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Carrier Fulfillment

Fulfillment Methods

  • Manual Fulfillment Tasks: once elections are made in Zenefits, we will generate a task with the corresponding member enrollment form (for supported carriers) for submission to the carrier
  • EDI: Zenefits will push an EDI feed to carriers once a week to update all enrollment changes that have occurred in the Zenefits system.

For questions on if you qualify for EDI or for which carriers forms are supported, please visit this page. For any further questions please consult with your Customer or Account Executive, where applicable.


Please note that the following fulfillment methods are only available under certain conditions. Please connect with your Customer or Account Executive for more information.

  • API: this form of fulfillment is only available for groups on Ben Connect with certain carriers.
  • Portal Automation: a method of fulfillment that uses the carrier's secure enrollment portal to complete member enrollment transactions automatically.

Task Types

Group Tasks

  • Open enrollment
  • New group enrollment/switch carrier enrollment

Individual Tasks

  • New hire enrollments
  • Terminations
  • QLEs
  • Demographic changes
  • Open enrollment

Form Automation

Definition: Form automation is a feature Zenefits offers which pre-populates  carrier forms with employee and group data, for submission to benefits carriers.  

Functionality: 

  • For select carriers, Zenefits maps carrier forms, along with employee & group data fields, so as to populate election and demographic data automically into carrier forms to make carrier fulfillment more simple for admins and/or brokers.
  • Form automation is available for New Hire, Open Enrollment, QLE, and Termination task types.
  • Form automation is not available for demographic task types.  

To verify form automation is available for your group's benefits carriers, please check to ensure Zenefits supports your carrier & state for form automation

Frequently Asked Questions About Fulfillment

Who is responsible for handling my enrollments if my group doesn't utilize EDI?

  • For groups with a Certified Broker Partner, your broker team handles and completes carrier fulfillment directly with the carrier. As the group administrator, if you would like additional involvement in the carrier fulfillment process, please work with your CBP for additional involvement in the process.
  • If your group is not utilizing a Certified Broker Partner, your group is responsible for completing all carrier fulfillment.

What happens after a renewal is sent through EDI?

  • Once the renewal file is sent via EDI, the carrier will begin updating the group structure for the new plan year. During the period of time between the submission of the file and the renewal effective date, the carrier will no longer accept the previous plan year's production files. This is commonly referred to as a "blackout period."
  • During this period EDI  feed for that carrier will be in a "paused" state in Zenefits
  • Any enrollment changes during this period will need to be manually processed with the carrier by the broker or company admin, instead of being sent through the EDI feed. Tasks will populate on the Fulfillment Task Dashboard until the renewal effective date. 
  • On the renewal effective date the EDI feed for the carrier will be resumed. Any enrollment changes after that will be sent via the EDI feed. Please note, any enrollment changes for expired plans will need to be manually sent to the carrier.

Am I able to filter tasks in the fulfillment dashboard?

  • Yes. Using the filter section found on the left side of the page, you can sort tasks by carrier, effective date, task creation date, assignees, and task type.

How do I sort tasks?

  • You are able to sort tasks by utilizing ascending & descending sort at the top of each column.

How can I add notes when completing task in Zenefits?

  • Navigate to the task, click on Activity Feed, and you can leave notes in the text box. You can also use "@" to mention, or tag, other users.

How do I annotate proof of submission after I've completed a task in the carrier portal or submitted an enrollment manually?

  • Navigate to the task, and on the Task Details tab, scroll down to Proof of Submission field. Here, you can upload your proof of submission to the task.

How do I send enrollments directly from Zenefits?

  • Click on the specific fulfillment task, scroll down to Send Forms and click the arrow.
  • Add the corresponding email address, subject line, and additional information you would like to include in the body of the email.
  • Click Send Form.

When do forms populate in Zenefits?

