Benefit Administration System Capabilities & Details. System Details v4 06_16

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1 Benefit Administration System Capabilities & Details

2 ACA Compliance ACA MANAGER You chose BenefitHelp TM for best in class benefits administration, service and support. Now you can deliver ACA compliance with the same confidence. ACAManager is a large-scale ACA compliance solution for companies nationwide. Unlike the competition, ACAManager unites comprehensive benefits administration technology with a compliance solution designed to mitigate risks and safeguard your company from costly penalties. ABC International ACA Manager Pay or Play Strategy Setup company information Interactive Pay or Play calculator Determine applicable large group status Determine FTE equivalency Determine penalties based on transition relief or standard rules ACA Manager Measurement Periods Setup multiple measurement, administrative and stability periods based on employer categories Track, review and manage initial measurement & standard measurement periods Periods can be classified by employee categories and divisions outlined in the BenefitHelp System ACA Manager Analytics Review employer affordability ratio Identify company compliance View alerts monitoring employee status changes View real-time statistics of employer Pay or Play calculator based on hours loaded ACA Manager Notifications Automatic triggering of model exchange notices Track & manage open notice submissions Customize content ACA Manager Reporting Reporting 6055-self insured (NON-ALE) Reporting 6056 ALE not self insured Reporting 605 & 6056 ALE who are also self insured 1

3 System Highlights BenefitHelp System The BenefitHelp System is a staple for any employer s benefit management system, from communication and enrollment to total benefits management. Our state of the art online enrollment and benefits administration system is utilized to manage all benefits information. Highlights of our system include easy uploads and downloads, electronic data reporting to carriers, online benefits enrollment for open enrollment, new hires, and lifestyle changes, benefit plan rules, eligibility, real time benefit confirmations, and robust reporting capabilities. Our system operates in a secured environment. All information is encrypted before being securely transmitted over the Internet. Enroller Payroll Self Serve Company Divisions Benefit Classes Pay Schedules Company Rules ACA Compliance Enrollment Info Carrier Feeds Payroll Feeds ACA Forms System HR Admin Benefit Providers Benefit Plans SPDs Qualifying Event Rules Eligibility Rules Carriers Benefit Data In Automated Data Exchange Secure & Seamless Transfers Benefit Data Out 2

4 Benefit Administration System Features The BenefitHelp System is an advanced, EDI-enabled, web-based, employee benefit enrollment and administration platform that will electronically connect HR administrators, employees, carriers, and third party administrators who participate in the benefits enrollment and administration process. Delivered via an internet browser, employees enter their personal information and make their elections electronically to enroll. Employees can also make changes for qualifying events as needed. Data can be electronically exchanged with any third party system such as carriers, payroll vendors, or corporate account systems. The following features and benefits are specific to the software s general system architecture. Product Features Flexible Administration Custom Branding Complete System Auditing Automatic Notifications Automatic Data Exchange & Report Scheduler Data Import/Export 80+ Preprogrammed Reports Context Sensitive Help System Practical Benefits Multiple company administrators can be set up, each with a different level of security and access to the system, facilitating the separation of the administrative duties, by company, department and personnel. Administrators can customize the software to display their organization s identity, such as name and logo. System activity is tracked and recorded by user type, date, time, work station and the detail of the activity. This is useful for auditing the changes to plan designs and the individual user information. This is an invaluable feature that increases user accountability and accuracy. Administrators have the option to receive system generated s, notifying them of an employee s access and activity with the software. The software has an easy-to-use scheduling utility that allows for the secured automatic data exchange, ( or FTP), of file exports and reports to occur at any day, date and time. Any current data that needs to be recorded into the software database can be imported electronically or manually entered, depending on an employer s preference. All of the data in the software database can be exported to other internal departments, external vendors, such as payroll processors, insurance carriers and brokers, or any organization that you need to share data with. There are over 80 preprogrammed reports available within the software, which can be queried in many ways. For example, by plan, year, date, enrollment, volume, age, years of service, employee class, division, etc. They can be printed or downloaded to Microsoft Excel for further manipulation. Additionally, they can be scheduled to run automatically, with frequencies generally ranging from daily to monthly. Accessing the help window within an area of the software will display the help content that corresponds to that area of the software. A table of contents and search mechanism is also available. 3

