Posts tagged carrier connect
Health Care Reform and Electronic Interface with Insurance Carriers
Apr 14th
By Les Goldstein, CEO, Ascentis
While there is currently a great deal of unknown concerning the recent health care legislation, we do know the following:
- We will all need to be flexible as we better understand the specific impact on individuals and corporations.
- The impact will occur over time as various aspects of the bill phase-in over a five year period.
- Companies that can more effectively communicate and administer their health care benefit programs will have an edge in the marketplace.
The last bullet is the one that most companies can deal with now, and along the way, accrue some pretty powerful advantages. These include the following:
- Employee self-service (ESS) capabilities allow employees to enroll in their benefits program through an easy-to-use, online interface. ESS can be deployed to employees through the Internet and can be accessed either from the office or at home. This ensures that employees have access to all plan information and are in a position to make their elections. ESS enhances morale by providing an easier enrollment process and, most importantly, eliminates the need to manage paper forms that tie HR personnel up with what is effectively an administrative task.
- An electronic insurance carrier interface allows the information received from employee self-service to be automatically transmitted to the insurance carrier in a format that can be easily received and processed by that carrier. This eliminates the need to take information that was entered by an employee and reduce it to paper before sending it to the insurance company. The elimination of manual handling and transcription errors makes this a very cost effective and efficient process.
In our collective desire to drive down health care costs, companies can take the above proactive approaches. In fact, inaccurate processes have caused businesses to inadvertently pay for health care coverage for employees that are no longer part of the company, as well as over-age dependents. It is estimated that these costs average about 8.5% of a company’s overall premium. This represents a major potential savings and this should be explored by all companies today.
One way to prevent over-charges is to automate reconciliation of carrier bills through a service such as Ascentis Carrier Connect. In conjunction with Ascentis Employee Self-Service, Carrier Connect supports a virtually paperless – and accurate – enrollment process, saving companies thousands of dollars.
The ABCs of Connecting Electronically to Your Insurance Carriers
Mar 11th
By Dwight Matheny, Ascentis Vice President and General Manager
So you’re tired of the paper mess around open enrollment and you’re thinking in the age of the Web there must be a better way, right? There is definitely a better way, but actually doing it on your own is not for the faint of heart. Many people don’t know the process and complexities involved, and many vendors have little experience in this area. That’s why it’s so important to partner with an HRIS or HR software vendor that has years of experience in this process. If you choose to do it yourself, you’ll have greatest success if you follow these critical steps:
Step 1: Negotiate - Will your carrier be interested in allowing connectivity from your company to their systems? How are your skills in negotiating with an insurance carrier? If your company is in the 100-1,000 employee range, will carriers be interested in dealing with you or will they only want to deal with larger groups where there is a greater return for them?
Step 2: Review the Carrier’s Companion Guide - What’s a companion guide? Isn’t there a federally mandated standard format? Well, yes … but carriers generally have a long list of enhancements, interpretations, and additions to the standard, and so they put those into a Companion Guide. Here’s a few examples from EyeMed, Independence Blue Cross, and AmeriHealth. These are all fun documents you can read in your spare time.
Step 3: Get the right technology - Get the right technology to securely communicate with the carrier. The carrier will let you know what’s required, and, by the way, each carrier is different. Be prepared to learn about encryption, secure transfer methods and other fun topics. And don’t forget to make sure you comply with the federal privacy and security regulations.
Step 4: Get to know 834 and start coding – Be prepared to write some code to get your enrollment data into the federally mandated ANSI X12N 834 file format. Make sure to follow the federal regulations (check out page 50,358… it’s my favorite). You can purchase the documentation on the 834 file format from WPC (only a few hundred pages of fun reading).
Step 5: Testing, testing, 123 - If you’ve made it through steps 1-4, you’re ready to test with your carrier. Could be a slight problem here… many carriers don’t do testing in November or December, and can only test for a couple of clients at a time, so be prepared to wait your turn. We’ve seen anywhere between five and 40 steps in a carrier’s testing processes, so be prepared to be actively involved in the process. You will have to arrange to respond to any errors in your data or programming, fix the errors, and get the new, improved file back to the carrier and then re-test (after getting back into line!). Oh, and did you think about your open enrollment date prior to this?
Step 6: Deploy! - Having passed steps 1-5, you’re ready to start the electronic feeds, and then you’re ready to do this again with your other five carriers!
Step 7: The “Are you kidding me?” step - Your CFO decides that it’s time to change carriers. Have a few margaritas, tell your family you’ll see them next year, and start over at Step 1!
Step 8: There’s a better way! - Ascentis specializes in connecting small to mid-sized companies to their carriers electronically through their flagship HRIS product, Ascentis HR. Using the Ascentis Carrier Connect Service, you can transmit data directly to your carriers, and eliminate billing errors and overpayments. If your company also deploys Ascentis Employee Self-Service, Carrier Connect virtually eliminates data errors and offers a truly paperless open enrollment environment. Download the free white paper: Web-based Online Enrollment: How a Paperless Process Saves Time, Eliminates Errors, and Increases Employee Satisfaction. Visit Ascentis for more details, or call 1.800.229.2713.
