EDI Implementation at TriNet

What is EDI? 

EDI stands for Electronic Data Interchange.  

EDI is an electronic method of communication which allows for a secure, automated exchange of data. Exchanged data follows the same standard format, making it easier for entities to exchange data.  

How does EDI work at TriNet? 

All of your employee enrollment data entered in TriNet is transmitted to our third-party vendor, OneKonnect, who then formats and sends the EDI file to your insurance carrier(s). Therefore, it is important to maintain TriNet as the system of record to ensure that the information passed on is accurate. 

What does the EDI implementation process look like? 

EDI implementations typically take between 8-12 weeks to complete. Exact timelines vary depending on several factors including carrier processing timelines, unique file requirements, and how quickly TriNet receives responses from your company and/or the carrier(s).  

During EDI Implementation, you will be asked to do the following:  

• Review and confirm the policy numbers in TriNet are identical to carrier records, updating TriNet as needed.  

• Provide TriNet with the EDI file specifications for all carriers. Your carrier will be able to provide this to you. 

• Provide contact information for i) your carrier’s Account Manager EDI and ii) any EDI analysts who will be working on EDI setup. 

• Provide a carrier enrollment census (the one that shows enrollments on the carrier’s system). 

• Provide the name of a company admin who will be responsible for responding to and reconciling any questions and/or errors the carrier raises regarding your EDI file(s). 

Until EDI implementation is completed, eligibility changes need to be handled manually by you and/or your broker. TriNet will continue to send you fulfillment tasks with the eligibility data needed to enroll/terminate employees directly with your insurance carrier(s). You can learn more about fulfillment tasks in our Help Center:  

• Frequently Asked Questions About Fulfillment  

• Fulfillment Task Dashboard 

• Fulfillment Task Details & Activity Feed 

What happens after our EDI files are moved to production?  

When an EDI file is implemented and passes the testing phase, the carrier approves it for production. After a file is moved to production, it will send all new enrollments, changes, and terminations to your carrier(s) on a fixed schedule, usually once a week.  

Many carriers send EDI reconciliation reports after processing an EDI file. This report is sent to the reconciliation contact provided to TriNet during the implementation process. More information about the types of questions carriers typically have and how to respond can be found here. 

What happens at renewal? 

Sometimes changes need to be made to your EDI file(s) when your benefits renew. TriNet will reach out before your renewal to collect any necessary information to ensure your enrollment data is transmitted smoothly. 

If you are changing plans, new plan IDs are usually issued, and changes will need to be made to your EDI file. If you are changing carriers, a new EDI implementation will be needed. Please note that EDI implementation timelines can run longer than 8-12 weeks if they take place during Q4, as carriers are often busiest during that time.  

Many carriers cannot accept EDI files for the current plan year once the Open Enrollment file is sent. Unless otherwise requested, TriNet will pause EDI files 1-3 days after your Open Enrollment period concludes. EDI files will then resume after your renewal date. During this time - often referred to as the ‘Black Out Period’ - manual tasks will generate for any enrollment changes. These tasks will need to be completed by a company administrator and/or your broker.   

Who do I reach out to if I have questions? 

If you want to discuss adding EDI to your current subscription, please contact your Customer Relationship Manager or TriNet Support. 

If you have questions on your EDI Implementation or an active EDI file, please contact edi@zenefits.com for assistance. 

Is my company eligible for EDI? 

Many carriers have criteria that a company must meet to set up an EDI file. For example, Aetna requires 100 enrolled employees for a company to be eligible for EDI. Please review this Help Center article for full list of approved carriers & EDI compatibility. 

How much does EDI cost? 

EDI costs vary based on a few factors, such as your company size and whether you are working with one of TriNet’s broker partners.  

Billing for EDI begins when the contract is executed and continues throughout EDI setup.