An HR Administrator's Guide to Carrier Connections

Purpose: We offer a direct, automated process in sending enrollment data to your carriers from BambooHR through an integration we have developed with a third-party data processing partner. This help guide goes over setting up a carrier connection from start to finish. 


To ensure a seamless installation experience, you will need to complete a few initial steps with your carrier and then start validating the connection with BambooHR. We have also created an email template for you to use for carrier communications. Read through this help guide to know what you need to complete during this process.

Once you have gathered all necessary details (Step 2a or 2b) from your carrier, please contact our Customer Support team to request a carrier connection. Our Support team will assist you with the next steps and ensure a smooth transition to setting up your carrier connection.

Step 1: Review our carrier partners list.

Before starting this process, verify that your carrier is one of our partners and that you meet their requirements. Click here to view the requirements for all of our carrier partners. 

  • If your carrier is not one of our partners, don’t worry! Proceed to Step 2b to learn more about requesting a carrier connection.
  • If your carrier is one of our partners, proceed to Step 2a.

Step 2a: Contact your carrier (on our list).

This step is to confirm that your carrier will allow a connection. Contact your carrier to confirm your eligibility for a connection and request your plan details. You can use the email template below, fill out the placeholders, and send it to your carrier. We also recommend copying your broker on the email so they are aware.

Once you hear back from your carrier, you can use the  information they provide to set up new benefit plans or verify existing benefit plans in BambooHR, according to your carrier-specific setup requirements.

Email template

Subject

Automated Data Feed for [Your Company Name] (Group # [Your Group number])

Body 

Hi [Carrier Contact Name], 

My name is [Your Name], and I am the [Your Title] at [Your Company Name]. Our group number is [Your Group Number].

Is our group eligible for an automated data feed to your platform? (Either an EDI 834 feed or an API connection). BambooHR is our benefits administration platform, and a third-party data integration partner would provide the feed.

If we are eligible, please send our plan summaries, rate sheets, and account structure details so we can ensure our setup is correct in BambooHR.

Thank you for your help.

Step 2b: Contact your carrier (not on our list).

If your carrier is not on our list, don’t worry! If you have at least 50 benefits-eligible employees, you can request a carrier connection. At this time, new connections are limited to the following insurance plan types:

  • Medical
  • Dental
  • Vision
  • Life
  • Disability
  • Accident
  • Hospital Indemnity
  • Critical Illness
  • Cancer

We do not offer connections for HSA, FSA, retirement, or other benefits like pet or legal insurance at this time. If you are a BambooHR Payroll customer and you would like to set up an automatic feed to your HSA, FSA, or 401k vendor, please review this help guide.

We provide an email template (see below) to help you request a connection with BambooHR. You will need to send this template to your account manager at your carrier. Just fill out the placeholders, and add [email protected] in the CC line before sending it so our technology partner is included in the conversation.

  • If your carrier agrees, our data integration partner will build the connection. We will work closely with you to ensure your account is set up with all the necessary benefits data. Once everything is ready, we will then assist you in syncing your data, resolving any data discrepancies, and activating your connection.
  • If your carrier declines, you can use the CSV data file export and/or PDF Form Builder to send enrollment data. 

Email template

Subject

Automated Data Feed for [Your Company Name] (Group # [Your Group number])

Body 

Hi [Carrier Contact Name], 

My name is [Your Name], and I am the [Your Title] at [Your Company Name]. Our group number is [Your Group Number].

Is our group eligible for an EDI 834 feed to your platform? BambooHR is our benefits administration platform, and Noyo (Cc’d) would provide the feed.

If we are eligible, please send our plan summaries, rate sheets, and account structure details so we can ensure our setup is correct in BambooHR.

Thank you for your help.


Step 3: Ensure benefits setup is complete.

It is imperative that all employees' enrollments and benefit data changes are submitted through an enrollment window, either by editing a previously approved election or by creating a new window. This process is crucial to establish a successful carrier connection, ensuring that all information is accurately and promptly communicated to your carrier.

If your carrier confirms the connection and provides all necessary information, you  will need to add or update the carrier’s details on the Carriers tab and then have a plan year set up with benefit plans (coverage effective dates, plan IDs, carrier details, etc.) in your BambooHR account. This will help ensure accuracy in data reporting. After setting up the plan year, make sure you have all required company, employee, and dependent data for the specific plan year. BambooHR takes note of any missing employee and dependent demographics (SSN, address, state, etc.) and/or company information (ACA settings).

In addition to setting up benefit plans, we recommend enabling the Benefit Vendors Discrepancies email alert in BambooHR so your admins will receive an email alert if there are any data discrepancies between BambooHR and your carrier's system. From within the email alert, you can click to resolve errors and resend the correct data to your carrier.

Updating missing data
Benefits

If the plan year has missing data, you will need to add the correct information before having enrollment data sent to your carriers. Click Update Missing Info (blue hyperlink) to add the correct information.

