Guest blogger Karrie Andes is in the house today. She’s a benefits pro like you, so be nice to her. Enjoy, and I’ll be back posting tomorrow. —K.B.
In high school, I remember sitting for hours typing documents on printing shells for my school’s Ditto machine. While my peers rushed to class in the afternoons, I sat silently typing quizzes, handouts and tests. Other students called me “little miss goody two-shoes,” but I didn’t mind. I knew working in the school office would teach me the necessary skills to succeed.
A decade later, armed with my expert office skills, I was processing enrollment forms by hand. Years passed, and I started keying enrollments into vendor online systems. Then came the loadable CSV or Excel spreadsheet for open enrollment sent directly to a carrier, which really impressed me. Even George Jetson would have been proud of my work.
This century is very different. We’ve developed online benefit portals and with only a few keystrokes, a complete file is sent on an electronic data interface (EDI). My simple view is it’s like happy hour for a bunch of computers — one system talks to another, then another, and hopefully they’ll all have cheerful dispositions. When happy hour prices go sour, so do the error messages I receive.
Over the past year, I’ve been knee-deep in EDIs. I’ve learned that everything is not always as it seems. Interface files were designed to speed up delivery, automate enrollment changes and streamline communications between the provider and customer. But if you’re not paying close attention to what is being sent, or what is being processed on the other side, disaster strikes.
In many cases, providers do not deliver processing reports, but rather, the client is expected to log into a website and grab reports. If these reports aren’t monitored, and errors aren’t corrected, it could mean dollars down the drain.
Employers don’t want to deal with COBRA penalties, terminated members left on a plan or unhappy new hires who don’t get their enrollment cards on-time. But if you ignore any of your benefit EDI processes, that’s exactly what you’ll get.
Let’s say an employee moves from full-time to part-time and loses benefits. A loss in coverage results in an opportunity for COBRA. Our system tends to be testy at times — if information isn’t entered just right, they won’t show up on the feed, and that’s a problem for me. Likewise, I have to make sure our COBRA provider has their system rules set up correctly. If I have end-of-the-month coverage and they send notices out with the wrong dates, the result is a whole lot of grumpy ex-employees.
Breakfast used to be about Froot Loops. Now, it’s fresh coffee and analyzing loops of data. I know more about 834 file types, FTP gates and file encryption than I ever intended to. My days are filled with audits, data sampling, test scenarios and I now know the VLookup Excel function like the back of my hand.
High school sure seemed easier. Then again, I really don’t miss the typewriter or ruined clothes spotted with blue ink. That Ditto machine never did like me.
Guest blogger Karrie Andes, SPHR, is a former EBN contributing editor and senior benefits manager for PGi in Kansas City, Mo. She can be reached at email@example.com. Do you have your own EDI experience? Share your stories in the comments.
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