Premium Billing Onboarding: 8 Factors for Success

To make onboarding your customers onto an automated SaaS premium billing platform successful, here are eight questions to ask when exploring potential solutions.

1. Data ingestion. Does the platform ensure the ingestion of timely, consistent, and high-quality data from the enrollment, benefits administration, payroll, and carriers? The success of automated premium billing is based on the quality and timeliness of data that comes into the billing platform. It’s essential to find a solution that can ingest data from disparate sources such as enrollment/benefits administration systems, payroll, carriers, and others—such as COBRA and HSA/FSA administrators—to provide an integrated benefit summary and consolidated monthly bills.
   
   
2. Data syncing. Does the platform keep up with changes in employee status? Once the open enrollment period is over, the starting data cannot be depended upon to be the “source of truth” throughout the year. Make sure the billing solution architecture can keep in constant sync with changes in employee status, such as marriage, the number of children, joining or leaving the employer, promotions, disability leave, and any mid-year options for changes in coverage.
   
   
3. Data transmission. Does the billing solution automate the secure data transmission from all ecosystem participants? Given the sensitive nature of medical information, email is not an acceptable method of sending data that contain Personally Identifiable Information (PII) and Protected Health Information (PHI). When you attach a spreadsheet containing sensitive data to an email, you put your clients at risk. Secure technologies such as sFTP or methods such as secure API are vastly superior in minimizing risk.
    

4. Tailored reporting. Can the solution provide customer-tailored reports? Your clients are not the same, and neither are their reporting needs. There are multiple ways that your customers’ premium billing needs can vary. Some of the most common tailoring variations revolve around:

• • Subtotals
  • Displays
  • Subgroup billing, such as franchises, subsidiaries, departments, associations, school districts, multi-locations, etc.

Select a solution that gives you the flexibility to easily set reporting variables and criteria and create ad hoc reports. Providing customized reporting helps your customers monitor costs and activities and bolsters your value.

5. White labeling. Does the solution allow you to white label bills and reports under your brand? Which would you rather have: every report and portal having the solution’s brand front and center, or yours? You should be able to reap all the brand recognition benefits, value, and loyalty—at every opportunity. This benefits you in the present, but it also creates an essential relationship, “stickiness.” When re-enrollment rolls around again, your name resonates with key customers and is also top of mind for word-of-mouth referrals. Many firms are bundling services such as sales, enrollment, and premium billing to extend the value of the relationships.
   
   
6. Workflows. Does the solution understand each role or functional area that will utilize the system and its corresponding workflows? Premium billing touches on several functional areas, each playing its part. But that doesn’t mean all roles need access to all information and billing workflows. Security should extend end-to-end throughout the billing process, not just in data transmission (as discussed above). A secure billing solution is one with “least privileged access” capabilities, ensuring that only the minimally required data is shown to allow functionality, protecting you and your customers sensitive data. For even greater confidence in your billing solution’s security, look for one that has the HITRUST certification of the NIST cybersecurity framework.
   
   
7. Plan rules. Does the solution enable you to codify plan rules upfront? As mentioned above, each of your customers and their plan rules are different. Here are just some of the many ways your customers’ plans, and their specific rules and limitations for coverage, can vary:

• • Lookback periods (30, 60, or 90 days) can be dictated by carriers or state authorities
  • Day-of-termination or end-of-month wash rules
  • Age-based premium allocations
  • Requirements for voluntary benefits
  • Premium aggregation to cover several benefits
  • Self-funded or fully-insured medical
  • Self-bill or list-bill billing types
  • Offset arrears (current or future month)
  • Payroll cycle carrier aligned billing or monthly carrier invoices
  • Actual versus expected payroll deductions

Rules can even get more complicated. With the last two items above, the respective coverages can even vary within a single-employer plan.

Flexibility is vital in delivering the best experience to your customers. Make sure the automated billing solution you select can seamlessly incorporate all unique rules and limitations.

8. Timing. Does the solution allow you to onboard onto the platform at any time during the year, or does it have to coincide with the open enrollment period? In other words, are there limits on when you can onboard on the billing platform based on what’s easiest for the billing solution provider or for you? As you seek to provide the best for your customers and demonstrate your immense value, the door to better opportunities and decision-making shouldn’t be limited to a relatively small window once a year. A truly customer-centric—and tech robust—premium billing platform has the flexibility to onboard plans at any time during the year, the ability to sunset the coverages in the current plan year, build towards the new plan years, and accommodate trailing adjustments.