Web-based Enrollment FAQ
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1 BLUEPRINT SOLUTIONS FOR MIDSIZE COMPANIES Web-based Enrollment FAQ for groups with eligible employees Visit us at mylifepath.com
2 Contents Overview of features and benefits Why is Blue Shield offering BeneTrac's Web-based enrollment solution?...1 How does Web-based enrollment work?...1 How does Web-based enrollment simplify benefit administration?...1 Can groups utilize the service to enroll with other health plan carriers?...2 Why is BeneTrac Blue Shield s preferred vendor for this service?...2 How does the Blue Shield subsidy process work?...6 How much work is required before I can know if Web-based enrollment is feasible for my group? How quickly can I receive this information?...2 Group qualification requirements and vendor collaboration Which groups qualify for Web-based enrollment at no additional cost?...3 Which products or plans can be used with Web-based enrollment?...3 How long does it take to install Web-based enrollment?...4 Is there a contract involved?...4 Are set-up fees required?...4 Will the vendor provide an account manager for my groups? If so, what is the account manager s role?...4 How often will my groups need assistance from the vendor or myself?...4 Set-up and implementation processes What are the technical requirements the groups must meet to use Web-based enrollment?...5 What s involved with the pre-qualification/qualification documents?...5 What is the renewal process for Web-based enrollment?...6 Will my client receive two separate statements?...6 Primary service contacts Who is the primary service contact for ongoing questions?...6 Who is the primary service contact at BeneTrac?...6
3 Frequently asked questions about Web-based enrollment Blue Shield of California has collaborated with BeneTrac to provide Web-based enrollment for qualified groups with 51-1,000 eligible employees. Web-based enrollment allows benefit administrators and employees to go directly online to perform a variety of tasks that can help streamline and simplify the benefits administration and enrollment process. We developed the following questions and answers to give you useful information about Web-based enrollment and help you explain its value to your clients. These questions are organized into four categories: 1. Overview of features and benefits 2. Group qualification requirements and vendor collaboration 3. Set-up and implementation processes 4. Primary service contacts Overview of features and benefits Why is Blue Shield offering BeneTrac's Web-based enrollment solution? We offer BeneTrac's Web-based enrollment solution as a resource for your clients to help simplify the benefits administration process and enable more insightful benefit management decisions. In addition, Web-based enrollment can help reduce the expense of plan communication, staff resources and other administrative elements typically associated with paper-based enrollment. How does Web-based enrollment work? Using the Web-based software, benefit administrators and employees are able to enroll in a plan, change demographic information and add or disenroll dependents across multiple carriers. The online process works this way: Employees enter and update their own benefit information by following a simple, intuitive process The system guides employees, calculates eligibility and provides personalized plan descriptions and access to provider network listings. The system then checks for errors, missed entries and conflicting information before forwarding the data. Benefit administrators maintain gatekeeper authority to review and approve all changes, in addition to tracking all system activity. Through a secure online connection, employer data is electronically submitted to Blue Shield. BeneTrac can also transmit data to other carriers, as applicable. How does Web-based enrollment simplify benefit administration? For benefit administrators, Web-based enrollment provides a variety of resources and features for completing enrollment tasks in a quick and efficient manner. They include: Online plan information, often including plan cost and provider networks Online benefit descriptions Employee, spouse and dependent demographic information Employee eligibility tracking Secure employee access for self-service Real-time open enrollment transactions Electronic transmission of enrollment transactions to multiple carriers Management reporting Can groups utilize the service to enroll with other health plan carriers? Yes. Unlike many carrier-based systems that administer only their own plans, BeneTrac's electronic enrollment offering helps groups manage multiple medical and ancillary benefit plans from a variety of carriers, all from a single, consistent and secure point-of-entry. This cross-carrier capability enables groups to save time and resources while enhancing their ability to make comprehensive comparisons of enrollment data and plan activities between carriers. For a complete listing of all participating carriers, visit BeneTrac's web site: 1