BambooHR

The Update Required Member Information page will show a list of employees with what information they (or their dependent) are missing. Navigate to an employee’s row and click Update Missing/Invalid Info. Once you add the required information, be sure to save the changes by clicking Update Required Info.

BambooHR

If there is missing company information, another table will appear above the employee list. Clicking Update Company Info will take you to Settings > Account > ACA Settings, where you can configure ACA settings and add the required company information.

After verifying all required information, you can then run an enrollment window (with a selected plan year) for your benefits-eligible employees* to make their benefit elections or select their current benefits if you are making a mid-year transition to Benefits Administration. This allows BambooHR to match data with your carrier when the connection is made. You will be able to review and approve your employees’ benefit elections once enrollment is complete.

*Benefits eligibility is determined in the benefit plan setup within your BambooHR account.


Step 4: Work on a test file with BambooHR.

Send the completed responses from your carrier to [email protected]. They will forward the information to the Carrier Connections team. With this information, the Carrier Connections team will work with your carrier to send them a test file. Once they pass the test file, the Carrier Connections team will work with your carrier to set up the production file.

Please be aware that the testing process and discrepancy review can take some time. It is normal to send several test files while we work to clear out any mismatched data in both systems. The timeframe for this configuration process can vary depending on the account's complexity and circumstances.


Step 5: Resolve any data discrepancies.

Data sync details

The data will flow from BambooHR to your carrier based on your carrier’s data sync schedule and requirements. Data in BambooHR must match what the carrier has on record for each employee. If there are any discrepancies between the two systems, you can make the appropriate changes in BambooHR and have these changes sent to your carrier.

The following fields and settings should be completed before sending enrollment data to your carriers.

Field/Setting
Settings Employees enabled with ESS
Eligible employees in Benefits Administration
Employee Data First Name
Middle Name (if applicable)
Last Name
Date of Birth
SSN
Gender
Address
City
State
ZIP
Employment Status
Hire Date
Termination Date (if applicable)
Job Title
Salary
Pay Type
Pay Frequency
Dependent Data First Name
Middle Name
Last Name
Date of Birth
Relationship
SSN
Address
City 
State
ZIP
Gender
Benefit Plan Setup Carrier Name
Carrier EIN
Group Name
Plan Name
Plan ID
Start & End Dates (for ALL plan types)
Coverage options (and costs for standard rate plans)
Completed Enrollment Window All employees with their dependents and elections

Once your file is in production, you will receive an email alert if there are any data discrepancies between BambooHR and the carrier's system. Click View the Issues to access additional details in BambooHR.

An error message will also appear under Settings > Benefits and the Benefits tab from the left sidebar menu. From either location, click Resolve Errors. This will take you to the Carrier Connections Issues page showing three different tabs: Election & Demographic, Missing People, and Other.

The Resolve Errors functionality is only available to Account Owners and Full Admins. Other users with benefits access will receive an error message letting them know to reach out to their HR administrator for support.

Election & Demographic tab

The Election & Demographic tab lists employees with errors in their benefit election and demographic data. Errors in dependent data are grouped under the employee to whom they pertain.

  1. Plan year: The Showing selector will only appear if you have errors across multiple plan years. Each plan year will have a number of errors next to the plan year name. If applicable, choose which plan year you want to review.
  2. Filter: The search bar is a filter where you can enter an employee's name to view only the errors associated with that particular employee.
  3. Columns: The Employee Name column includes the employee's name while the Issues column shows the number of errors they have.
  4. Sorting: The Election & Demographic tab sorts errors by their urgency and then by employees' last name. The Urgent banner will appear if employees have urgent errors that you need to resolve for the carrier connection to work properly. Errors under the Warning section will not impact your carrier connection, but we still recommend resolving "warning" errors for both systems (BambooHR and the carrier's) to have the most accurate data on file.
  5. Resolution: Click View for a specific employee to review the error(s) and resolve them automatically. Below is an example of the error resolution process.

Error resolution example

The error resolution page will show all unresolved and resolved errors pertaining to the employee in the left column, grouped by employee and their dependents (spouse and/or child). The section on the right shows two options: BambooHR and the carrier, representing the information each system has. In the example above, the employee has a SSN discrepancy. I will need to select which system has the correct SSN and then update the incorrect SSN in the other system (see below). 

Clicking Skip for Now will take you to the next error until all errors are resolved.

There are two possible workflows based on which system has the correct information. 

  • If data in BambooHR is correct, you will need to work with your carrier on updating data in their system before activating the carrier connection. If needed, you can choose Skip for Now to return at another time. Once updated, return to this page to mark the checkbox as complete and then click Mark as Resolved* in the top right corner.
  • If data in the carrier's system is correct, you will be able to automatically update the employee's (or dependent) information directly within BambooHR. Enter the correct information in any applicable fields on this page and click Resolve and Update in the top right corner. 

*Resolving some data discrepancies will require additional assistance from our Support team, indicated by Mark as Resolved being grayed-out. 