  • Zenefits will generate forms automatically and prepopulate data into the form for specific supported carriers. Some examples include Anthem, UHC, Kaiser, Guardian, MetLife, and Principal.

How do I view tasks I've closed out in the past?

  • Scroll down to the bottom of the All Filter section on the left side of the Fulfillment page and click the link that reads See Closed Tasks.
  • You'll find all the historical closed tasks and be able to see who processed it and when.

What do I do if my carrier doesn't support form automation or my carrier is unsupported in Zenefits?

  • Please reach out to the Zenefits Customer Care team or your Partner Success Manager for requests to add new carriers or to add form automation for a carrier (Zenefits will review requests on an individual basis).

How do I assign tasks, close out tasks, or do either in bulk?

Assigning Tasks

  • Click on the checkbox for the task that you want to assign out.
  • Click Assign icon.
  • Select Assignee.

or

  • Click on the task to open the task box.
  • Select Assignee from the drop down menu at the top right of the task box.

Closing Tasks

  • Click on the checkbox for the task that you wish to close out.
  • Click Close Task button that populates at the top of the fulfillment inbox.

or

  • Click on the task to open up the task box.
  • Click Mark as Closed button at the top right of the task box.

Bulk Assign/Close Tasks

  • Click on the checkboxes for all tasks that you want assigned or closed or click on the checkbox that has the down arrow at the top of the fulfillment inbox.
  • When all applicable tasks are chosen, click Assign to bulk assign or Close Tasks to bulk close.

Group Tasks

Group Tasks are Carrier Fulfillment tasks that automatically generate after a group completes a company level enrollment event, such as open enrollment with current benefits carriers or a switch/new group enrollment, with new benefits carriers.  These tasks contain election information for employees that needs to be submitted to benefits’ carriers.

FAQs

What’s the difference between employee tasks and group tasks?? 

  • Group renewal tasks generate after a group completes 1) open enrollment 2) new group enrollment/switch carrier enrollment.
  • Employee tasks generate after an employee completes a unique event for that one employee  such as their new hire enrollment, a qualifying life event enrollment, a termination occurs, or an applicable demographic change occurs for the employee.
  • Group tasks include data for multiple employees because it is generated by a company wide event. 

What is the timing of group task generation?

  • Group tasks generate one day after the enrollment closes. 
  • Example: If your Open Enrollment ends on January 30th, the group renewal task will generate on January 31st.  

What information is included on group tasks?

  • Event Details:
    • Group effective date
    • Lines of coverage 
    • Event type
  • Reports:
    • Census Report
    • OE Change Report (if the group renewed with the same carrier)
  • Employees to be enrolled:
    • List of all employees that need to be enrolled.
    • Employee enrollment forms (if the group’s carrier has supported forms).

Will the data in a group task change?

  • No, the data included on a group task is a snapshot of employee elections as of the time the task was generated.
  • When reviewing old group tasks, data in reports and election information is a snapshot as of the date the task generated.  

What if employees make changes to their enrollment?

  • Zenefits will generate a new group task and include a new section in the task highlighting employees adds/removals/changes.  

If a new task generates, how do you know what enrollments were previously submitted to the carrier?

  • If the task was previously closed by a user, the system assumes the fulfillment was complete for those employees. The new group task will highlight employee enrollments that were sent and show the enrollments to be done in the new task  
  • The “Employees To Be Enrolled” section will show the list of employees for whom enrollment data needs to be submitted to the carrier.

Why is my task linked to another task?

  • If employees make changes to their elections after a group enrollment period, Zenefits will generate a new group task and link it to the previous task for referential purposes.

Upcoming changes on 6th September 2021

Starting 9 / 6 /2021 Group Tasks will be managed a little differently within Zenefits. The original Group Task will continue to generate once the Open Enrollment window has ended, but will not regenerate if there are individual employee changes. Instead, as new employee-specific changes occur, new member-level tasks specific to each employee will now be created, making it easier to track and manage changes. 

