Ideon Insights: Prudential’s Sherri Bycroft on carrier-BenTech connectivity and APIs

Welcome to Episode 5 of Ideon Insights, our monthly interview series featuring thought leaders and innovators driving the benefits industry forward. In this episode, we sat down with Sherri Bycroft, Director–Benefit Technology Relationships at Prudential, to discuss how carriers are prioritizing certain APIs, partnerships with technology platforms, and how Ideon and Prudential developed an advanced solution for EOI auditing and decisions. 

In this insightful Q&A, Sherri shares how Prudential is approaching the future of partnerships and technology, and why connected experiences are the key to growth and member satisfaction in the benefits space. 

Watch the full episode of Ideon Insights. Below, we’ve highlighted key moments from the conversation.

IDEON: Why are technology partnerships so important for carriers like Prudential today? 

SHERRI BYCROFT, Prudential: 15, 20 years ago, we often didn’t know who the platform was that housed data for that customer until after they were sold. Now, it’s on the RFP. If we don’t have a relationship with a group’s technology partner, we could be dead in the water on the sale before we even get to quote it. They’re going to look at that and say, ‘we’re going to choose a carrier that wants to work with our partner.’ 

It’s just so important in today’s world to be able to exchange data and have a connected experience. My team is being invited to finalist meetings all the time now. They want to hear from the technology team: What are you offering? How are you connecting? What does that look like for me? Connected technology experiences are where they’re making decisions today. 

How has the role of brokers evolved in this more connected benefits landscape? 

10 plus years ago, you didn’t really see brokers being engaged in how or who a group was choosing for their technology partner. Now brokers are actually bringing technology solutions directly to their customers. It’s creating some stickiness for the broker. 

We’ve seen it on the carrier side, that customers are now more committed to their technology solution than they are to a carrier or their broker. The loyalty now is to ‘what is the hardest part of my life to change, and that’s the technology.’ 

What technologies and APIs are carriers prioritizing now? 

Decision support is definitely a huge point of interest right now. Another is quoting APIs. The quote process wasn’t even in conversation five years ago, but now it’s a huge point of interest. 

Plan data is another area where we’ve seen progress. We’re finally at a point where carriers are rolling out solutions to send plan configuration data into the technology system. 

Everybody’s working toward their own roadmaps and some are very strong in one place and maybe not so much in another. We used to just be so focused on enrollment and eligibility information. But now, our eyes have been opened a bit as to what we can do to make the experience better, and be more proactive in preventing issues with that enrollment data. And so that really leads to plan build and Evidence of Insurability (EOI), and even quoting, all being an interconnected technology experience from quote to claim. 

Why did Prudential choose to partner with Ideon? 

One of the main reasons Prudential decided to partner with Ideon is because the folks at Ideon understand there’s more opportunity than just what’s being accomplished today. That willingness to say, ‘hey, there are opportunities to do things that have never been done before–let’s find a way to do it together.’ 

It gave us a lot of excitement for what we could do together, instead of being so siloed in, ‘the technology partner versus the carrier and whose roadmap is more important’. Instead, we have a partner like Ideon, where we are really both committed to delivering something new and better to the market. 

How are Ideon and Prudential working together to solve EOI data challenges? 

The EOI audit process that Ideon is creating for us is really taking the EOI rules that we have around our plans, and applying them to the enrollment data that’s received from the technology partner. The solution looks at how many of these folks have an amount approved over a guaranteed issue amount, and whether they actually went through the EOI decision process. 

By having this EOI audit in place, we can uncover problems before claims time, and prevent a negative claims experience. It’s really important to us to ensure that we’re doing that right. But we just didn’t have the mechanisms in our toolbox to create this. So, Ideon has helped us build this from the ground up. We’re really excited about the fact that it’s going to flush out issues much earlier on. 

It also ensures that the EOI decisions that we’ve made have been correctly updated into that technology platform. This actually serves in between as that connectivity, and reports back if we’ve approved something and it’s not updated in that downstream system. It’ll flush out issues and report it back to the platform, so we can make sure that it’s corrected. 

How does Ideon help improve data quality for carriers? 

The only thing that solves data quality issues is having robust validations on that data. Ideon has applied a more robust set of validations to all of our transactions. If the data is not in good order, Ideon catches it at the time they receive it and doesn’t pass it on to us. This helps keep bad data out of our system and reduces operational costs.”

What’s the state of API adoption in the benefits industry? 

