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Topic: InsurTechs

Namely Selects Ideon to Streamline Digital Employee Benefits Enrollment

Posted on by Ideon

Ideon’s APIs enhance Namely’s best-in-class enrollment experience through real-time connectivity with health insurers and ancillary benefits carriers

Ideon, the API platform powering digital experiences in health insurance and employee benefits, announced today that Namely, the leading HR software for mid-sized businesses, has integrated with Ideon’s API. The integration enables Namely to deliver a faster, more efficient benefits administration experience to its clients, across a broad spectrum of insurers.

In order to provide employees with modern features and a smooth enrollment journey, two-way data exchange with insurance carriers is a necessity for HR and benefits platforms. Building individual point-to-point integrations with hundreds of carriers is cost-prohibitive, resource-intensive, and, ultimately, unsustainable. With Ideon, Namely gains a seamless and scalable means to connect and exchange data with multiple insurers.

“The needs of our customers are at the core of everything we do at Namely,” said Namely CEO Larry Dunivan. “Our solution was designed to easily construct APIs that expand its functionality to ensure our clients have access to high quality data, real-time connectivity, and the latest employee engagement technologies. We’re excited to partner with Ideon, a leading platform provider that shares our vision of advancing the user experience and making worktech easier.”

HR and benefits platforms leverage Ideon’s APIs to enable multi-carrier functionality throughout the user journey, including plan quoting and decision support, group setup and member enrollment, member management, and renewals. Once a platform integrates with Ideon, it gains scalable connectivity to a comprehensive network of insurance carriers, including Kaiser Permanente, Beam, Aetna, Anthem, Blue Shield of California, Cigna, Guardian, Humana, MetLife, and Principal.

Namely serves as a single system of record for mid-market companies, a segment employing more than 50 million workers in the U.S. Namely integrates payroll, benefits, talent management, and other key business functions in a modern, intuitive platform that employees and employers love to use.

“The addition of Namely to the Ideon platform further affirms that industry-leading benefits administration software companies view our fast, seamless connections with insurance carriers as paramount to delivering a better digital enrollment experience,” said Michael W. Levin, Ideon’s co-founder and CEO.

About Ideon

Ideon is the way health insurance carriers and employee benefits providers connect with technology partners to deliver seamless consumer experiences at every stage of the member journey. Ideon is not the websites or apps one uses to choose a plan or find a doctor. It is the infrastructure, the ‘pipes,’ that simplify the complex exchange of quoting, enrollment, and eligibility data between carriers and the technology partners so that they can, in turn, deliver health and employee benefits to hundreds of millions of Americans everyday. Ideon’s APIs transmit billions of data points between InsurTechs and insurance carriers, powering an amazing benefits experience for all. Faster. Better. Awesomely. To learn more, please visit: www.ideonapi.com. 

About Namely

Combining intuitive HR technology and best-in-class service, Namely empowers mid-size companies to build better workplaces. Simplifying the complexities of recruiting, onboarding, time & attendance, performance management, benefits administration, compliance, payroll, and HR analytics, Namely offers an integrated platform that saves companies time and improves their employees’ experiences. Distinguished by a dedicated support model and enhanced service offerings, Namely delivers an all-in-one HR solution for today’s people teams. Learn more at Namely.com and follow us @NamelyHR.

GetInsured’s Story: How Ideon saved the company time and resources—and boosted stakeholder confidence

Posted on by Ideon

“It’s a streamlined process when we’re working with a trusted, experienced data partner”

GetInsured powers state-based health insurance marketplaces by providing health insurance technology and customer service solutions for state governments. An important feature of the company’s offering is that consumers have the ability to shop for plans by healthcare provider, which helps individuals keep their doctors when enrolling in a new plan.

Back in the day, sourcing provider-network data was quite the headache. Says GetInsured’s director of product management, Archana Dekate:

Before Ideon we were getting our data directly from carriers or through other vendors. And each vendor had their own APIs and their own set of implementation procedures, which meant that we would have to modify our code every time to accept their data, then QA it, test it, and so on. It was time consuming; every product release would take anywhere from one to three months of setup time.