After you resolve all errors for a specific employee, you will receive a celebratory message notifying you that updated data has been sent to the carrier for review. 

Missing People tab

The Missing People tab shows employees who have errors but do not have an employee profile in BambooHR. To open the resolution modal, hover your cursor over an employee's row and click View.

You will need to complete some manual work to resolve a missing employee error. Select which system has correct information and then update the other system by following the resolution steps. In the example above, there are two possible workflows based on which system has the correct information.

  1. Carrier is correct: If the carrier is correct, follow the resolution steps to update information in BambooHR to match the carrier's system. Once completed, mark I have updated BambooHR and then click Mark as Resolved.
  2. BambooHR is correct: If BambooHR is correct, contact your carrier to remove the employee's coverage before activating the carrier connection. Once completed, mark I have updated the carrier's records and then click Mark as Resolved.*

*Resolving some data discrepancies will require additional assistance from our Support team, indicated by Mark as Resolved being grayed-out. Please contact our Support team.

Other tab

The Other tab lists errors, identified by our data integration partners, that our system has not accounted for. Errors are sorted by carrier. Hover your cursor over an error and click View. Then, enter what you did to resolve the error. If you need further assistance, you can contact our Support team by clicking Contact Support. Once everything looks correct, click Mark as Resolved.


Step 6: Verify data transmission.

Enrollment data is tied to the enrollment windows you create in BambooHR (i.e., open enrollment, new hire, qualifying life event). If you make changes outside an enrollment window, the carrier connection will still send the change to the carrier. Examples include changes in salary, address, and dates of birth.


Frequently asked questions (FAQ)
  1. Do I need to fill out an EDI questionnaire?
    • It depends on the carrier. For example, UHC and Principal require an EDI questionnaire form (supplied by our third-party integration partners), but Aetna, Kaiser, and Anthem do not.
  2. Which file format is utilized?
    • We have an API connection with our third-party integration partners. They send individual files to the carriers, with the most common type being an 834 EDI file. However, our partners have an API connection with a few carriers, such as Principal, Kaiser, and Guardian.
  3. Can a termination date be submitted on each member record within a family that is equal to the last day of their coverage?
    • Yes, we send a coverage termination date for the employee subscriber and each of their dependent members, as defined by the plan setup.
  4. Do I need to provide the vendor name, contact email ID, address?
    • When the time comes to enable the connection, our Carrier Connections team will reach out to your carrier to provide any needed information. You will need to have the following items ready for the connection:
      • Completed carrier answers to the eligibility template
      • All employee, dependent, and plan data
      • All employees enabled in Ben Admin and a completed enrollment window
  5. Will the carrier connection only send enrollment data, or does it include other data points/non-enrollment data?
    • A carrier connection will send enrollment data tied to the enrollment windows you create in BambooHR (i.e., open enrollment, new hire, qualifying life event). If you add a change to non-enrollment data, the carrier connection will still send the change to the carrier. Examples of non-enrollment data changes include salary, address, and dates of birth.
  6. Can terminated records be removed from the EDI file after the termination date has been transmitted once?
    • Yes.
  7. If I make benefit election changes for an employee through the admin approval page within an enrollment window, will the changes sync to the carrier?
    • Yes.
  8. Will changes to an employee's benefit enrollment in BambooHR, made outside of the approval page, be sent to the carrier?
    • Yes, any changes made to an employee's original benefit enrollment submission in BambooHR—whether through the employee profile, bulk enrollment, or importer—will be sent to the carrier. 

      The original submission from the enrollment window is sent to the carrier, and if you later make changes, the updated information will also be sent to the carrier. The initial enrollment submission remains unchanged and is not overridden. This process ensures a complete and valid data package is sent every time.

  9. If an employee is terminated in BambooHR, will that termination record be automatically sent to the carrier connection?
    • Yes, the employment status change and coverage end dates will automatically be sent to the carrier. However, we do not capture the termination reason for COBRA processing
  10. Will the carrier connection still work if my company has remote employees in the U.S. while their benefits are based in a specific state?
    • The data feed will be aligned with where your company is located (domiciled).
  11. What happens if an employee does not get on their insurance due to an API connection failure? What is your API service contract?
    • We have SLAs in place to ensure data accuracy, and if something happens, there are remedies in place to correct the data. Even though we take on the transactional piece of sending data to carriers, you are not absolved of your responsibility to audit your employee count with the carriers (typically done through your monthly billing) and to bring any discrepancies to our attention so that we may act upon it.
  12. Will beneficiary information for life insurance plans be automatically sent to the carrier?
    • No. Beneficiary information is not currently synced to carriers through carrier connections.
  13. Does a carrier connection always have to be established when there is a direct relationship with the carrier?
    • With our three-pronged approach, you have the option to choose which approach to use for sending enrollment data, meaning we do not require you to select one option over another. You can select what is best for you and fits your company's needs.