Resolving Enrollment Errors After Broker Transition



Introduction:

A large client in the Aquaculture/Water treatment & Fishery industry faced significant challenges after transitioning from their previous broker to Benefit Group (BG) as their new Agency of Record (AOR). The client discovered numerous enrollment errors and omissions in carrier records and their BenAdmin system, impacting employee benefits and compliance. Benefit Group intervened to rectify the situation, ensure accurate enrollment, and establish compliance procedures.

Company Overview:

During the transition to Benefit Group as their AOR, they uncovered significant discrepancies in employee enrollment data, causing confusion and potential issues with benefits coverage.

Challenges and Objectives:

• Enrollment Errors: Employees were enrolled in incorrect plans with carriers and had incorrect tiers in the BenAdmin system.
• Claims Liability Risk: The enrollment errors exposed the employer to potential claims liability due to incorrect coverage.
• Compliance Gaps: The previous HR team failed to properly set up ACA (Affordable Care Act) tracking and reporting, increasing the risk of non-compliance and penalties.
• Payroll Vendor Refusal: The payroll vendor declined to assist with ACA reporting, further complicating compliance efforts.
• Late Payments: Late payments to vendors jeopardized the client’s benefits program and risked policy cancellations.
• The client’s objectives were to correct enrollment errors, mitigate claims liability, establish compliance procedures, and ensure timely vendor payments.

Benefit Group implemented a comprehensive solution to address the client’s challenges:

Carrier Updates: Worked directly with carriers to update employee elections, correcting incorrect plans and tiers.

Data Audit: Conducted a thorough audit of the BenAdmin system to identify and rectify discrepancies in enrollment data.

Compliance Documents and Procedures: Established required compliance documents and procedures for ACA reporting and other regulatory requirements, including Cafeteria Plan, Section 125, and QMSCO procedures.

Vendor Communication: Facilitated communication between the client and payroll vendor to resolve ACA reporting issues and ensure compliance.

Payment Tracking: Implemented a system to track vendor payments, ensuring timely payments and avoiding policy cancellations.

By demonstrating our expertise in compliance and benefits consulting, we aim to attract and serve clients who seek reliable guidance and support in navigating the complexities of employee benefits regulations.

Results and Impact:

Claims Liability Mitigation: Corrected enrollment errors, removing potential claims liability for the employer.

Compliance Assurance: Established compliance documents and procedures, ensuring ongoing ACA reporting and minimizing the risk of penalties.

Improved Vendor Communication: Facilitated effective communication with the payroll vendor, resolving ACA reporting issues..

Timely Payments: Implemented payment tracking, ensuring timely payments to vendors and avoiding policy cancellations.

Employee Satisfaction: Corrected enrollment errors and ensured accurate benefits coverage for employees, improving their overall satisfaction.

Conclusion:

This case study demonstrates Benefit Group’s expertise in resolving enrollment errors, ensuring compliance, and improving benefits administration. By working directly with carriers, conducting audits, and establishing robust procedures, we helped the client overcome significant challenges and protect their interests.

Key Takeaways:

1. Thorough audits and data cleanup are essential after broker transitions to ensure accurate enrollment.
2. Proactive compliance measures are crucial for mitigating risk and avoiding penalties.
3. Effective communication and collaboration with vendors are essential for smooth benefits administration.
4. Timely vendor payments are critical for maintaining benefits coverage and avoiding disruptions.