Meet the Shifting Demands of Benefit Plan Management with eBenefitSync™

A leading benefit plan management solution that creates a single end-to-end source of truth and streamlines claims processing.

Improve Data Consistency, Accuracy, and Accessibility

Industry Challenge

  • Homegrown legacy systems and inefficient processes
  • Spreadsheet driven benefit product development
  • Multiple sources of truth

Impact

  • Benefit data inaccuracies
  • Inconsistency of data across systems
  • Reduced Star ratings

Our Solution

  • Establishes a single source of truth
  • Configurable to embed any business uniqueness
  • Offers omnichannel integrations/experience
  • Benefits all stakeholders possible – list all
Discover how we helped a mid-size health plan integrate benefit plan data with their Core-Admin from a single source of truth.
Get the Full Customer Story

Automate Workflows and Increase Collaboration

Industry Challenge

  • Multiple handoffs within and outside teams to complete commercial benefit product lifecycle or custom group benefit creation
  • Manual reviews for audit of product
  • Manual review of documents that need to be generated for filing and for members

Impact

  • Misinterpretations and errors
  • Process inefficiencies
  • Strained teams due to last minute rush for filings
  • Compliance challenges

Our Solution

  • Enhanced collaboration to incrementally build benefit product
  • Configurable workflow
  • Automated validations and additional governance as applicable
Discover how we helped a health plan improve efficiency, reduce administrative costs, and increase speed-to-market with eBenefitSync™.
Uncover the Customer Success Story

Improve Compliance and Efficiency

Industry Challenge

  • Manually creating filing-related documents after building all products
  • Manually building member communication documents
  • Teams performing repetitive tasks
  • Managing material manually without a single source of truth

Impact

  • Inefficient utilization of manpower
  • Delays in product launches
  • Compliance fines and errata

Our Solution

  • Allows setting guardrails for product build to ensure products are accurately built
  • Uses the guardrails to automate the generation of range documents for filing
  • Leverages language repository for omni-channel reuse of language
  • Any document supported for benefits information – list docs

Highly Configurable, Modular, and Scalable Solution

Industry Challenge

  • Highly dynamic and competitive market
  • Continuously evolving CMS and state regulations
  • Corporate policy implementations for benefits

Impact

  • Reduced focus and effort on innovation/creativity to design benefits
  • Increased last-minute efforts to handle regulatory changes
  • Inadequate focus on staying competitive

Our Solution

  • Easily configures any complex benefit design
  • Modular to address specific pain points
  • Scales with your growth into states and markets

Why eBenefitSync™ ?

Work smarter and faster with eBenefitSync™! Enabling Payers, TPAs, and ASOs to drive agility by leveraging automation to remove manual congestion, increase operational efficiency, control risk and cost, and accelerate speed to market.
Data Accuracy
80%
Speed to Market
70%
Data Reusability
95%
Claims Recoveries
70%
Maintenance Timeframes
60%
Industry-leading solution to solve commercial benefit plan management challenges

Choose an end-to-end solution or select any module to solve specific pain points

Our benefit plan management solution can be molded according to your business. Select from our integrated modules that suits your business to address your pain points and maximize investments.
.Source

Benefit Data Management

  • Establish a single source of truth
  • Automate end-to-end benefit product lifecycle
  • Annotate and track changes for regulatory and business communication content
  • Automate audits
  • Eliminate Excel grids
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.Filing

Filing Automation

  • Simplify Large Group filings (and for ACA in some states)
  • Automate SOB/Handbooks/Contracts/EOCs
  • Annotate and track changes for regulatory and business communication content
  • Enable omni-channel language reuse
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.Integrate

Benefit Data and System Integration

  • Integrate single source of truth across the enterprise
  • Integrate via RESTful APIs, Event-based APIs, Data streaming via KAFKA or Event Hub, ETL, batch file
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Integration of other solutions with eBenefitSync™ ecosystem

eClaimsEngine™ – Our claims configuration solution, integrates as a component of eBenefitSync™ to configure your commercial plans’ benefits data at one place with intelligent decision support, eliminate repetitive data entry into Core-Admin and other systems, keep your claims system up-to-date, and automate the maintenance of your benefit configuration.
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Our Success Stories

Leading health plans rely on Simplify Healthcare to work smarter, faster, and optimize operational efficiency. Read about our success stories and learn how we have enabled higher client satisfaction.

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A Large Payer Improved SBC Generation Timelines by up to 50% with eBenefitSync™

A large Healthcare Payer on the East Coast with more than half a million members and a very high growth rate was challenged with an outdated tool and inefficient SBC generation process. The Payer creates more than 7,000 SBCs every year. It was looking for a solution that could accurately auto-generate SBCs and integrate SBCs to the central data repository.