5 Enrollment & Eligibility Administration Features Product Features Enrollment History Compatible with over 30 Benefit Plan Types Repository of Benefit Plan Designs Robust Benefit Plan Design Capabilities Optional Underwriting Workflow Process Flexible Employee Enrollment Process Maintaining Maximum Guarantee Issues Perform Manual Adjustments Automatic Adjustment Reporting Life Event Management Practical Benefits The history of the employee benefit elections, including the coverage selected, employer/ employee cost, and the date and time of the election is maintained by the system. The system is robust, allowing for the setup and enrollment in thirty different types of employee benefits, health, life, disability, retirement, and flexible spending accounts are just a few of the benefits available. Administrators can create and store benefit plan designs that can be used over and over again. This will greatly reduce the amount of time spent on plan designs and will also eliminate errors. The software can accommodate unique and complex benefit plan designs, examples include: - Flexibility with same sex or domestic partner coverage - Allowing employee dependents to enroll in different benefit plans than the employee - Disability insurance buy-up options can be based on multiple rate tables and contribution amounts - Flexible benefit plan contingency rules -Determining the employer s percentage of contribution - Eligibility determination by employee class, years of service, salary, waiting periods, department, zip code, etc. - Coverage determination using x-times salary or flat amounts - Benefit cost determination using age-banded tables or flat dollar amounts - Minimum/maximum coverage determination or contribution amounts - Setup Cafeteria Plan and the corresponding attributes There are two methods for transferring the employee s medical history information to the carrier. The first method and the most efficient are electronically. The second method involves printing the information on the carrier-specific underwriting forms The software allows the administrators to only set up the benefit plans that are available to an organization. This will simplify the enrollment process because employees are only presented with the screens/pages for the benefits that are available to them. An Evidence of Insurability form will be presented to the employee when a benefit plan s guarantee issue value is exceeded. The coverage and cost is determined using the guarantee issue value until the carrier has indicated the evidence of insurability has been received, which will release the full coverage elected and the associated cost. System will also allow for guaranteed issue subsequent enrollment guidelines. Administrators can make changes and corrections to the employee enrollment records. Administrators can lock the payroll, billing or plan enrollment reports and then elect to have the software automatically report any adjustments made for the locked reporting period. This feature allows retroactive enrollment activity to be properly managed and provides accuracy and efficiency to billing administrators. Administrators can establish qualified life events and assign them to one or more of the benefit plans. All qualified life events possess configurable rules. These rules include retroactive days, transaction verification workflow options and eligible enrollment actions (only change/ terminate coverage or any action). This feature is essential for the accurate ongoing management of employee benefits. 4

6 Payroll & HRIS Features Payroll Features The following features and benefits are specific to the payroll module. Product Features Payroll History Evidence of Insurability Premium Calculations Paid Time-off Categories Real-time Deductions Imputed Income Sample Paycheck Practical Benefits A history of the employee s payroll information is maintained in the software database including, pay rate, paid time-off and federal and state withholding taxes. Holds evidence of insurability amounts from payroll. The system calculates premium amounts. Paid time-off categories can be created and used by managers/supervisors to maintain the employee s use of paid time-off. Employees can view their balances at any time. When the employee elects coverage in a benefit plan that has an employee cost factor the payroll deduction and net paycheck amount are updated at the same time. Calculations related to imputed income are provided. Employees can view how their benefit elections impact their net pay by viewing a sample paycheck listing their deductions and year-to-date totals. HRIS Features The following features and benefits are specific to the software s HRIS module. Product Features HRIS History Address Changes Reporting Bill Reconciliation Turnover Management Recognition Life Event Management Tracking PTO Practical Benefits A history of the employee and dependent information is maintained in the software database including, personal, employment, beneficiaries, education, emergency contact and medical. Employees can keep their addresses up-to-date by logging in making their changes online; a confirmation of the change can be automatically provided to the employee and to the supervisor. Census reports, new hire reports, and many other general HRIS reports can be easily generated. Data to reconcile monthly vendor bills, or to create self-billing reports can be set-up to capture activity between payments which greatly simplifies the bill reconciliation process. The system can provide several different variations of employee turnover reporting within the first 90 days, within the first year, etc. to provide HR with accurate information needed to measure turnover reduction initiatives. Employee birthday lists, service year s lists, etc. can be generated. Administrators can establish qualified life events and assign them to one or more of the benefit plans. All qualified life events possess configurable rules. These rules include retroactive days, transaction verification workflow options and eligible enrollment actions (only change or terminate coverage or any action). This feature is essential for the accurate ongoing management of employee benefits. The system can track paid time off. 5

