eBenefitSync™ - Benefit Plan Management Solution
 

Simplify Benefit Plan Management.

  • Create a single source of truth for Benefit Plan Data.
  • Increase operational efficiency.
  • Reduce admin costs.
  • Go to market faster.

 
 

Leading Benefit Plan Management solution that creates an end-to-end single source of truth.

Highly configurable benefit plan management solution

Highly configurable, modular and scalable solution.

Our market leading patent-pending SaaS solution for Benefit Plan Management that automates the end-to-end benefit product lifecycle. Creates single source of truth for benefits data and dynamically generates plan documents.

A benefit plan configuration solution developed by health plan professionals

The only solution developed by health plan professionals.

Unlike other cross industry BPM and PLM solutions, eBenefitSync is the only solution developed specifically for health plans and TPAs by health plan professionals. Its Modular Approach allows you to implement any or all modules in the order of your most critical pain points and priorities.

House all your benefit plans in one solution

House all your health plans in one solution.

eBenefitSync enables you to house all health plans (all LOB and market segments) and non-health product information in a single source of truth solution.  This presents a significant strategic advantage to 'cross-serve' the groups, members, agents, brokers with products across all lines of business.

 
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Why eBenefitSync?

eBenefitSync improves speed-to-market, accuracy, and cost-effectiveness of benefit plan design.

Data Accuracy

Increase data accuracy and consistency up to 80%

Speed-to-Market

Increase speed-to-market up to 70%

Data Reusability

Increase data reusability up to 95%

Claims Recoveries

Decrease claim recoveries up to 70%

Maintenance

Decrease Benefit Maintenance timeframes up to 60%
 
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eBenefitSync named "Sole Leader" in IDC's MarketScape.

IDC MarketScape: U.S. Health Plan Product/Plan Benefit Configuration Solutions

2016 Vendor Assessment of U.S. Health Plan Product/Plan Benefit Configuration Solutions.

Benefit Product/Plan Configuration Solution Vendor Assessment

Source: IDC, 2016

 
 

An end-to-end solution for eliminating disparate legacy systems and error-prone processes.

 
Easy benefit plan configuration
 

CONFIGURE.

  • Simplify configuration of benefit plans with intelligent decision support for sales, product development and document generation teams

  • Comply with configurable guardrails for regulations, business policy via centralized business rules.

  • Flexibly capture ALL types of benefit plans:

    • Commercial and Government

    • Standard and Custom

    • Individual, Small Group and Large Group

    • Ancillary (Dental, Vision, Pharmacy, STD, LTD, Life etc.)

 
Effortless collaboration across all benefit plan teams
 

COLLABORATE.

  • Engage all stakeholders via integrated use-case specific workflows vs. emails

  • Incrementally build benefit plans with inputs across teams

  • Annotate and track changes for regulatory and business communication content from single source

  • Robust audit trails enable compliance to regulatory agencies and external auditors

 
Generate benefit plan communication documents
 

COMMUNICATE.

  • Generate all benefit plan communications document materials from the single source – SBC, SoBs, ANOC, EOC, Contract, SPD, Amendment, Rider, QHP

  • Seamlessly integrate benefit plan information via ETL, Web API or Batch files to/from:

    • CRM (Salesforce, MS Dynamics, Siebel)

    • Core-Admin systems

    • CMS PBP for MA BIDs

    • Portals (Member, Provider, Customer Service, Broker, Agent)

    • Rating

    • Quoting

    • MDM

  • Support future AI / Machine learning initiatives via real time benefit explanation

 
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Frequently Asked Questions (FAQ's)

Please click on question to explore more

A. Health Plans often have thousands of benefits plans and products which they need to manage. Every year some new plans are created, and existing plans are updated to reflect competitive needs and regulatory requirements. Certain plan types, such as Medicare Advantage plans or Qualified Health Plans (QHPs) must be submitted to the government for approval by specific deadlines. All plans then need to have plan information fed to other systems to support claim payments, member support, group sales, etc. This end-to-end process of managing benefit plans is known as Benefit Plan Management.

A. Traditional benefit plan management processes can create a lot of issues that may lead to last-minute rush, significant manual efforts to manage and audit plans, and inaccuracies in data (and the downstream implications of these). Most of Health Plans maintain their benefit plan data in spreadsheets (aka benefit grids) and documents. During benefit plan configuration, these get emailed around in manual, error-prone process that frequently leads to version control problems. The traditional benefit plan management processes can lead to various challenges such as:

  • Managing version control
  • Core admin systems may require manual keying of the data introducing hard to find and costly errors
  • Due to version control issues and other factors, key downstream applications get different versions of benefits information
  • Manual processes make the benefit plan management slow, labor-intensive, expensive, and creates downstream errors
  • Benefit teams lose the opportunity to perform more productive tasks such as analyzing the market and consumer trends to offer improved products.

A. With a benefit plan management solution like eBenefitSync™ – Health Plans can automate end-to-end benefit plan management process while improving their operational efficiency by up to 75%. With its unique capabilities, Health Plans can create a single source of truth for their benefits data and can generate various benefit documents in a single click. With a benefit plan management solution, a Health Plan can reduce their process backlogs, increase data accuracy, and improve their speed-to-market. Having a single source of truth solution means Health Plans can edit data at a single entry point and have it reflect across the entire benefit plan. This not just improves valuable benefit product turnaround time; it can also help Health Plans avoid losses due to incorrect data entry.

A. To help you streamline your benefit plan processes, eBenefitSync™ ingests your existing benefit grids to create the single Source of Truth for all benefits information. From here, you can configure your plans to comply with guardrails for regulations and business policies via centralized business rules. Its Modular Approach allows you to implement any or all modules in the order of your most critical pain points and priorities. eBenefitSync™ enables you to house all health plans (all LOB and market segments) and non-health product information in a single source of truth solution. This presents a significant strategic advantage to 'cross-serve' the groups, members, agents, brokers with products across all lines of business.

A. Simplify Healthcare’s solution, eBenefitSync™, is the only solution in the market built with a full understanding of the benefit plan management process in mind. eBenefitSync™ starts by ingesting your existing benefit grids and documents to create the single Source of Truth for all benefits information. From here, you can configure your plans to comply with guardrails for regulations and business policies via centralized business rules. With eBenefitSync™, you can collaborate with all stakeholders to manage your plans with the robust workflow capability including routing, notifications, and a logging function to track all changes. Then you can communicate needed information to members with required documents and to other parts of the health plan.

 

 

Case Studies.

eBenefitSync | Large Health Plan Consortium Case Study

Large Health Plan Consortium: 70% Faster to Market

eBenefitSync improved their speed to market by 70% and reduced data redundancy by 90%.

eBenefitSync | Large TPA Case Study

Large TPA:  Automating Onboarding and Renewals

eBenefitSync improved their speed to market by 70% and reduced customer service quality by 70%.  

eBenefitSync | Mid-size Health Plan Case Study

Mid-size Health Plan:  Integrating with Core Admin

eBenefitSync improved data reusability by 98% and speed to market by 50%.
 

 
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