I think we’re still in our infancy, maybe toddler stage, but we certainly have a long way to go. I remember sitting in a room full of carriers and we were having discussions around APIs in 2016, and it was like everybody wanted to be there by 2020. We’ve learned a lot since and we’ve seen how long this has taken, but I think like all technology, you’re going to see it start to accelerate. But how far along are we going to be? We might be getting ready to enter our teenage years. 

Stay tuned for more episodes of Ideon Insights each month! To get the latest updates and industry trends, subscribe to our newsletter below. 

Ideon Insights: Pacific Life execs on building a digitally-native benefits division

Welcome to Episode 4 of Ideon Insights, our monthly interview series featuring thought leaders and innovators driving the benefits industry forward. In this episode, we talked with two leaders from Pacific Life’s new workforce benefits division, Bram Spector (CFO) and TJ Clayton (Head of Partner Management).

In this Q&A, Bram and TJ discuss building a digitally-native, startup-like benefits provider, backed by the resources and reputation of a 155-year-old insurance giant. They also explain why the benefits experience is ripe for digital innovation, how digital connectivity fueled Pacific Life’s go-to-market strategy, the role of Ideon, and their vision for the future.

Watch the full episode of Ideon Insights here. Below we’ve highlighted key moments from the conversation.

IDEON: Why did Pacific Life enter the benefits industry?

BRAM SPECTOR: Pacific Life has legacy and a track record of incubating and building new businesses. Our corporate strategy team spent a couple years evaluating options, various markets that we weren’t in previously, and ultimately made the decision that employee benefits was the place where we wanted to invest in building a new business.

Our strategy started by assembling a team of folks from across the group insurance industry who had spent the last 10, 15, 20 years of their careers in carrier roles and wanted an opportunity to deliver exceptional experiences to customers. We built a team that was focused on solving our customers’ biggest issues, then we did a ton of research to validate the pain points today across the industry.

We spent a lot of time challenging ourselves to understand why our competitors have not been able to solve those challenges. And then we architected our strategy around a series of experiences that are designed to make our customers’ and stakeholders’ lives better.

IDEON: Walk us through your initial launch strategy… what were your priorities?

BRAM SPECTOR: Ultimately, we decided to build the business based on a couple of key principles. One, we want to operate like a startup — agile, move quick, use an MVP-based approach to get to market. And two, we’re focused on building a digitally-native workforce benefits business. We’re also thrilled to launch with three technology partners: Employee Navigator, ADP, and Selerix.

IDEON: What does it mean to be a digitally-native benefits provider?

TJ CLAYTON: When we think about being digitally native, the key is not to just be digital for digital sake. What are the pain points, the friction points that brokers and employers experience all day, every day? That’s what we want to solve with a digitally-native approach.

What are the pain points around billing, around commissions, around setting up cases, enrollment, and file feeds? What are the challenges that make this industry what it is, and how do we turn those things on their head via a digitally native experience? We set out to solve problems, not to just put a digital label on a new logo and a new company.

BRAM SPECTOR: We’ve got the benefit of starting with a completely blank slate from an architecture perspective. We’re making sure we take advantage of that opportunity to really architect our experiences and our business processes in a way that supports our customers.

IDEON: What parts of the benefits experience did Pacific Life focus on initially?

BRAM SPECTOR: We heard resoundingly that the industry’s billing experience is terrible. It’s challenging, and frankly, it shouldn’t be. Onboarding, or customer implementation, is another issue that customers consistently have said is a pain point and a challenge. So we’ve got the opportunity to set a great first impression if we do that implementation right, and to set ourselves up for a successful customer relationship.

IDEON: From an API, digital connectivity standpoint, where have you prioritized development?

TJ CLAYTON: We’ve invested significantly in building API connections with key technology partners. The functionality that excites me the most is that first initial step, the case set up. We’re able to set up a case in 30 minutes or less with a click of a few buttons and an API pulling all of that information right out of Pacific Life’s core system, right into our partner system.

What used to be days, sometimes weeks of manually keying in eligibility rules and rates, class mapping, not to mention the error-prone nature of manual data entry — all the things you’d have to do just to get someone ready for enrollment — we’re making it happen almost in real-time.

IDEON: How does partnering with Ideon fit into Pacific Life’s digital connectivity strategy?

TJ CLAYTON: For us, it’s about getting out into the market quicker with more partners. If there was a time where we had a disconnect between our shared values, technically, and someone else’s, Ideon can help bridge that gap.