Thanks to Ideon, that’s all safely in the rearview mirror. To learn how partnering with Ideon helped GetInsured on multiple fronts, download our case study here.

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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.

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

Posted on by Ideon

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

Four Benefits-Focused Insurtech Predictions for 2022

Posted on by Ideon

By John Carson, Ideon’s Chief Revenue Officer

2021 has been a banner year for employee-benefits insurtechs—and not just because investors have committed more than $6 billion to U.S. insurtech startups this year. The rate at which benefits-focused insurtechs have introduced innovative solutions to solve long-standing challenges has been inspiring.

But for all the progress, the industry’s digital transformation is far from complete. Some employees still enroll in benefits via paper forms. Others lack the tools to fully understand their options. Still others continue to struggle to maximize their benefits year-round. Not to mention that, behind the scenes, a significant portion of brokers, HR teams, and other stakeholders deal with inefficiencies and limited automation as they undertake day-to-day, benefits-related tasks.

Collectively, though, the industry is heading in the right direction. We can say that because Ideon—a data platform that powers carrier connectivity and digital experiences for benefits-focused insurtechs, HRtechs, and benefits-administration software—has a front-row seat to all that runs this industry. And we see several digital trends gaining momentum. Here are our top benefits-focused insurtech predictions for 2022.  

1. Decision-support tools will transition from “nice-to-have” to “essential feature.” Decision-support tools are gaining traction in two primary ways: first, by helping employees select and enroll in the health insurance and benefits plans that best match their and their family’s specific needs; and second, by enabling employees to make better decisions year-round, e.g., using virtual assistants to steer employees toward in-network doctors to keep out-of-pocket costs low. 

In 2022, we expect most benefits-focused insurtechs to integrate advanced technologies into their decision-support tools. From AI and on-demand virtual assistants to machine learning and data-powered personalized recommendations, new tech is starting to ripple through the benefits industry. Expect a splash in 2022; according to a Guardian survey, 41% of employees want more decision-support tools for the enrollment process.

2. More small employers will offer advanced digital enrollment experiences. For years, insurance carriers and benefits platforms have leaned on EDI for the automated exchange of enrollment and eligibility data. But EDI has been out of reach for most small businesses, leaving them to rely on paper forms and other manual processes. (Nearly 40% of small employers—those with fewer than 50 employees—use paper as the main method for submitting enrollment data to carriers.) 

But the tide is turning. Thanks to APIs like Ideon, more HR and benefits administration platforms are bringing the advantages of automation and streamlined data exchange to small businesses. The result: a faster, more efficient, more accurate enrollment experience. That’s why we expect that in 2022 the benefits experiences offered to small-business employees will begin to catch up to those offered at larger companies.

3. The shift to all-API transactions will accelerate (slowly). There’s been much discussion about the shift from EDI feeds to API connections for data exchange. And that shift is very real. Still, most carriers remain tied to EDI systems, even as some are beginning to develop APIs. We see much the same in 2022—an industry majority continuing to use EDI for most data exchanges as the uphill climb toward API transactions progresses relentlessly. As (relatively) unbiased observers, we can say that carrier-connectivity solutions (such as those offered by Ideon) enable benefits-focused insurtechs and HR platforms to connect to multiple carriers through one easy integration regardless of whether carriers prefer EDI, API, or other means.

4. Back-end processes take a front-row seat. From an employee’s perspective, digital enrollment has become commonplace. Most employees (at large firms, at least) have the ability—through the benefits software or app provided by their employer—to review, select, and enroll in benefits digitally. But from the perspective of folks behind the scenes? Not so much. 

That’s why we think there will be a focus in 2022 on streamlining enrollment and administration for brokers, HR teams, and enrollment-processing departments at carriers and benefits-administration platforms. For these stakeholders, much of open enrollment is spent setting up EDI feeds, manually keying data into carrier portals, correcting errors, and editing spreadsheets. Streamlining those processes, most industry experts have learned, has a trickle-down effect that makes enrollment faster, more accurate, and more enjoyable for employees, too.

Are we fairly certain about these predictions? Yes. Are we even more certain that however the year unfolds Ideon will be there to smooth out the inevitable bumps in the road? You bet.

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.