4 Why is BeneTrac Blue Shield s preferred vendor for this service? We ve collaborated with BeneTrac based on its proven capability to deliver efficient, effective and affordable electronic enrollment and benefit management services based on the following criteria: Strong client base with successful account management history Sound distribution channel with flexible service capacity Financial stability Experienced relationships with other California and national carriers Cost-effective solutions with customization capabilities Commitment to technical innovation BeneTrac has developed its system solutions by combining software engineering, group health benefits and human resources expertise. In addition, BeneTrac has the capacity to develop a customized solution involving unique business rules or multiple office locations. Blue Shield also accepts Web-based enrollment transmissions from vendors other than BeneTrac on a case-by-case basis. To determine if a group is eligible, contact your Blue Shield representative. How does the Blue Shield subsidy process work? Through the promotional offer, Blue Shield will provide a subsidy to BeneTrac of $3.25 per employee per month on behalf of the group for each eligible employee who enrolls using BeneTrac services, regardless of enrolling in a Blue Shield medical plan or a plan offered by another carrier. The $3.25 subsidy applies only to BeneTrac s basic system package services, available to Blue Shield groups at a preferred rate of $3.25 per employee per month. In addition to the subsidy, Blue Shield will also cover the initial onetime set-up fee, equivalent to $3.25 per employee multiplied by the total number of employees who enroll through the BeneTrac system. Additional services and features may cost extra and are the financial obligation of the group. This offer is not available in conjunction with any other Blue Shield promotion. Groups currently receiving a Blue Shield subsidy for BeneTrac services are not eligible for the $3.25 subsidy prior to completing their existing twelve-month (12) contract with BeneTrac. Following the fulfillment of this contract, only groups renewing prior to January 31, 2005 are eligible to receive this $3.25 subsidy upon their renewal date with Blue Shield. How much work is required before I can know if Web-based enrollment is feasible for my group? How quickly can I receive this information? Eligibility for Web-based enrollment services can be determined by completing and submitting simple prequalification and qualification documents. The documents contain general questions regarding group size, vendor preferences and file transfer information. Once the appropriate documents are completed and submitted, Blue Shield s Electronic Eligibility Transfer (EET) team reviews the information and begins a case for the group to determine eligibility. Under most circumstances, a group would qualify for electronic enrollment as long as member level benefits or variable-life amounts are not required. Once eligibility is confirmed, you will be notified of case status and next steps. On average, the pre-qualification process requires two weeks to complete. Group qualification requirements and vendor collaboration Which groups qualify for Web-based enrollment at no additional cost? Beginning February 1, 2004 through January 31, 2005, qualified groups who purchase or renew a Blue Shield medical plan can utilize Web-based enrollment services through BeneTrac at no additional charge for a period of 12 months (terms and conditions apply). To qualify, groups must meet the following criteria: employees 2
5 At least 50% of the group s employees are enrolled in a Blue Shield medical plan with a minimum of 25 employees enrolled through the BeneTrac system. Enrolling group must meet one of the following criteria: New groups to Blue Shield and BeneTrac New groups to Blue Shield but are existing BeneTrac clients Renewing Blue Shield group (eligible upon renewal date) and new BeneTrac client Renewing Blue Shield group (eligible upon renewal date) and existing BeneTrac client Please note: Blue Shield may modify or terminate this promotional program at any time. In the event of termination, all subsidy payments will cease as of the date of termination of this program. In such an event, the group may continue to receive services at its own expense. Which products or plans can be used with Web-based enrollment? Typically, any Blue Shield of California and Blue Shield Life & Health plan or service can be managed through Webbased enrollment as part of the group s standard medical plan. Certain plans, such as those involving member level benefits and variable life amounts, may require specific review before being administered through a Web-based enrollment system. Benetrac s Web-based enrollment service can be used to enroll multiple medical and ancillary plans from other health plan carriers as well. How long does it take to install Web-based enrollment? New groups currently using BeneTrac services: 2-4 weeks New groups currently using other vendors: 4-6 weeks Current groups switching to BeneTrac services: 4-6 weeks Current groups using another vendor: 8-12 weeks Is there a contract involved? Employer groups who elect to use Web-based enrollment through BeneTrac will be required to sign a service agreement directly with the vendor for those services selected. The BeneTrac service agreement is for a period of 12 months. None of the terms and conditions of Blue Shield s health plans apply. Qualified groups who maintain their Blue Shield medical plan service will not be required to pay for BeneTrac's standard service package during the 12-month promotional period. To be eligible to continue to receive the subsidy, groups must remain a customer of Blue Shield, use the BeneTrac services and continue to be a qualified group. Are set-up fees required? As part of the promotion, Blue Shield will cover the initial one-time set-up fee, equivalent to $3.25 per employee multiplied by the total number of employees who enroll in BeneTrac's standard service package. The amount and payment structure for any additional services selected by the group may cost extra and are the financial obligation of the group. Will the vendor provide an account manager for my groups? If so, what is the account manager s role? BeneTrac will assign an account representative for each employer group. The representative's role is to facilitate the installation process, coordinate training sessions for benefit administrators and employees and provide ongoing support as needed. Once implementation is complete, BeneTrac support staff will provide either remote or on-site training as needed. This training will cover a variety of issues ranging from employee profile set-up and creating new employer systems or locations to tracking data submissions and leveraging management reporting tools. 3
