1. Let your carrier and broker know that you want to convert from the current process to an automated one with BambooHR. This step is to confirm that your carrier will allow a connection. Do not have your carrier reach out to BambooHR at this point.
   • You can fill out the email template and send it to your broker/carrier to work with you to complete.
   • Once completed, you will use this information to set up your plans in BambooHR. 
     • If you are an existing Ben Admin customer, review your places in BambooHR to confirm details.
2. Confirm that your carrier qualifies for the automated data feed. 
   • Each carrier has requirements you will need to meet in order for the carrier to receive data electronically.
3. Verify that you meet the carrier's requirements.
4. Confirm that your carrier is capable of a carrier connection integration with their current insurance carrier administration/billing platform. 
5. Obtain the account structure form from your carrier to set up group numbers and plan IDs in BambooHR.
6. Agree upon a desired activation date. The date is what you will enter in BambooHR to begin the automated data feed.

For all carriers

• Can I convert my current process to the BambooHR carrier connections process of automated data reporting?
• What is the desired carrier connections start date?
• When do you want the first file to be sent?
• What is the plan year/benefits start date? Are they the same?

AND

For existing carriers

• Carrier name
• Carrier EIN
• Are you offering the same plans?
  • What are the plan IDs?
• Will you be offering new plans?
  • What are the plan IDs?
  • What are the coverage effective dates?
• What is your current process of getting data to your carrier?

For new carriers

• Carrier name
• Carrier EIN
• Are you offering the same plans?
  • What are the plan IDs?
  • What are the coverage effective dates?

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; we are looking to validate:
  • 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 zip code or unique eligibility requirements on a plan level
• 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]

If you qualify for activating carrier connections, you will need to ensure that all of your benefits-eligible employees are part of a completed enrollment window. They may lose coverage or be excluded if they are not listed as a benefits-eligible employee in Benefits Administration. 

1. Once you have the completed responses from your carrier, make sure your BambooHR account has a plan year set up with benefit plans (coverage effective dates, plan IDs, carrier details, etc.) and add the carrier's details (EIN, group number). This will help ensure accuracy in data reporting. 
2. To avoid data errors, review the plan year on the Plan Years tab to make sure you have all required company, employee, and dependent data. If the plan year has missing data, you will need to add the correct information before having enrollment data sent to your carriers.
3. After verifying the required information, you will need to run an enrollment window in your account for your employees to make their benefit elections for the plan year during open enrollment 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.
4. Approve all benefit elections for the enrollment window in your account.
5. Send the completed responses from your carrier to [email protected]. They will forward the information to the Carrier Connections team.
6. 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. 
7. Once your file is in production, you will receive a notification if there are any file discrepancies. You will be responsible to fix any data errors in BambooHR by following the workflow listed below.
8. After setting up the carrier connection, you can expect your enrollment data to be sent to your carrier automatically (typically on a weekly basis). 
   • Once enabled, the 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.

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 complete before sending enrollment data to your carriers.

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 a manual adjustment to an employee's benefits as opposed to coming from the enrollment process, will that adjustment still sync to the carrier?
   • Yes. 
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.