An Insider’s Perspective on How to Process Thousands of Employee Benefits Changes in Just Minutes

Are you manually enrolling your employees into employee benefits? Does it take you days to process a change, while your inbox fills with other important tasks you wish you could focus on? If this is the process that you are currently using: STOP! I’m going to show you how to process thousands of changes in minutes and stop wasting your precious time.

A few years ago, I was manually enrolling employees into carriers via an email and a “complete” handwritten enrollment form. Often some of the information was illegible, which would cause me to have to reach out to Human Resources to confirm the information. Sometimes it would take a day to confirm information, so the enrollment would remain incomplete while I waited. When groups would send me spreadsheets, I would key all the information into each carrier one at a time — while it was sometimes nice to put on a jazz mix and get into the zone while typing, it certainly wasn’t the best use of my time. There was also the possibility of human error; regardless of the size of these errors, it’s best to be accurate the first time.

The best thing about Electronic Data Exchange (EDI) is that a file can be sent for groups of all sizes and, with less need for human intervention, there are fewer errors.

Doesn’t that sound easy? Effective? Better than enrolling those employees one at a time? Of course it does! Who wouldn’t want to enroll a multitude of employees with a few clicks?

The EDI 834 file can do that for you. The 834 file allows you to electronically exchange your employee’s health insurance enrollment from the employer to the carrier in the blink of an eye.  I went from spending hours or even days enrolling employees into the carrier to just minutes. The greatest thing about the 834 is that you NEVER have to go into the carrier for anything. The file takes care of new enrollments, terms, and life events. When you compare the employee information in your system to the information listed in the carrier’s system, they are a perfect match. That’s what the 834 does: it moves the information that you enter into your system to the carrier, without you having to go through the hoops of the carrier’s system. The feed is not only convenient but is a powerful tool for accuracy.

What is the true cost of paper enrollment? From printing, to filing, to staff corrections – can you really put a price on all that wasted time? An EDI will help you get that time back!

What happens after the carrier gets the file?

Once the information is sent to the carriers, there can of course be discrepancies, such as an invalid social security number.  If an employee goes from a temporary social security number to a permanent one, then the carrier would want to confirm. If there is a dependent listed on two employee’s coverages – which parent should carry the coverage? This is where I come in! I put on my investigator hat and get to work, pouring over the discrepancy reports to figure out the what’s and why’s of those data issues. Most of the time I can make all the corrections with the carrier without ever having to reach out to the group.

How fast does the 834 process? After a file is sent, the information would be available in the system anywhere from instantly to 24 hours, depending on the carrier.

Is this file just for medical coverage?

No; while the 834 File applies to any medical, dental, and vision coverages, there are other eligibility files that work with supplemental coverages, such as life or long-term disability as well as COBRA.

Open Enrollment

Our favorite time of the year, right? Many changes happen during this time of the year and the goal is to make sure everything runs smoothly, and all information is as accurate as possible. With the 834 being set up, all the group has to worry about is making sure employees make the changes they want for the following year, whether that be to add dependents, change medical plans, change addresses or any other demographics; once those changes are done, the file takes care of the rest. Of course, it does not stop there because after every file that is sent, the carrier sends a discrepancy report.

To put the icing on the cake, GRA has multiple carriers that are integrated with Employee Navigator, so when we are sending an 834 file, we send the information straight out of Navigator. What you see in Navigator is what we would see in the carrier.

So how can we get your group’s Electronic Data Interchange set up?

With our help, setting up your group to send their employee data via 834 file is a very simple process. To get this ball rolling, often carriers only require the agent of record’s permission. There are some carriers who require the group to sign a liability agreement, and once that step is taken care of, we work with the carriers on all the painstaking programming required. Once we have completed all of the testing, we will notify you that your group is all set up.

How uncomplicated does that sound? GRA is here to make this process straight-forward and effortless, so you can get back to focusing on your business the way you want to, and not waste time on complicated enrollments.

If you have questions, contact GRA Benefits Group and we will get started streamlining your eligibility.