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eBenefits Network Implementation Training for Infinisource February 2014
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Today’s Topics ●What is eBenefits Network? o Overview o Key capabilities o Carriers o How it works o Set-up & production processes o Small group enrollment (SGE) support o Open Enrollment (OE) support 2
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WHAT IS EBENEFITS NETWORK? 3
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What is eBN? iSolved Employee Enrollment Data Medical Others 401k, FSA Life Dental eBN Cloud-based Automated Employee enrollment data exchange 4
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Secure end-to-end data exchange; HIPAA privacy compliance Large carrier network (over 300 health & non-health today) Supports all carrier data formats Supports hosted and on-premise deployments Automatic scheduling and file transmission On-going EDI/file management (including OE support) Initial and on-going customer and carrier communications Key Capabilities 5
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Carrier Network (April 2013) 6 24Hour FlexCiti StreetGreat WestMedical MutualRxN'GO ACSClear Benefits Inc.Great-West Health CareMedTrakScott & White Admin Pro AdvantageColonialGroup HealthMeritainSecurian AdminResources & ConsultingColonialGroup ResourcesMerrill LynchSelect Health ADPCommunityCareGuardianMES VisionSelf-Funding Admin Advanced Benefits StrategiesComp BenefitsHart FMLAMetLifeSentinel Benefits AdvanticaConexisHartfordMGISShenandoah AetnaConnectiCareHarvard PilgrimMoney ManagerSHL/HPN (UHC) AFLACConnecticut GeneralHealth AllianceMountain States AdminSierra AllegianceConsult A DocHealth Mgmt Systems AmericaMurfee MeadowsSouthern Health Allied AdministratorsCore-FlexHealth NetMutual of AmericaSpectera Allied Benefit SystemsCoreSourceHealth PartnersMutual of OmahaSpectera AmeriBenCoventry Health CareHealth Plan of NevadaMVP HealthcareSRC American Specialty HealthCreative BenefitsHealthcare Mgmt AdminMVP Select CareStandard Insurance AmeriflexCustom DesignHealthNetMy Cafeteria PlanStarMount/Always Care AmeritasDatapathHealthsmartNational Benefit ServicesSterling AnthemDavis VisionHealthyRoadsNational Vision Admin NVASummacare AscensusDearborn FinancialHFS BenefitsNCASSunLife AssurantDeCare DentalHighmarkNexcaliberSuperior Vision AvesisDelta DentalHirsh FinancialNGS AmericanT. Rowe Price Award Incentive GroupDental Care PlusHMAOptum HealthTASC BB&TDental SelectHomeland HealthcareOxfordTelaDoc BCBSDirect DentalHorizon BCBSPacific BenefitsThe Advantage Group BenecardDiscovery BenefitsHR SimplifiedPayFlexThe Loomis Company Benefit CoordinatorsDiverisfied Benefits ServicesHumanaPBSThe ODS Companies Benefit ResourceEmpire BCBSHyatt LegalPCMITufts BenefitFocusEmployee Benefit Mgmt (EBMS)IGOEPersonal Choice AccountsUCCI Benefits StrategiesEmployee Benefits CorporationIndependence AdminPNC AdvisorsUFCW National Health BeneflexEmployee Benefits SolutionIndependence Blue CrossPreferred Health SystemsUMR BeniversalEmployer Dental ServicesInfinisourcePreferred OneUnderwriters Services Corp Blue AdvantageESIINGPremeraUnicare (Wellpoint) Blue Care NetworkEyeMed Vision CareInsurance Mgmt AdminPremier AccessUnited Benefits (FBMC) Blue ChoiceFidelityIntegrated Benefits AdminPrePaid Legal ServicesUnited Concordia Blue CrossFirst Choice HealthiVisionPresbyterian Health PlanUnited Healthcare Blue GrassFirst Continental Life FCLJAD BenefitsPrimePayUnum (Unum Provident) Blue ShieldFlex Plan ServicesJob TraxPrincipal FinancialVantage Financial Group Inc BMI KSFlex SystemJSL AdministratorsPrincipal LifeVeritas Bright HorizonsFlexCorpKaiser PermanentePriority HealthVision Benefits of America Cal Choice PlusFlores AssociatesKMG AmericaProBenefitsVision Plan of America CareFirstFlorida Combined LifeKSPHProfessional Benefits ServicesViverae CareMarkFMH BenefitsLifewise Assurance CompanyProgressive Benefit SolutionsVSP CBIZGenesis BenefitsLincoln FinancialPrudentialWageWorks CeridianGenworthLincoln National LifeRegenceWDS Chard SnyderGeorgia Bankers AssocMedBenReliance StandardWellmark BCBS Charles SchwabGilsbarMedica (UHC)Rocky Mountain AdminWellpoint CIGNAGrace/MayerMedical Eye ServicesRx BenefitsWells Fargo Western Health Advantage Workable Solutions
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How eBN Works customers (iSolved Users)Benefit Carriers Employee enrollment data eBN Web Service eBN Cloud ServerCarrier File-out Extract employee enrollment data From iSolved system Transmit to cloud server Data mapping, translation & validation Virtual connections Scheduled, triggered, on-demand Workflow & business rules Standard data formats (HIPAA 834, etc.) Carrier-specific data formats All file types Secure and Private 7
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eBN End-to-End Process Testing (eBN) Production (eBN) Generate data set customer Data Analysis Carrier Business Rules customer-carrier data mapping configuration Complete Data Transformation customer Test File Carrier Testing Data Reconciliation (customer & carrier) Transmission Schedules Monitoring transmissions Manage data Discrepancies Performance analytics Carrier Set-UpRegular Processing Data Mapping (eBN) Define plans Enter data Validate database Prepare customer DB (customer/Infinisour ce) Pre Set-Up 8-10 weeks (estimate) 8 Multiple test cycles may be required, Based on qualify to customer’s data
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Implementation Process 9
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Infinisource Process 10 All tasks have been incorporated into Salesforce in the respective sections (Payroll IS, Benefits IS, etc) A new section has been created for the eBenefits coordinator (Lance) Included in this section will be a status fields that anyone will be able to view in order to see the status of the connections The Implementation Leader playbook has all of the necessary templates
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Small Group Enrollment (SGE) Support ●What is SGE Support? o Intended for use with carriers that do not support EDI inputs from employers due to small enrollment sizes. o Instead the carriers may accept alternative inputs from these “small group” employers Manual data entry via carrier-provided secure Web portal (becoming more common) o For SGE customers whose carriers support Web portal or spreadsheet inputs, eBN… Automatically extracts the enrollment data from the iSolved system Performs the manual data entry into the carrier portal on behalf of the employer 11
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How SGE Support Works in eBN 1.Enrollment data automatically extracted from iSolved per the schedule. 2.Changes Report generated by comparing current data to last. This identifies all adds/changes/terminations. 3.Work Order triggered to the eBN data entry team. 4.eBN staff log in to carrier portal (using employer-authorized log in credentials) and manually enter the changes. 5.Email sent to employer confirming that the changes were successfully entered. 12
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QUESTIONS? 13
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For More Information… Caroline Guirguis, Account Manager 813-333-9079 Caroline.guirguis@ebenefitsnetwork.com Tom Tillman, Business Development 813-504-0414 ttillman@ebenefitsnetwork.com
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