Automate SBC Generation and Integration to Central Repository

Automated SBC Generation

Reduced the time required to generate SBCs by up to 50%.
Improved Compliance

Enabled the downstream of compliant documents to targeted systems
Streamlined Workflows

Created a robust and efficient workflow that boosted productivity and efficiency.
Automated Exporting of SBCs

Enabled transfer of SBCs to the client’s central data repository in a few clicks.
 

Based on all the challenges we faced, we wanted a single source of truth to provide everything we needed for SBC integration. We teamed up with the Simplify Healthcare Team to create not only the SBCs but the Metadata and .csv files needed to move the SBC internally. This streamlined our whole process.

–Senior Technical Business Consultant

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A Large Health Plan Automated its State Filings and Benefit Plan Configuration With eBenefitSync™

A large health plan in the Northeast, providing small and large group coverage and serving more than a million members, needed a solution that could ensure all its benefit information from thousands of plans was up-to-date, reusable, and available enterprise-wide. It also needed to expedite the benefit plan development process and compliance by automating state submissions, a regulatory mandate.

Automate State Filings and Benefit Plan Configuration

Access to a Single Source of Truth

Eliminated 95% of data redundancy and minimized errors
Reduced Operational Costs

Achieved the ability to seamlessly suspend and reinstate products and plan packages in real-time
Automated State Filings

Automation of state filings process by generating necessary documents accurately in a few clicks
Improved Member Satisfaction

Improvement in member service through better manpower allocation resulting from efficient processes

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A leading Payer reduced quotes to claims configuration processing timelines by 50% with eBenefitSync™

A leading health plan on the East Coast was challenged due to disparate legacy systems and manual processes across the account operations unit. Their complicated quotes to claims configuration processes were slow and prone to errors and took an average of 23-37 calendar days for varying complexity plans. They were looking for an end-to-end benefit plan management solution to redesign and streamline the operational processes, reduce the number of manual steps, save time from quotes to claims processing, and get groups into production.

Reduce quotes to claims configuration processing timelines by 50%

Shorter processing time

Helped in achieving zero claims processing errors with shorter processing time and fast turnaround of the products.
Performance Optimization

Helped in reducing the quotes to claims configuration processing time to 10 calendar days from an average 23-37 days.
Improved product setup time

57% reduction in the average product setup and 64% time saved in the end-to-end group setup time.
Savings in non-claims activities

57% savings in non-claims activities which helped in reducing time and cost and achieve operational excellence.
 

eBenefitSync™ has been a tremendous success, and we have met or exceeded all of our goals! We have gained significant efficiencies while eliminating costly manual errors. We cut the end-to-end group setup time by 64%, and there have been zero claims processing errors from the plan setup.

–Director, Operations

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A large Payer reduced its benefit product build timelines by 80% using eBenefitSync™

A large health plan on the East Coast with more than half a million members and a very high growth rate was challenged with manual, outdated, and error-prone benefit product configuration processes. It was an ongoing challenge for the health plan to streamline enrollment period activities and other benefit plan management processes without any last minute back and forth. To improve the benefit plan management processes, they set a goal of reducing their product build timelines to 7 calendar days.

Reduce benefit product build timelines by 80%

Faster product build timelines

80% reduction in the benefit product build timelines using a single source of truth.
Faster optimized processes

The benefit plan management processes reduced from an average of 18 calendar days to 3.5 calendar days.
Reduced claims recoveries

Reduction in the errors impacting the claims management processes with faster turnaround time.
Simplify plan management

Faster optimization and automated processes to deal with high volumes of new groups and renewals.
 

The eBenefitSync™ tool has enabled us to greatly reduce turnaround times while improving and maintaining quality results. Our performance results during this past Open Enrollment cycle were our best to date; and we attribute those results to the combination of people, process and technology- with the eBenefitSync™ technology being a key contributor to our outcomes. We view eBenefitSync™ as a true partner and look forward to our continued collaboration.

–Director, IT Delivery who has accountability for the Product configuration team

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A consortium of large Payers improved speed to market by 70% and reduces data redundancy by 90%

A consortium of large health plans was challenged by benefit plan data proliferation across their IT ecosystem. Their end-to-end benefit plan lifecycle was error-prone with disconnected manual processes involving a series of bandaid solutions. Additionally, the consortium had large health plans with conflicting priorities, which prevented a “one size fits all solution.”

Create a single source of truth for benefit plans and improve speed to market by 70%

Faster speed to market

Improved speed to market by up to 70% by reducing the renewal process time from 28 hours to 4 hours.
Improved data quality and consistency

Reduced data redundancy by up to 90% and improved data accuracy and consistency by up to 80%.
Improved processes and efficiency

Reduced benefit errors by up to 70% and improved process efficiency by up to 67%.
Improved member satisfaction

Significant improvement in member Provider satisfaction.

