Carrier Fulfillment

  • 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.

Group Tasks

  • Open enrollment
  • New group enrollment/switch carrier enrollment

Individual Tasks

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

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

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.

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?

  1. Click on the specific fulfillment task, scroll down to Send Forms and click the arrow.
  2. Add the corresponding email address, subject line, and additional information you would like to include in the body of the email.
  3. 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?
  1. 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.
  2. 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

  1. Click on the checkbox for the task that you want to assign out.
  2. Click Assign icon.
  3. Select Assignee.
or
  1. Click on the task to open the task box.
  2. Select Assignee from the drop down menu at the top right of the task box.

Closing Tasks

  1. Click on the checkbox for the task that you wish to close out.
  2. Click Close Task button that populates at the top of the fulfillment inbox.
or
  1. Click on the task to open up the task box.
  2. Click Mark as Closed button at the top right of the task box.

Bulk Assign/Close Tasks

  1. 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.
  2. When all applicable tasks are chosen, click Assign to bulk assign or Close Tasks to bulk close.

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.

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.  
2. 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
3. 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
4. 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
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

Zenefits does not support/generate employee waivers at this time.  

Overview: Users with to the Benefits Administration and fulfillment permissions are 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 o 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 selected the vertical ellpses  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.
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.

Overview

Task details provide fulfillment users to quickly view an employee's enrollment information that needs to be submitted to benefits carrier(s).  To access task details, simply click on one of the open/closed tasks in your dashboard.  Once you do, a modal will populate 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 the 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 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 an email notification.

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