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April 14, 2010 | Benefits Management | Posted by Les Goldstein

Healthcare Reform and Electronic Interface with Insurance Carriers

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.