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A large TPA consolidated over 250 pages of Group and plan data and automated documents

A large TPA was struggling with a tedious manual process for onboarding new groups and renewing them. Their process involved capturing benefit plan and new group onboarding data across 20+ disjoint documents with 250+ pages each. In addition to this, the SBC, Benefit Matrix, Faxback, and SPDs were generated manually.

Automate onboarding and renewals and improve customer service quality by 70%

Faster speed to market

80% improvement in speed to market with data consolidated in a single source of truth.
Faster turnaround time

Automated document generation provided a fast turnaround time to TPA client change requests.
Robust workflow process

A robust workflow process ensured all the stakeholders were informed and data was well organized and loaded by TPA.
Simplify document management

Auto-generation of key collateral materials and accurate management of benefit plan and new group onboarding data.

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A midsize Payer integrates Core-Admin systems with a single source of truth to reduce data redundancy by 98%

A mid-size health plan wanted to optimize the benefit plan implementation on the Core-Admin platforms. The following were their key pain points:

  • Significant data redundancy which prevented them from effectively testing and troubleshooting
  • Integration with Salesforce – a lot of the front-end information was captured in the CRM tool that had to be re-keyed
  • SBCs, QHPs, and other document generation – the manual processes were time-consuming and error-prone

Integrate with Core-Admin systems and improve data reusability by 98%

Faster Core-Admin integration

Faster Core-Admin platform benefit product build in less than 4.5 calendar days using a single source of truth.
Improved quality scores

Improved quality scores by up to 95.7% across all touchpoints using automated benefit plan management solution.
Faster Implementation

Reduction in average renewal time per product to 13 mins and new group implementation time to 3 hours.
Increase in data reusability

Improved data consistency within the Core-Admin system and data reusability by up to 98%.

Listen to our Customers

''Working on a few benefits product development and enhancement projects, I had the opportunity and pleasure of working with Simplify Healthcare. I found the team very enterprising, innovative, and committed, with the way they executed their responsibilities, overcame challenges, explored solutions, and solved problems.''
— Benefits Implementation Manager
''They help teams to do their jobs better and faster by dummy-proofing various aspects of the product build. eBenefitSync™ enables and encourages consistent product builds, but allows for group-specific benefit requests.''
— Former Health Plan CIO
''What I appreciate about Simplify Healthcare is that they anticipate what will be needed to complete the entire project end-to-end, which minimizes late project life cycle budget increases.''
— Benefits Testing Manager

Frequently Asked Questions (FAQs)

Here are the answers to the most frequently asked questions about implementing end-to-end benefit plan management solution and partnering with Simplify Healthcare.

1. Why use a ready solution for benefit plan management?

eBenefitSync™ is a turnkey solution specifically designed for Payers, TPAs, and ASOs. This makes it a ready-to-go solution that seamlessly integrates with the existing technology infrastructure and starts performing without a lot of time and money on customization and implementation.

2. What are the top three challenges that eBenefitSync™ solves?

eBenefitSync™ solves the following top three challenges:

  • Establishes a single source of truth to ensure data accuracy and consistency
  • Automates accurate document generation to improve compliance
  • Eliminate data and team silos to improve operational efficiency

3. Can I create a single source of truth by importing existing data?

Users can import their existing benefits data in eBenefitSync™ to create a single source of truth for Large Group, Small Group, and Individual benefit plans.

4. Can I manage changes without going through IT and deployment?

eBenefitSync™ comes with easy-to-use administrative screens to allow non-technical staff to define and maintain configuration rules with precision control.

5. What are the processes automated by eBenefitSync™?

eBenefitSync™ automates the following processes in a benefit plan’s lifecycle:

  • Plan design, configuration, and maintenance
  • Workflows
  • Documents
  • Filing
  • Reporting
  • Sales

What's Trending

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Press Releases

A leading Health Plan on the East Coast reduced their quotes to claims configuration processing timelines by 50% with eBenefitSync™

Simplify Healthcare, a leading healthcare technology solutions provider, announced that a leading Health Plan on the East Coast was able to automate its end-to-end benefit and claims data setup processing system with eBenefitSync™.

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A large Health Plan on the East Coast configured its benefit product builds in 3.5 calendar days

Simplify Healthcare, a leading healthcare technology solutions company for Payers, is pleased to announce that their benefit plan management solution, eBenefitSync™, enabled a large Payer to configure its benefit product builds in less than 3.5 calendar days while meeting enrollment goals.

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eBenefitSync - Press Release Banner
A large health plan in Pennsylvania turns benefit product builds in 7 days with eBenefitSync, meeting enrollment goals

Simplify Healthcare, the market leader in benefit plan configuration, announced the outcome of automating the benefit product configuration process in Facets using its flagship solution eBenefitSync at a leading health plan in central Pennsylvania.

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