Simplifying and Improving the Private Exchange Experience. Brought to you by Paylogix and Exchange Builder
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1 Simplifying and Improving the Private Exchange Experience Brought to you by Paylogix and Exchange Builder
2 Private Exchanges are evolving Better Communication (online) Better decision making tools (online) Expanding beyond employee core benefits Supplemental and ancillary benefits communicated and enrolled via the EE portal
3 The Challenges More choice - great for the employee A greater challenge for the employer Billing, reconciliation and payments to multiple providers can be complex Transaction history is disjointed - Clear audit trail needed for elections, transactions and premium payments Costs prohibit downward scalability
4 The Challenges Employee accesses the exchange Hosted Exchange and Benefit Administration systems Employer payroll and finance Insurance carriers & benefit providers Billing, reconciliation and premium remittance is left between the employer and carriers
5 The Solution Provide all stakeholders access to do what they need to do Support flexible EDI for smooth integration and greater efficiency Add Consolidated Billing and Common Remitter Services Employer HR & Payroll EDI Access Broker, Benefit Counselor Access Employee Communication Employee Election HR and benefit counselor assisted enrollment Consolidated Billing and Common Remitter Services New hire enrollment, QLE changes, and employee benefit resource center Employee Access Insurance Carriers EDI Access Consolidated Billing & Common Remitter Services are Paylogix Registered Trademarks
6 We improve and simplify by: Providing greater transparency 24/7 access for all authorized users Employee, Employer, Broker, Carrier, Enroller Consolidating the processes Communication, elections of all benefits Billing and premium processing Adding value to the EE portal Encourage the employee to visit their resource center more often than 20 minutes once a year
7 The plumbing and the process Accurate and timely feeds to insurance carriers and benefit providers needed Flexible EDI is helpful (example: P&C Group Programs) Web based access for authorized users provides greater transparency Pro-active reconciliation much better than reactive
8 Employee portals Today Communication, Election, Defined Contribution Decision making tools Improve and Simplify - Payroll deduction details (most helpful when Single Slot Administration is used) Claim status updates Employee purchasing program payment and financial wellness updates
9 Employer HR & Payroll Employer to PX Ongoing updates to report Participant Eligibility, Deductions Withheld & Status changes (Active, Term, LOA) One payment (remittance) for all benefit carriers and products PX to Employer Ongoing updates to payroll to report deduction changes and cancellations. Employee Communication Employee Election HR and benefit counselor assisted enrollment Consolidated Billing and Common Remitter Services Employee Electronic enrollment Benefit communication New Hire Enrollment Plan/Product Documentation Product changes due to QLE New hire enrollment, QLE changes, and Employee resource center Broker, Benefit Counselor Authorized users should have access to the system One on one enrollment should be supported Call Center enrollment should be supported Consolidated Billing & Common Remitter Services are Paylogix Registered Trademarks Insurance Carriers PX to Insurance Carriers Update files to report participant payroll system status changes (Active, Term, LOA) New benefit elections, changes & eligibility where applicable Premium disbursement with remittance data. Insurance Carriers to PX Billing and election updates as applicable Claim status updates as applicable 9
10 Employer Interface with the Admin Platform Employer to Admin Platform Ongoing updates to report Participant Eligibility, Deductions Withheld & Status changes (Active, Term, LOA) One payment (remittance) for all benefit carriers and products Admin Platform to Employer Ongoing updates to payroll to report deduction changes and cancellations.
11 Insurance Carrier Interface with the Admin Platform Admin Platform to Insurance Carriers Update files to report participant payroll system status changes (Active, Term, LOA) New benefit elections, changes & eligibility where applicable Premium disbursement with remittance data. Insurance Carriers to Admin Platform Billing and election updates as applicable Claim status updates as applicable
12 Employee Access to the Admin Platform Electronic enrollment Benefit communication New Hire Enrollment Plan/Product Documentation Product changes due to QLE
13 Broker and Benefit Counselor Access to the Admin Platform Authorized users should have access to the system One on one enrollment should be supported Call Center enrollment should be supported
14 Employer HR & Payroll Employer to Paylogix Ongoing updates to report Participant Eligibility, Deductions Withheld & Status changes (Active, Term, LOA) One payment (remittance) for all benefit carriers and products Employee Electronic enrollment Benefit communication New Hire Enrollment Plan/Product Documentation Product changes due to QLE Paylogix to Employer Ongoing updates to payroll to report deduction changes and cancellations. Consolidated Billing and Common Remitter Services Premium Processing and Eligibility Management Managed Payroll Deduction Carrier Call Center Enrollment Pro-Enroll lists contact information for benefit programs that require direct carrier enrollment Paylogix Pro-Enroll Employee Communication and Election Portal HR and benefit counselor assisted enrollment Broker, Benefit Counselor Authorized users may access the system One on one enrollment supported Call Center enrollment supported Insurance Carriers Paylogix to Insurance Carriers Update files to report participant payroll system status changes (Active, Term, LOA) New benefit elections, changes & eligibility where applicable Premium disbursement with remittance data. Insurance Carriers to Paylogix Billing and election updates as applicable 14
15 Scalability Scalability Scalability Scalability Scalability
16 A cloud based private exchange development platform for agents and brokers to create a customized benefit marketplace with Consolidated Billing and other valued service options.
17 Summary The front end looks great? OK But be sure to check the plumbing! Add billing and premium processing to the mix Provide greater choice and authorized access for all stakeholders via an integrated platform Allow the agent to build a private exchange and give the carrier the option to control underwriting, communication, and pricing
18 Simple yet Elegant
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