Obviously, we prefer to receive data via API, because we believe that that’s the way of the future and that’s going to differentiate us. If a partner is not ready to send data in that manner, but there’s other reasons why we should work with that partner and Ideon can help bridge that gap in terms of enrollment data exchange, well, then there’s a great fit right there. So for us, choosing to partner with Ideon was about helping us get out in the marketplace with more partners, in a technically advanced way. 

IDEON: Why is offering a great digital experience so important in the benefits industry?

BRAM SPECTOR: We want to simplify that experience so members can spend more time taking care of themselves, taking care of their families, instead of filling out endless forms to get their claims fulfilled.

Additionally, we’re looking to simplify the lives of brokers. While a lot of our digital experiences aren’t designed specifically for them, our connectivity strategy is designed to help make their lives easier. We’re simplifying the administration of benefits so that they can focus their time, their energy, and their limited capacity on helping their customers make the right decisions around how to protect their employees.

IDEON: What’s next for Pacific Life’s Workforce Benefits Division?

TJ CLAYTON: More partners, but not every partner. When I think about where we’re starting: no legacy technology, no legacy tech stack, the ability to have APIs throughout the whole value chain, but who’s ready to go on that journey with us? It’s not everyone. We want to bring the industry and bring the ecosystem along with us.

 

Stay tuned for new episodes of Ideon Insights each month. Subscribe to our newsletter below to stay in-the-know about Ideon and receive our latest content directly to your inbox.

Ideon Insights: Guardian’s Josh Weaver on APIs and digital partnerships

Welcome to Episode 3 of Ideon Insights, our monthly interview series featuring thought leaders and innovators driving the benefits industry forward. In this episode, we sat down with Josh Weaver, Head of Digital Ecosystem & Partner Management at Guardian Life, a leading provider of life, disability, dental, and vision insurance and other group benefits.

In this Q&A, Josh explains how Guardian leverages technology to enhance the benefits experience, their focus on API connectivity and strategic tech partner selection, and their collaboration with middleware solutions like Ideon. He also dives into Guardian’s real-time quoting capabilities, winning business in today’s small group market, and more.

Watch the full episode of Ideon Insights here. Below we’ve highlighted five key moments from the conversation.

IDEON: How do you evaluate and choose benefits technology partners?

JOSH WEAVER: To me, it all starts with value. Guardian is really focused on the overall well-being of our plan holders. So really, the first piece is, you want partners that are focused on the same thing. Are these partners focused on really improving the experience for our plan holders? Number two, we think about the entire lifecycle of a member, and really how do we, through connectivity, engage with these partners—API preferred—to create a better experience than Guardian could provide alone.

 

Do you select partners based on their connectivity capabilities?

If you’re not an API-enabled partner, there has to be a very unique value prop you’re bringing to market for us to want to partner with you in a commercial or a more strategic manner. If I fast forward five, six, seven years from now, I think you’re going to see API connectivity is replacing EDI.

So really, if you’re not on a modern technology stack, then you’re not necessarily the companies that we’re looking to partner with moving forward. 

 

​​Does connectivity impact which carrier a group chooses?

Benefits are still an extremely important part of the conversation. But it’s also around, as an employer, how does working with Guardian make my life easier? Do they work with my benefit administration platform? Do they offer online EOI or EOI API?

You’re seeing plan holders and brokers, when they’re recommending carriers to clients, they’re looking at not just what benefit package makes the most sense, but really what’s going to fit all of their needs. You’re seeing the technology, and that ecosystem-partnership piece, being just as important as the benefits conversation. If you have a subpar value prop with a platform, oftentimes the broker is not even going to recommend you or even look to quote you.

 

How does Ideon fit into Guardian’s digital strategy?

Guardian has the ability, through Ideon, to connect with multiple platforms that, for us to connect with each one of these individually, it’d be such a massive investment and endeavor. Working through Ideon allows us to get with more platforms faster.

As a carrier, there are only so many API connections you can build. So, the middleware allows us to access a greater number of platforms, which ultimately empowers the employer to be able to pick a broader set of platforms that are going to work well with Guardian. From our perspective, engaging with middleware really is about reaching more clients in the ecosystem they choose.

Just through the lens of BenAdmin and enrollment, the more connectivity you have, the better. There may be a reason that an employer chose a platform that Guardian is not integrated directly with. That’s fine. And that’s where the middleware allows us to really have that connectivity and expand our portfolio.

 

What digital solutions has Guardian implemented in the small group space?

