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.

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! You can use the CSV data file export and/or PDF Form Builder to send enrollment data. 
  • If your carrier is one of our partners, proceed to Step 2.

Step 2: Contact your carrier.

This step is to confirm that your carrier will allow a connection. Do not have your carrier reach out to BambooHR at this point. First, contact your carrier and broker and let them know you want to convert your current process to an automated one with BambooHR. You can fill out the following email template and send it to your broker/carrier to work with you to complete. Once completed, you will use the provided information to set up new benefit plans or verify existing benefit plans in BambooHR, according to your carrier-specific setup requirements.

When communicating with the carrier, you will need to confirm the following details:

  1. Can the carrier connect their platform to your BambooHR account?
  2. Do you meet the carrier’s requirements for them to receive data electronically?
  3. Is the carrier capable of a carrier connection with their current insurance carrier administration/billing platform?
  4. What is the desired activation date? (The date is what you will enter in BambooHR to begin the automated data feed.)
  5. When do you want the first file to be sent?

In addition to the above details, obtain the account structure form from your carrier to set up group numbers and plan IDs for each benefit plan in BambooHR.

  1. Are you offering the same benefit plans?
    • What are the plan IDs?
  2. Will you be offering new benefit plans?
    • What are the plan IDs?
    • What are the coverage effective dates?
Email template

Subject

Regarding Benefits Enrollment with BambooHR Benefits Administration: [Provide your company name and group number] 

Copy 

Dear [Name], 

We are considering implementing BambooHR’s benefits administration solution and plan to convert our current process with you to BambooHR’s automated Carrier Connections. To do so, we need your help to complete the following information: 

  • Are we eligible to convert our current benefits administration process with you to the BambooHR Carrier Connections process of automated data feeds? BambooHR utilizes Ideon as its third-party data integration partner.
  • Please confirm your company EIN tax ID.
  • Please provide a copy of our account structure so we can correctly set up our benefit plan details in BambooHR and ensure a smooth connection process. (Please note this is not a request for an EDI file feed yet, simply a request for information to ensure our plans match, etc.)
    • The group number associated with our account
    • The individual plan IDs associated with our account
    • The class codes if more than one associated with our account
    • Any state, zip code, or unique eligibility requirements on a plan level, etc.
  • What do I need to do to make the transition from my current process to the BambooHR automated one?
  • Once our connection testing is completed, what information/confirmation do we need to provide to you to push the connection into production?
  • Once our data sync is in production, what access levels do I have with my administration portal?

Please provide the requested information to me as soon as possible. 

Please note that we anticipate leveraging BambooHR's data integration partner, Ideon, to send you our enrollment and eligibility data.  They will be contacting you once our system is set up and ready for testing. Please do not reach out to BambooHR directly.

Thank you for your help with this. If you have any questions, please give me a call.

 

Sincerely, 

 

[Your Name]


Step 3: Ensure benefits setup is complete.

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 Ideon, that our system have 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.

After setting up the carrier connection, you can expect your enrollment data to be sent to your carrier automatically (typically on a weekly basis). 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 partner, Ideon), but Aetna, Kaiser, and Anthem do not.
  2. Which file format is utilized?
    • We have an API connection to a third-party vendor, Ideon. They send individual files to the carriers, with the most common type being an 834 EDI file. However, a few carriers have an API with 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, but please keep in mind that benefit election changes outside of the admin approval page (e.g., Benefits tab on the employee profile, bulk enrollment tool, benefits importer) will not sync to the carrier. We recommend communicating with your carrier as soon as a change outside of the approval page is made.
  8. If an employee is terminated in BambooHR, will that termination record be automatically sent to the carrier connection?
    • If you have a carrier connection with one of our partners and properly terminate the employee with their benefits, the termination record will be automatically sent to the carrier. To properly terminate an employee's coverage, you will first need to terminate the employee in BambooHR and then open a qualifying life event (QLE) window.
  9. 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).
  10. What happens if an employee does not get 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.
  11. 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.