APIs enables end-to-end functionality including new group installation, renewals, broker of record changes, member additions, terminations and changes, reconciliation and normalized enrollment status and error handling across all lines of coverage.
“Great products need great foundations. Vericred is critical, foundational infrastructure for our insurance and benefits products at Rippling. We could not have built Rippling without this partnership,” said Parker Conrad, Rippling’s co-founder and CEO.
COVID-19 is a catalyst for the industry’s digital transformation, adding a new layer of complexity to the busy Fall enrollment season. Social distancing regulations permits few, if any, in-person meetings between brokers and their group clients. Open enrollments are being conducted virtually. Employers and brokers need tools and connectivity in order to deliver modern digital experiences to their clients and employees. Vericred’s Platform is essential for those looking to quickly and efficiently scale their digital solutions.
Vericred partners with leading California carriers to create a new standard
CaliforniaChoice, Kaiser Permanente and Oscar, representing a majority of California small group medical members, will use Vericred for health insurance and benefits enrollment and management in California and other regions in which these companies offer coverage.
“Small group health insurance has been stuck in the early 2000s as far as online enrolling, managing and renewing,” noted Kirk Whelan, National Vice President of Small Group Commercial business for Kaiser Permanente. “We support the efforts to move toward digitizing small group enrollments.”
“As the Nation’s largest private exchange we are continuously innovating to meet the needs of our brokers and General Agent partners, and our small business customers,” said Michael Close, CEO of CHOICE Administrators, the parent of CaliforniaChoice and ChoiceBuilder. “Vericred allows us to leverage our own investment in APIs across GAs, tech enabled brokers and a broad spectrum of enrollment and benefit administration solutions.”
In addition to the above health insurance carriers, Vericred is working with Aetna, Anthem, Blue Shield of California, Cigna, Guardian, Humana, MetLife, Principal, Regence Blue Cross Blue Shield, and UnitedHealthcare. Vericred has aggressive plans to complete more than 200 carrier integrations over the next two years.
Interested parties should contact sales@vericred.com for more information.
About Beam
Beam Dental was built around the idea that blending technology with traditional insurance policies could bring incredible value to a commoditized employee benefits market. Beam Dental is a company’s best choice for a differentiated, innovative take on dental and ancillary employee benefits with a nationwide network of dentists. For more information, visit beam.dental.
About CHOICE Administrators
CHOICE Administrators is the parent organization of the nation’s largest multi-carrier, small group private health exchange, CaliforniaChoice, and America’s first ancillary benefits exchange, ChoiceBuilder. Together, the two exchanges currently offer access to 11 health plans and carriers to more than 27,000 small business clients and nearly 450,000 members across the state of California.
About Kaiser Permanente
Kaiser Permanente is one of America’s leading health care providers and not-for-profit health plans. The organization currently serves 12.4 million members in 8 states and the District of Columbia. www.kp.org
About Oscar
Oscar is the first health insurance company built to make health care easy. Headquartered in New York City, Oscar has been challenging the health care system’s status quo since our founding in 2012, developing seamless technology and providing personalized support to help our members navigate their health care. Oscar was the first insurer to offer $0, 24/7 telemedicine to members and to integrate direct scheduling with providers through our app.
Oscar plans also include access to a network of first-rate physicians and hospitals, as well as a personalized Care Team that supports members every step of the way, from finding a doctor to navigating costs. Oscar is known for its easy-to-use digital tools, including a website and mobile app that let members view their health history, speak directly with their Care Teams and virtual providers, and access their account information.
All products and services are provided exclusively by or through operating subsidiaries of Mulberry Health Inc., including Oscar Insurance Company and its affiliates. Say hi or learn more at https://www.hioscar.com or follow us at https://twitter.com/OscarHealth.
About Vericred
Vericred has built the first end-to-end quoting, enrollment and member management middleware (API) platform for health insurance and employee benefits. By simplifying the exchange of data between carriers and technology companies, Vericred is enabling the digital transformation of the health insurance and employee benefits industry. Vericred offers robust solutions for the employer market, as well as the under 65 individual, Medicaid and Medicare markets.