I think an area that we’re really starting to push into—and push forward with Ideon—is really around real-time quoting capabilities. For us, if we think about the small group segment, a lot of brokers and group general agencies want to be empowered to self-quote, they want to be able to do it on their own time, on their platform.

And so really, utilizing that real-time quoting technology is an area that we are continuing to focus on. We feel like to create that shop through purchase through implemented-with-Guardian experience, where it’s a one-touch sales process, quoting technology is important. It can be a differentiator in the market.

 

Stay tuned for new episodes of Ideon Insights each month. Subscribe to our newsletter below to stay in-the-know about Ideon and receive our latest content directly to your inbox.

How BenAdmin Platforms Setup Carrier Connections in 5 Days

In the competitive world of benefits administration, setting up carrier connections can be an operational nightmare. What if you had a strategic guide to a better process?

This infographic is a gameboard for a BenAdmin’s operational life. Read it, play along, and compare two pathways side-by-side:

  • Navigate the EDI path: This industry standard typically takes an 8-12 week journey filled with building and testing files, errors, and constant communication with carriers.
  • Take a shortcut and win with API-powered connectivity: This alternate route reduces connection setup to around five days, optimizing your operational efficiency.

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How technology partnerships improve member experience and the bottom line

Watch the Webinar
On Demand

Today’s leading carriers leverage an expansive (and growing) benefits technology ecosystem. But choosing and integrating with the right partners can be challenging.

In this webinar, Ideon hosts executives from Prudential, PlanSource, and Brella to discuss how carriers successfully develop robust 3rd-party partnership strategies to meet members’ needs and increase revenue.

Discussion points include:

  • Balancing in-house development with external technology partnerships
  • Meeting members where they are (the case for carrier-BenTech partnerships)
  • Industry-leading examples of successful carrier-BenTech partnerships
  • Key challenges in choosing the right partners, and integrating with external systems

 

 

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An API Road Map for Insurance Carriers

More and more carriers are adopting APIs to support fast, accurate data exchange with benefits administration platforms.

Why? Because API-powered enrollment and eligibility experiences are quickly becoming key carrier advantages.

But carriers focused on API development need a proven road map to follow, because the sequence is as critical as the API functionality.

 

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Introducing the Ideon Dashboard for real-time visibility of enrollment data

At Ideon, we’re dedicated to facilitating seamless enrollments and data exchange for our carrier and benefits platform customers. That means not only maintaining the fast, accurate, and scalable connections they expect, but also providing greater transparency and visibility—qualities that have been lacking in our industry.

That’s why we’re excited to introduce a major enhancement to our product suite: the Ideon Dashboard, a powerful new interface that compliments our existing API endpoints. With enhanced monitoring of group implementation statuses and the ability to submit, track, and resolve issues, this dashboard brings unparalleled visibility, efficiency, and collaboration to Ideon’s enrollment customers.

The dashboard enables effective three-way collaboration between carriers, benefits platforms, and Ideon, allowing for the swift resolution of issues when they arise. It eliminates the clutter of email threads and ensures no issues are overlooked, all in a centralized, user-friendly tool that keeps all parties in the loop.

Let’s take a closer look at some of the key features.

 

Improved Visibility with the Enrollment Tasks Manager

Historically, setting up and managing group enrollments required numerous steps and lots of back-and-forth communication between carriers and benefits platforms. Ideon’s dashboard changes this equation. Carriers and platforms can now access real-time updates on the status of enrollment data that’s been loaded into Ideon’s system. This added visibility minimizes confusion and prevents potential delays in member enrollment.

At a glance, customers can get an immediate overview of their data across all groups, including details such as carrier-specific identifiers and coverage start and end dates. For each coverage period, they can monitor the status and owner of all completed and upcoming setup tasks. 

Tasks can be assigned to specific users from the platform, Ideon, or the carrier, ensuring there’s alignment on next steps and responsibilities. Additionally, comments and attachments can be added to each task, providing necessary context and encouraging collaboration. This not only eliminates lengthy email exchanges but expedites the process of getting groups live.

Through the transparency and visibility provided by the Enrollment Tasks Manager, Ideon customers will always be informed about the status of their groups. They’ll have accurate and up-to-date information to share with members, brokers, and HR teams, ensuring a better enrollment experience with clear timelines and expectations.

Efficient Issue Resolution with the Customer Ticketing System

As carriers and benefits platforms’ operational teams know all too well, issues are bound to happen in our industry, whether it’s discrepant group information, a member inquiry, or another pressing matter.