What if employees make changes to their enrollment?

  • Zenefits will create employee / member renewal tasks and not modify the group renewal task

If a new task generates, how do you know what enrollments were previously submitted to the carrier?

  • Member tasks will be created for changes after a group task is created. These need to be submitted to the carrier.
  • If a task is closed by a user, the system assumes the fulfillment was complete for those employees. 
  • It's good practice to check all open and closed tasks (both member and group) for a given renewal to ensure all tasks are accounted for.

Will group tasks be automatically closed and new ones created?

  • Group tasks will not be closed automatically except in one case -  if the insurance carrier for a line of coverage is changed and the group task is still open, then a new group task will be created with the new carrier. 

Are there any changes for which new member/group tasks will not be created?

  • There are few scenarios such as cost correction, contribution correction, demographic changes, etc. for which a user may not see new member tasks created as there is no impact to enrollment on the carrier side. In such cases member tasks will be created only if the group task is still open. If a group task is closed, then no tasks will be created. 
  • It is recommended that any enrollment change after the group renewal task is already closed, is communicated directly to the carrier, because the system generally assumes fulfillment is complete when a task is closed.

Why do I see multiple group tasks and also member tasks for renewal, for the same carrier and line of coverage?

  • The feature for creating member renewal tasks may have been released after group tasks were regenerated as per the old behavior. Ensure employee enrollments on the latest group task and any member tasks created post that, are submitted to the carrier.

Reconciling EDI Data

If you are working with a Certified Broker Partner, please work with them to make any updates you need to reconcile your EDI file feed.  Otherwise, if you are using your own broker, you will need to make these updates or work with your broker to update Zenefits.

Groups who utilize EDI on Zenefits may receive reports from the insurance carriers that require your attention.  Below are some common reasons why the insurance carrier may need your help in order to correct or clarify enrollment information and how to resolve the issue:

  1. Member/Dependent Dropped or Added
  • When a member is terminated from the company or when an employee removes a dependent from coverage, Zenefits sends the date this occurred via the EDI file.  However, sometimes the carrier still double checks this information, especially if there are many affected employees, to ensure this was not an error
  • This type of request will also be made when enrollments are changed with the insurance carrier directly and not with Zenefits.  To avoid this, make sure you and your employees are always making changes directly in Zenefits
  • To verify the enrollment event date in Zenefits, follow the steps on this page and respond to the carrier with the applicable information.  
  1. Demographic Mismatch
  • This occurs when there is conflicting information between Zenefits and the insurance carrier, such as SSN or DOB.  This can happen if information was changed directly with the carrier and not Zenefits or if an employee is waiting for a SSN to be issued and entered a placeholder in the meantime
  • If the data in Zenefits is correct, then you will need to indicate on the carrier report that their records should be changed.  If the carrier is correct, the data in Zenefits must be updated - any sensitive information will need to be updated by the employee.  Instructions to update dependent details can be found here, while employee details can be found here
  1. Effective Date Mismatch
  • There are several reasons why an effective date for a line of coverage may not coincide with what the insurance carrier has on file, some of which may be: the waiting period in Zenefits differs from the carrier's, a member enrolled outside of a normal enrollment window without a valid Qualifying Life Event, or the carrier just needs to confirm a QLE  event date
  • To verify the effective date sent by Zenefits, look up the information here.  If you need assistance updating the group settings in Zenefits, please reach out to your broker or, if needed, to Customer Care via the Support app on your Zenefits dashboard
  1. Coverage Tier/Plan Mismatch
  • If the carrier has an employee enrolled in a different plan or categorized in a different division code than what is listed in Zenefits, it will be flagged as an error.  This typically happens if changes were made with the carrier directly and not in Zenefits
  • If the data in Zenefits is correct, then you will need to indicate on the carrier report that their records should be changed.  If the carrier is correct, the data in Zenefits can be updated by following the steps here
  1. Other Things to Know
  • If you would like to change the person at your company who receives these emails from the carrier, simply let the carrier know and they will update their system.
  • If you have questions about how to read or update the information in Zenefits, you can reach out to our Customer Care team by clicking on the Support app in your Zenefits dashboard.  
  • If you have questions about how your group benefits are set up with the carrier, please reach out to your insurance broker.
  • If you have questions on the information contained in the report or need clarification on what is being asked, please reach out to the insurance carrier