7 System Communication System Communication Features Product Features Benefit Plan Descriptions Statement of Benefits Forms Broadcasts Bulletins/News Flashes Real-Time Benefits Education Performance Evaluations Practical Benefits Administrators are provided with an easy-to-use feature that allows them to control the benefit plan descriptions that the employees view. During the enrollment process and on an ongoing basis, employees can view detailed information about the benefit plans being offered. If the employer offers more than one type of a particular benefit, the employee can view a side-by-side product comparison to assist them in choosing the product that meets their particular needs. Employees can also download corresponding benefit plan description documents and are provided with links to web sites that may contain more helpful information. Employees are able to view a real-time benefits statement that lists their salary, benefits, employer/employee contributions, paid time-off, and payroll taxes, etc. are presented to the employee and a percentage above the employee s regular salary is calculated and displayed. This feature clearly shows employees the full benefits the employer is providing and is an excellent employee retention tool. Administrators can upload external documents for the employees to download for viewing, increasing communication efficiencies and reducing the paper shuffle. Administrators can send messages to specific groups of employees based on demographic information stored in the database. Administrators can create bulletins for employees to download. The bulletins can be created using a content management feature, which also allows images to be uploaded and displayed. In addition, external documents can be imported and attached to the bulletin. Employees can easily download the bulletins through the employee communications module. While enrolling, employees can have real time access to overviews of the benefit plans with one click. Managers/supervisors have access to an employee review feature that allows them to record the employee s review date, pay rate, bonus information, notes and time of the next review. They can also upload and attach external documents to the employee review record. The manager/ supervisor has the option to allow the employee to view their employee review. 6

8 Reports BenefitHelp System Reports Unlike other products on the market, BenefitHelp provides robust reporting capabilities. The system has a wide variety of reports, data export capabilities, and an integrated report writer. Below is a list of standard system reports. Employee Census contains employee demographic data Dependent Census contains dependent demographic data and relation to employee. Add/Change/Delete contains detailed information regarding any changes to employee records for a selected date span. COBRA Employee Status contains information on employees with a status of COBRA as well as the COBRA begin date, end date and number of days remaining. Employee Eligibility contains information regarding the employees eligibility of benefit plans. Plan Enrollment contains employee benefit plan enrollment for a selected date span. Plan Summary contains information regarding benefit plan setup. Payroll Deduction contains the payroll deduction amounts for selected employees. Consolidated Billing run a bill for selected plans and date span. Carrier Billing run a bill to a particular carrier for a selected date span. Billing Report History contains historical bills for previous billing periods. Imputed Income contains information regarding imputed income calculations for pre-tax group life plans that exceed a combined benefit of $50,000. Employee Spending Credits contains information regarding the allotted, used and available spending credits by employee. Import/Export Validation contains information regarding previously run imports and exports. System Utilization contains information regarding user login activity. Forms Tracking contains a history of when forms were last generated by employee 7

9 Features BenefitHelp Features BenefitHelp has a robust set of features that will meet the needs of nearly any employer organization. This highly customizable system has the following features: General System Features Complete System Auditing Automatic Data Exchange Data Import/Export Robust System Security Automatic Notification Report Scheduler 80+ Pre-programmed Reports Customizable User Permissions Enrollment & Eligibility Features Enrollment History Benefit Plan Design Library Optional Underwriting Workflow Maximum Guarantee Issue Automatic Adjustment Reporting Spending Credits Care Provider Directories Extensive Plan Type Compatibility Flexible Benefit Plan Design Automatic COBRA Notification Flexible Employee Enrollment Process Manual Adjustments Life Event Management Requiring/Ordering Plans Employee Benefits Statements Payroll Payroll History Real-time Deductions Paid Time Off Tracking Sample Paycheck HRIS HRIS History Employee Handbook Performance Review Company Directory Communications Benefit Plan Descriptions Forms Bulletins/News Flashes Broadcasts 8