The Ideon Dashboard offers streamlined issue resolution with its intuitive Customer Ticketing System. It centralizes communication and collaboration, allowing customers to easily submit, track, and resolve their questions, concerns, and escalations. With everything in one place, scattered communication channels like Slack and email are eliminated, and tickets are monitored right alongside the groups they belong to.

For each ticket, customers can provide notes, severity info, and useful attachments or documentation. Comment threads help maintain individualized communication with Ideon, and watcher functionality and email notifications keep customers in-the-know at all times.

Conclusion

The Ideon Dashboard is a powerful addition to Ideon’s enrollment solution, providing greater levels of visibility, efficiency, and collaboration to carriers and platforms—both during group setup and in production.

The new interface is designed to enhance the overall transparency and effectiveness of working with Ideon in a secure, centralized way. But it’s meant to complement, not replace Ideon’s suite of APIs.

All data and functionality offered by the dashboard are also available via Ideon’s existing API endpoints and webhooks. Using these features, our customers can seamlessly integrate status updates and other information into their own tooling and user experience. It’s all part of the unrivaled enrollment experience that Ideon delivers to our customers, their operations teams, and, ultimately, members, employers, and brokers.

Schedule a demo

The Ideon Dashboard has already seen great success among several of our carrier and benefits platform customers, and we can’t wait to show you all of its features. You can watch a short demo above, or reach out to schedule a personalized walkthrough.

 

How BenAdmin platforms turn carrier connectivity into a competitive advantage

Benefits administration platforms’ (BenAdmins) sales, operations, and product teams have a ton to think about these days: 

  • How do we become a year-round benefits destination for employees? 
  • How do we take advantage of the growing popularity of voluntary benefits? 
  • How do we ensure our employee experience is a competitive differentiator?

One topic that is all too often overlooked: carrier connectivity. On one hand, carrier connectivity has become table stakes — after all, doesn’t every BenAdmin platform communicate enrollments and member changes to carriers digitally, mostly via EDI feeds?

Yes, but leading BenAdmins view carrier connectivity as much more than a technical requirement: done correctly, it’s a competitive advantage, enabling scalability, efficient operations, and a fast, accurate enrollment experience.

In the benefits industry, “fast” and “scalable” are rarely used to describe group setup and implementation. We know from speaking with our customers that it takes most BenAdmins 8-12 weeks — and often longer — to build typical BenAdmin-to-carrier EDI feeds. But that’s all changing now. We’ve seen several platforms reduce their group setup timeline to as few as five days. 

The obvious question: How are BenAdmins reducing group setup to days, instead of months?

The answer lies in a new way of managing carrier connections, a strategic decision to partner with companies that specialize in exchanging enrollment data between BenAdmins and carriers. 

The results for BenAdmins speak for themselves:

  • Group setup completed in five days
  • The ability to send enrollment data in a consistent format
  • Elimination of several manual steps that typically prolong EDI implementation

Our new infographic compares, side-by-side, this enhanced carrier connectivity strategy vs. traditional EDI setup. Fast, accurate, and scalable — it’s a new world of connectivity without complexity. Download the infographic to learn more.

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Error management with Ideon, Part 2: Auto-reconciliation

By Jashan Ahuja
Group Product Manager – Enrollment

In Part 1 of our error management blog series, we explored Ideon’s ability to process errors in a centralized and consistent way. Now, in Part 2, we delve into our industry-leading auto-reconciliation feature, which proactively identifies discrepancies between platform and carrier systems.

It’s a scenario all too common in the group benefits industry: a benefits administration (BenAdmin) platform sends enrollment data to a carrier via an EDI file and waits a week or more — with no visibility into whether the information was accepted — only to receive back an unreadable report of errors and discrepancies.

Now imagine a world with lightning-fast data exchange, two-way communication, and seamless reconciliation between platforms and carriers. The platform would receive a notification within minutes that lists all discrepancies between the two systems.

Ideon’s automatic reconciliation system makes the above not only possible, but easy to implement and scalable across carriers. It’s an industry-first feature that offers the capability of proactive data reconciliation between the platform and carrier systems.

In our prior blog, we explored Ideon’s ability to standardize and expose errors generated by carrier systems, transforming them into a consistent, human-readable, and actionable format. That crucial feature forms the foundation for closing the feedback loop with carriers. But Ideon doesn’t stop there. In this blog, we examine auto-reconciliation, a revolutionary process that identifies and surfaces discrepancies in near real-time, even before the data has been sent to the carrier

What is auto-reconciliation?

