Benefitfirst

Many employers in the current business landscape continue to erroneously pay claims for employees who are no longer eligible for the benefits plan. There have even been cases where claims have continued to flow for years after an individual’s employment had been terminated. A key reason behind this oversight is the failure of technology that lacks the appropriate data management and validation processes to notify insurance carriers of the changes within their workforce. This lack of accurate data on employee benefits creates substantial losses for companies.

Addressing this challenge with its cloud-based benefits management platform that ensures eligibility accuracy is Benefitfirst. “We conduct an audit and reconciliation process on all existing client data to ensure the accuracy of employee benefits program before deployment, maintaining a less than one percent error ratio,” states JD Whalen, Director of Business Development, Benefitfirst. The company’s platform automates and streamlines employees’ life cycle to manage all the variables down to the business rules of an employer as well as the insurance carrier, state, and federal requirements, thereby saving a significant amount of time. Following onboarding, the company continuously validates the client workforce data (including carrier export files) every week.

The Benefitfirst platform offers ease of access for all users through its mobile-responsive design and Android and iOS applications. The firm’s administrative portal also provides robust data analytics capabilities and reporting modules that allow employers to review population analytics for enrollment, eligibility, deduction, billing, and compliance, seamlessly via standard and ad hoc reports.

Furthermore, the platform’s architecture allows administrators to attain complete control of their benefits process from a visibility and process perspective while leveraging AI to automate and enhance the efficiencies of day-to-day tasks and streamline benefits-related activities. Alternatively, the Benefitfirst employee gateway provides users with an intuitive dashboard that incorporates educational materials, guides, plan summaries, and decision support tools that boost accessibility to their current benefits summary, benefits elections, dependent coverage, and beneficiary data. Clients can analyze multiple fiscal years simultaneously and support users in managing their past, current, and future transactions with its robust benefits administration solution. This is a key differentiator for Benefitfirst as it is one of the pioneers to offer simultaneous management of past, current, and future benefits elections in the current market.

We conduct an audit and reconciliation process on all existing client data to ensure the accuracy of employee benefits program before deploying our platform, maintaining a less than one percent error ratio

Highlighting the impact of these features is a client success story where Benefitfirst assisted a customer in ensuring the accuracy of their deduction data and helped manage the eligibility data of over 900 employees. Initially, due to the employer’s benefits election data not reflecting accurately in their insurance carrier system, they were experiencing adverse hard and soft dollar effects. Once Benefitfirst stepped in, their proprietary auditing technology and processes realized savings of up to $3 million in claims and premium errors. The company uncovered over $800,000 in medical premium discrepancies and around $20,000 in dental premium inaccuracies. Consequently, the Benefitfirst platform enabled a premium and claims liability ROI of approximately $3.8 million for the client.

Currently, the Benefitfirst platform supports the management of employees and is mitigating the undesirable effects of the digitalizing realms of insurance and HR. In the coming years, the company plans to continue the steady growth of its technology and distribution partnerships. JD and his team firmly believe that human capital is as crucial as technology. This belief poises Benefitfirst to play a vital role in the future of employee benefits.