Employee Waivers

Zenefits does not generate employee waivers on enrollment forms, but we do collect waiver reasons in the enrollment experience.  This information can be accessed via a report on the right side of the Benefits Administration app, titled EMPLOYEE BENEFITS WAIVER REPORT

Fulfillment Task Dashboard

Overview: Users with access to the Benefits Administration app and with fulfillment permissions will be able to access the fulfillment dashboard which contains all open and closed manual fulfillment tasks.  The fulfillment dashboard is available within the Benefits Administration app by clicking on the "Fulfillment" tab at the top of the page.  

Feature(s): 

  • By default, the fulfillment dashboard will display tasks that are currently open.
  • Users are able to sort the tasks using the filter pane on the left side of the screen.
  • To view closed tasks, users must use the filters pane and select "See Closed Tasks."
  • Users are able to assign / re-assign  tasks by selecting the task and clicking the "Assign" button.  Users are only able to assign / re-assign tasks to users with fulfillment permissions.  
  • Tasks will be automatically sorted based on the effective date of the event, as displayed in the "Effective" column.
  • Users are able to export all their open/closed tasks into a CSV  file as needed by selecting the vertical ellipses at the top right-hand corner of the screen and clicking the "Export to CSV" button.
  • Users can bulk close tasks by select multiple tasks in the dashboard and clicking the "Close Tasks" button at the top of the page. Note: Once a task is closed it cannot be reopened.
  • If a task is Opened or Snoozed and the employee makes changes to their enrollment, the system will close out the task, create a new Open one, and will contain a link to the closed task

Best Practices:

  • Close tasks after submitting enrollments to your carrier.
  • Snooze tasks if you are waiting for additional information from the group/employee for their enrollment(s). 
  • Designate a primary point of contact within your brokerge/ company to handle all fulfillment tasks.

Fulfillment Task Details & Activity Feed

Overview

Fulfillment Tasks help fulfillment users to quickly view an employee's enrollment information that needs to be submitted to benefits carrier(s).  To access the task details, simply click on one of the open/closed tasks in your dashboard.  A modal will open on the page, and you will be able to view the related enrollment details for your employee(s).

Task Detail/Activity Feed Fields & Definitions

Event Details

  • Effective Date - The effective date in an employee specific fulfillment task will align with the employee's enrollment effective date.  A group task effective date will align with the enrollment event date for your company (e.g., if you process Open Enrollment for 2-1-202X  the effective date for the group task will be 2-1-202X.  
  • Event Type - Event type reflects the type of enrollment you are submitting on behalf of the employee/group: New hire enrollments, qualifying life events, move to full-time, open enrollment, terminations, et al.
  • Affected Enrollments - Provides a list of the lines of coverage the specific task aligns with.  If you have the same carrier for medical, dental, vision, and life coverage, Zenefits will generate a single task for all those lines of coverage.

Employee Forms

  • Send Forms - The send forms feature allows users to create and send emails directly from the Zenefits product so as to allow users to quickly and easily submit enrollment information to carriers.  Note: As a best practice, it is recommended that users always cc themselves when using this feature so they can maintain a copy of their correspondence with benefits carriers.
  • View/edit Forms - Fulfillment users are able to view & edit forms by clicking the title of the attached enrollment form or by clicking the "pencil" icon to the right of the form name.  The intention of this functionality is to allow users to update basic information that could be missing when an employee completes their elections (i.e. group policy number).  If election information needs to change, employee should make those changes directly in the product or via paper form (if changes are submitted via paper form, ensure you update the employee's enrollment information in Zenefits or costs will be wrong).
  • Errors - Any missing data fields will prompt an error to populate within the task details page.  The most common form error is a missing group policy number.
  • Downloading forms - Fulfillment users can download the enrollment form by clicking the download button to the right of the form name.

