In the last ten years most employers have invested quite a bit of capital on HRMS infrastructure such as online employee self service and benefits enrollment software.
Most of the investments have been focused on improving the administration, the efficiency, and productivity of the HR organization and making it easier for employees to communicate with HR and to make the HR information more accurate – an inward focus. But now, especially with health care reform legislation, there are new challenges in the areas of benefits administration that are coming about for employers and for insurance carriers, particularly in the areas of eligibility management and enrollment reporting.
So if you take these new challenges with where employers are today with their HR automation investments, it’s more important than ever to automate “The Last Mile” of the benefits admin process, and that’s the enrollment communication with the carriers on the back end.
Several Important Points HRMS Execs Are Realizing About the Last Mile
Carrier connections defined:
It is the process of automating the benefit enrollment data management through pre-built secure and fully-managed data integrations between HR system of record and all benefit insurance carriers and providers. It’s an end-to-end communication process from your system to each of your carriers.
Automating carrier connections:
- Improves the employee benefit experience at the point of service.
- Offers opportunities to reduce HR Department overhead burden associated with benefits admin.
- Elimination or reduced cost “leakages” – caused by inaccurate or inefficient reporting with the insurance carriers.
- Better positions HR department to comply with current and evolving legislative and regulatory requirements.
Key Capabilities Needed
For an answer to enrollment communication with the carriers (carrier connections) the vehicle used must:
- Be simple and reliable.
- Be secure and private.
- Support all benefit carriers.
- Handle special enrollment reporting procedures.
- Catch “missed enrollments”.
The Big Pay Off
All of this reduces HR administration burden. A look at how many HR depts report enrollment changes to your carriers today will be a first clue to the increased efficiency a well designed connection carrier brings to the table. Enrollment without connection carrier process in place includes most of the following:
- A carrier required custom report.
- A multiplicity of benefit forms, paperwork.
- Visiting a carrier web portal.
- Signing on through a secure log-in.
- Entering data manually.
After all that there is no assurance that the carrier enrollment records are correct unless an enrollment audit or a data reconciliation is regularly completed.
Let’s frame this as enrollment cost “leaks”. An enrollment cost leak is where, for instance, the employer is overpaying premiums for employees or dependents that should have been terminated off of coverage.
Then there is the opposite scenario or dependents that should be covered – you think they are covered, they assume they are covered but they haven’t been picked up on the premiums, and they might even actually be denied service. So in either case, you’re either underpaying now and overpaying later.
With new legislation it’s going to be harder to reconcile these past premium overpayments and get refunds for them.
A well designed connection carrier system through its regular and automatic updating capabilities, tends to plug up these cost leaks so they don’t occur.
Are you doing all you can to ensure that cost leaks aren’t occuring or that your HR staff isn’t overburdened with administration work regarding benefits enrollment?