10 Benefit Plan Types BenefitHelp Benefit Plan Types BenefitHelp enrollment and administration business rules are compatible with the following benefit plan types: Health Medical Dental Vision Prescription Drug Telemedicine Hospital Income Cancer Critical Illness Life Basic Life Voluntary Life Dependent Life Voluntary Dependent Life Supplemental Dependent Life Voluntary Term Life Voluntary Whole Life Universal Life Reimbursement Health Care Reimbursement Dependent Care Reimbursement Health Reimbursement Account Premium Conversion Direct Reimbursement Parking Expense Reimbursement Parking Garage Reimbursement Transit Check AD&D AD&D Voluntary AD&D Voluntary Dependent AD&D Disability Long-term Disability Short-term Disability Voluntary Long-term Disability Voluntary Short-term Disability Individual Disability Supplemental Disability Accident Care Retirement Retirement 401(k) SAR-SEP SIMPLE IRA Profit Sharing Money Purchase Pension Salary Continuance Other Auto/Homeowners Voluntary Prepaid Legal Voluntary Identity Theft Individual Premium Account Employee Assistance Program 9

11 Data Exchange BenefitHelp Data Exchange with Vendors The BenefitHelp system has unique capabilities for data exchange that we believe far exceeds industry standards. Unlike most systems, our system does not always mandate customized data exports. BenefitHelp has more than a hundred different variations of customizable reports that administrators can export electronically (even on a scheduled auto-run basis) - custom format, ordering, and delivery methods. These reports are available with a selection of file formats (.html,.pdf or.csv) which usually accommodate carrier/vendor data transmission requirements as well as payroll and accounting departments Options for carrier/vendor data exchange from the BenefitHelp system. 1. Built-In Reporting and Exports Utilizing the system reporting described above, we assist the plan administrator in querying the information and format needed in our pre-built reporting interface to run on a scheduled basis. These can be auto run reports which can be ed, zipped, encrypted, password protected, or delivered to a FTP server. 2. Export ALL to Microsoft Access - Our system has an export all into a unified formatted menu of access tables. Any access programmer (your IT, or BenefitHelp staff) can build a simple query to extract the data in custom formats needed. To use BenefitHelp to build custom queries, there is a charge of $ per hour. Once a query is built, it can be run weekly/monthly, etc. without charge. Your IT staff may access this feature without charge. Most systems do not allow the flexibility to access reports/exports to your programmers. 3. Paperless Forms Administration Another differentiator is that our system has a very unique feature to administer any product, compliance form, etc. utilizing carrier specific required forms. We can pre-populate these forms with employee demographic information which eliminates redundancies when filling out multiple forms. Some employers are challenged when moving to an electronic system due to customized data exchange needs from the vendors. System updates, changes to a mainframe, even a software intake interface can change data requirements as well as ongoing state and federal regulations that impact the need of a form and/or wet signature. The BenefitHelp system s unique forms administration feature can address these issues. How it works: We can image and build and interface to any carrier form. The cost is a one time charge of $ per form. When enrolling, the employee simply clicks through the enrollment as if the form did not exist. The Plan Administrator runs a report (this too can be a scheduled automatic report) that will batch process the forms. The Plan Administrator can batch print them to a fax machine and the paper is never generated on the employer s side. The carrier receives a specific pre-filled form via fax or . The system also has tracking features to remind the Plan Administrator which forms need to be processed. 4. An additional forms feature is available when carriers or vendors need the employee s wet signature on the form. In this case the $ per form would apply. When the employee is enrolling in that plan, the BenefitHelp system pops the form at the time the employee is enrolling with instructions on printing and turning in the form (usually to HR). 5. EDI (Electronic Data Interface) Recognizing that some carriers require data in their exact format, customized feeds can be built for an additional charge. We have a library of EDIs that have been built for other customers/vendors/carriers. To customize an existing EDI, the cost is $1,295 (carrier/vendor) $ 4,995 (payroll/hris) with a $100 per month on-going maintenance fee. Our library consists of over 1000 feeds and includes most of the major carriers. If the EDI is not in our library and must be created from scratch, the price would typically range between $7,000 and $10,000. For EDIs from our library to payroll systems/vendors, the cost is around $5, Standard Data Transfer to vendors, carriers, and payroll Included in the system charge as long as the vendor will accept BenefitHelp standard system data formats. Most carriers have been flexible to accept our formats in the past. If custom formatting is required please see the data section for pricing. BenefitHelp will assist in setup of scheduled system reporting and data transfer. The plan administrator is responsible for monitoring and maintaining on an ongoing basis. 10

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