Proof of Submission

  • File Upload - Fulfillment users can add attachments in to their tasks as they submit enrollment information to carriers.  As you submit enrollment information to carriers, you can upload screenshots of the carrier portal or downloads of email threads to reference later, as needed.

Employee Details

  • Personal Details - Basic demographic details that a broker/group need in order to submit enrollment information to a carrier.  If you use a carrier that Zenefits supports with Form Automation, Zenefits will map these details into the enrollment form.
  • Employment Details - Basic employment information such as hire date, salary, and job title.
  • Enrollment Details - Basic enrollment information such as lines of coverage, plan names, and enrolled dependents.  

Activity Feed

  • Comments - Fulfillment users are able to add comments / notes into a specific task so that you can annotate any special circumstances, information, or details while processing enrollment data with carriers. Note: @ commenting does not generate any email notification.

Flexible Fulfillment

Assigning Tasks to an Admin at the Company

For companies utilizing a Certified Broker Partner (CBP), Zenefits now supports assigning a default user to receive and process enrollments for either employee-level changes (new hires, terminations, and QLEs) or group-level changes (renewing existing plans or adding new lines of coverage).   The user can be an admin at the company with fulfillment permissions or an individual/generic inbox at the brokerage.

In order to enable this feature, navigate to the Company tab of the Benefits Administration app, scroll down to Fulfillment Task Responsibilities, click the edit pencil icon in the top right corner, select the user from the applicable dropdown menu, and click Submit.  If you do not see the desired user, they first need fulfillment permissions assigned (seen as: Complete tasks and receive notifications related to employee benefits).

Key Features:

  • If nothing is changed for a particular account, the system will continue to function the same way it does today
  • As soon as a default owner is set/changed, that person is the only one who will receive notifications about fulfillment tasks going forward
  • When setting the default task owner to the group, a  CBP  admin can only select the main company administrator (MCA).  The MCA can then change the default owner to anyone within their organization with proper permissions
  • The default user is able to assign individual tasks to others within their own organization with proper permissions
  • Company administrators can set themselves or others within their organization as the default task owner, but they cannot make changes once this role is set to users at the CBP
  • A  CBP admin can change the default owner to the main company administrator or to a CBP user at any time 
  • A CBP fulfillment user can see tasks assigned to an admin by clicking Include externally assigned tasks on the left side of the fulfillment page
  • A  CBP  fulfillment user can  re-assign  individual tasks from an admin to themselves, but cannot assign these tasks back to the admin
  • Clicking Change History in the Fulfillment Task Responsibilities section will show a log of all task owner changes

Assigning Tasks to a Third Party (GA)

For groups utilizing a CBP, Zenefits also supports assigning tasks to a third party, such as a GA, to be the default user to process enrollments for either employee-level or group-level changes.  In order to enable this feature, please reach out to Customer Care.

Key Features:

  • Third party users will have their own Partner Dashboard account that will give access to only the companies to which they are assigned the default task owner
  • Third party users will be granted  Fulfillment Manager permissions and be able to make edits to employee benefits data, if granted
  • Third party users will be able to be the default task owner across multiple brokerages
  • CBP admin users can associate one third party email domain to your brokerage
  • A  CBP  fulfillment user can see tasks assigned to a third party by clicking Include externally assigned tasks on the left side of the fulfillment page
  • A CBP fulfillment user can re-assign individual tasks from a third party to themselves, but cannot assign these tasks back to the third party
  • Clicking Change History in the Fulfillment Task Responsibilities section will show a log of all task owner changes
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