Auto-reconciliation is an essential component of Ideon’s data exchange process, significantly streamlining the enrollment workflow for carriers and benefits platforms alike. This innovative process flags discrepancies before data reaches the carrier’s system, dramatically reducing downstream errors that could otherwise wreak havoc on carrier operations—and members.

Here’s how it works: Ideon’s reconciliation engine proactively pulls all member and coverage information for a group from the carrier, converts it to our data model, and compares it to the platform data on a field-by-field basis.

The comparison encompasses 18 data points, also known as “discrepancy parameters,” including demographic data (e.g., birth date, SSN), coverage details (e.g., plan start date, plan volume), or even the existence of a member or their coverage in one system but not the other. We’re able to specify the source of any discrepancies for our partners and provide both platform and carrier values, creating a clear, actionable pathway to resolution.

Consider the example below, where a carrier’s system contains a different birth date compared to the one entered on the benefits platform. Without validation, this discrepancy would inevitably lead to errors for this subscriber. However, by matching the carrier’s existing information with the enrollment record, Ideon can promptly detect the discrepancy and return the record to the platform for correction.

"errors": [
    {
      "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
      "member_id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
      "plan_id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
      "coverage_period_id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
      "discrepancy": {
        "parameter": "birth date",
        "carrier": "1/1/93",
        "platform": "2/1/93"
      }
    ]

 

During our processing, we reconcile 18 different critical fields, as well as verify the presence of the member in the carrier’s database. 

Annual earnings

Birth date

Coverage

Dependent

Employment end date

Employment start date

Employment status

Gender 

Marital status

Plan ID

Plan end date

Plan start date

Plan volume

Primary care provider

Residential address

Social security number

Subscriber

Wage frequency

 

Additional features

Ideon’s auto-reconciliation system boasts several features for fast, accurate data exchange, smooth operations, and an enhanced member experience.

Deduplication

Automatic reconciliation operates daily, comparing new discrepancies against open ones from the previous run and resolving any that are no longer relevant. This keeps carrier and platform systems in sync with current data and ensures the list of open discrepancies is directly relevant.

Frequency + Timing

Automatic Reconciliation runs as frequently as daily for carriers supporting an API-based, automatic census retrieval. Resolved discrepancies are closed every morning, while newly identified ones are opened.

We are currently expanding our auto-reconciliation functionality with carrier partners that don’t yet support a daily census.

As part of our reconciliation process, we carefully consider the timing of data in and out of our system. When our system receives a data element that hasn’t been sent to the carrier yet, our reconciliation logic takes this into account by comparing the carrier’s data with the previous version of that data field. Once the field is transmitted to the carrier, it is incorporated into the next reconciliation cycle, with a buffer for carrier processing time. This thoughtful approach prevents noise, such as unwarranted and erroneous discrepancies.

Surfacing Discrepancies

All actionable enrollment discrepancies—originating from either auto-reconciliation or carrier error reports—are returned in a consistent, normalized format. Partners can access this information through:

      • direct GET requests via our API endpoints
      • proactive push notifications using webhooks, or
      • our standardized Enrollment Discrepancies CSV, delivered periodically

By centralizing Enrollment Discrepancies, we enable a more efficient and streamlined operational process, allowing benefits platforms to view errors generated by carriers and the results of auto-reconciliation all in one place.


Impact

Leveraging our unique, central position between platform and carrier systems, we have quantified the volume of out-of-sync data. After analyzing data from hundreds of groups and thousands of members, we found that about 8% of employee enrollments have a critical coverage issue, i.e. incorrect coverage dates, plan information, or birth date, or they’re missing entirely from either the carrier or platform system. For one specific platform-carrier combination, we saw 10.3% of subscribers with at least one error that affects enrollment accuracy. Additionally, 80% of groups with more than 20 subscribers had one or more critical errors.

Overall, proactively identifying coverage-affecting errors is critical for reducing inaccurate enrollments and downstream issues. Automatic reconciliation allows groups to detect and resolve discrepancies before the initial transmission to the carrier. This improves success rates for the initial transition of groups into production and allows for faster, more accurate group setups, ultimately resulting in a better member experience.

Coming soon – Part 3: Account structure consolidation and mapping

Enrolling members in the correct plans with the correct carriers all starts with precise, streamlined setup processes. In the next blog in this series, we’ll detail how Ideon enhances a platform’s mapping capabilities, making it easier to configure complex group setups when employers have multiple plans, classes, and divisions.