6 How often will my groups need assistance from the vendor or myself? BeneTrac's Web-based enrollment service is designed to provide a streamlined, turnkey process for benefits administration that requires little maintenance after the initial service set-up and training process. In the event that the employer group's plan benefits are changed or updated, the group is required to coordinate these changes, including payment for such changes as applicable, directly with BeneTrac. Updates requiring coordination include, but are not limited to, such items as changing plan types, open enrollment-based changes and adding rider agreements. Ongoing support from BeneTrac is included as part of the standard system package, with optional services and support available as needed. Set-up and implementation processes What are the technical requirements a group must meet to use Web-based enrollment? To successfully utilize Web-based enrollment, each group must meet these requirements: The ability to submit an approved HIPAA-compliant format layout. To determine your groups compliance capabilities, contact your Blue Shield representative. BeneTrac requirements: Personal computer access for benefit administrators and participating employees Internet access (56K dial-up or faster) Web browser: Netscape Navigator 4.0 or Microsoft Internet Explorer 4.01, SP2 or higher* Printer connection is needed if printing Web pages and documents from the online system Adobe Acrobat Reader is needed to view and manage some documents For benefit administrators, Microsoft Office 2000 is recommended, to maximize data management tools. What s involved with the pre-qualification/ qualification documents? The pre-qualification and qualification documents contain a series of questions necessary for Blue Shield s EET team to determine whether a group qualifies for electronic enrollment. 1. The pre-qualification document should be completed by the prospective group under the supervision of its Blue Shield representative and forwarded to the EET team for approval. 2. Once the EET team approves the pre-qualification document, the group will need to complete a second qualification document and return it to the EET team. Both the pre-qualification and qualification documents are available at the Producer Connection section of mylifepath.com. What is the renewal process for Web-based enrollment? Following the date of termination of this program all Blue Shield subsidy payments will cease. Prior to the completion of the group's 12-month service agreement, BeneTrac will provide renewal notices via to the broker on behalf of the group, which is to be forwarded to the group approximately 45 days prior to the renewal date. At such time, groups may elect to renew their BeneTrac service agreement at their own expense. Using Web-based software, benefit administrators and employees can enroll in a plan, change demographic information and add or disenroll dependents across multiple carriers. 4
7 Will my client receive two separate statements? The employer groups and/or their brokers will receive a monthly statement for the Web-based enrollment services provided. For qualified groups enrolling in the service during the promotional period ending January 31, 2005, the first 12 statements will reflect a credit for the portion of the service that Blue Shield will pay as part of the $3.25 per employee per month promotional subsidy. The subsidy is available for each employee, up to 1,000 employees per group, who enrolls in the BeneTrac service. Groups who subscribe to Web-based enrollment services will continue to receive a separate, monthly statement for their Blue Shield medical and ancillary plan coverage and benefits. Primary service contacts Streamline and simplify the benefits administration and enrollment process. Who is the primary service contact for ongoing questions? For brokers, the primary contact regarding Blue Shield support and questions is the Blue Shield sales representative. For questions and support regarding BeneTrac's services, BeneTrac will assign an account representative for each employer group and its broker. Who is the primary service contact at BeneTrac? Art Brooks Vice President of Sales (619) abrooks@benetrac.com Microsoft, Encarta, MSN, and Windows are either registered trademarks or trademarks of Microsoft Corporation in the United States and/or other countries Netscape and the Netscape N and Ship's Wheel logos are registered trademarks of Netscape Communications Corporation in the U.S. and other countries. Netscape Navigator is also a trademark of Netscape Communications Corporation and may be registered outside the U.S Adobe, Acrobat are either registered trademarks or trademarks of Adobe Systems Incorporated in the United States and/or other countries. 5
8 A16018-FAQ (2/04)
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