Benefits Administration

Eligibility management. There is a better way.

Medical Eligibility Files Nightmare

HR Systems have quickly gone from your system of record to an administrative nightmare. How can this must-have and a must-do be saved from being a daily must-fix?

A needle in a haystack.

Eligibility files: the bedrock of benefits, and the bane of many HR professionals’ week. While they are the central point of truth when it comes to every benefit for your people, they’re also often the root cause of much of the confusion and error in employee benefits. One typo in one file and the benefits system around that file can fail, causing a catastrophic domino effect that can take weeks to solve.

We like to call it 1980’s technology talking to 1980’s technology.

A story we recently heard from a director of benefits for a rapidly growing company illustrates just how burdensome the eligibility process has become. It all started on a typical Monday morning when her team ran eligibility files like they did every Monday—making sure their people were covered and the data was sent to their benefits partners correctly.

But on this Monday, the files were sent back from each partner with a cryptic “Error” message and their team had no idea what the issue was. After double checking the files and not finding any issues, they re-submit and get back to their day. An hour later, the files are kicked back by the partner with the same message. After half a day repeating this frustrating effort, neither their team or the partner can identify what’s amiss. As five o’clock approaches, her team finally learns the problem is in the records of two of their people. Yet, they still can’t get the file to load. So what do they do?

A. Give up
B. Fire the two people
C. Delete all digital traces of those two people
D. All of the above

If you answered D, that’s exactly what happened. Their team had to virtually fire the two people whose files were the root of the problem and then “rehire” them before IT intervened and shut the people out of the systems or they realized what happened. This whole process of identifying two errors in the file and “fixing” them took an entire work day to deal with and resulted in creating inaccurate records and information in their “system of record”. Believe it or not, this is all too common in benefits today and this story is just one of many illustrating how backwards managing the system of record has become.

One file. Many versions.

It’s likely the eligibility system of record for your people is outdated and not compatible with your benefits partners’ requirements. The system is outdated and doesn’t interface well, and like most benefits teams, you’ve purchased additional software to integrate with the system you have, all in the effort to help people manage enrollment. Even the layered-on software doesn’t take away from the fact that eligibility files remain a massive time sink for your team.

We like to call it 1980’s technology talking to 1980’s technology.

Our team thought there had to be a better way, so we created it.

Imagine.

  • Sending one integration for eligibility that works for you. No longer are you replacing or reformatting the file seven times. You simply finish it and hit send.
  • When there is a problem identified, a benefits partner lets you and your team know exactly where the problem is. The first time.
  • Once the file is fixed, that partner sends the file out to all your different benefits partners.
  • Now imagine all the time you and your team have back. No longer are you suffering through Eligibility Mondays.

With Collective Health, we think it’s about time that things should work the way you’ve always wanted them to. Our process saves our customers hours every week and lets you say goodbye forever to Eligibility Mondays. How we solve your eligibility headaches is just one of the many ways Collective Health brings a fresh perspective to the market.

Our customers include:
eBay Red Bull Activision Blizzard
Zendesk Counsyl eBay
Red Bull Trace3 DataSafe
eBay Red Bull
Activision Blizzard
eBay
Zendesk Counsyl
Trace3 DataSafe
eBay Red Bull Activision Blizzard Zendesk Counsyl Trace3 DataSafe