New Companion ‘Application Acknowledgement’ Specification Provides Foundation For Efficient Enrollment Data Error Handling.
Employers, benefits services outsourcers, and insurers have an important new tool for improving the speed and reliability of enrollments in employee benefit plans. The HR-XML Consortium has approved an updated version of its benefits enrollment standard. The newly revised specification includes a variety of improvements as well as greatly expanded implementation guidance and examples. A companion “Application Acknowledgement” specification provides a means for efficient handling of enrollment exceptions and errors.
The HR-XML Consortium’s Benefits Enrollment specification is an open, freely available standard designed to make it easier for employers, plan record keepers, and health plans to exchange enrollment and eligibility data. “As an XML-based standard, the HR-XML Consortium’s Enrollment specification is the clear choice for organizations wanting to move from batch to near-real- time enrollment processes,” according to Kelly Cohen, Hewitt Associates Connections Strategic Initiatives Leader and co-chair of the HR-XML Consortium Enrollment Workgroup.
The updated Enrollment specification, like the original, was developed so that it can be readily transformed to the legacy EDI transaction sets mandated under the U.S. Health Insurance Portability and Accountability Act (HIPAA).
The companion Application Acknowledgement specification targets the complex and time-consuming task of handling exceptions following an initial enrollment transaction. The Application Acknowledgement contains information on partial successes, errors, and other exceptions that must be resolved or reviewed.
“A better way to handle exceptions has advantages for all stakeholders in the enrollment process since resolving exceptions is much more time-consuming and expensive than the initial transmission of enrollment data,” according to Chuck Allen, HR-XML Consortium Director. Of course, streamlining the error resolution process is extremely consequential for plan participant satisfaction,” comments Allen.
Many of the improvements to the Enrollment specification, documentation, and examples were directly the result of HR-XML’s “Benetest Program.” This program, which included the participation of leading benefits outsourcing companies (Fidelity and Hewitt) and leading insurance carriers (MetLife and United Healthcare) involved a year-long program of pilot testing in preparation for putting the enrollment specification into production.
“We were pleased to be a part of the process to enhance the HR-XML standard,” said Mark Hammersmith, senior vice president, MetLife Information Technology. “This is a perfect example of how information technology and the business units work together for the benefit of our customers.”
A second phase of the Benetest Program will focus on scenarios using the new Application Acknowledgement specification as well as additional enrollment scenarios. Insurance carriers, benefits services outsourcers, and other HR solution providers interested in joining the second phase of this program are urged to contact Chuck Allen, HR-XML Consortium Director (chucka@hr-xml.org).
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