Allison Loehman January 13, 2019 12 min read

How To Evaluate Your Benefits Administration Outsourcing Vendor After Open Enrollment

Benefits administration outsourcing vendor

If you've followed along with us for the last few weeks, you know that we've been focusing on providing helpful content to guide your post-open enrollment analysis efforts.

Today we wrap-up our series with a list of questions you can use to evaluate your benefits administration outsourcing vendor's performance after open enrollment.

The questions are broken down into four main topics:

  1. Did your vendor meet their service level agreements?
  2. What are the areas for improvement?
  3. What were the key accomplishments?
  4. What's next? Is your vendor prepared to take you further in 2019?

These key questions are the starting point for the oftentimes difficult, and always meaningful task of evaluating your benefits administration outsourcing vendor after open enrollment has ended.

Keep reading to get the full list of questions!

Did your benefits administration outsourcing vendor meet their Service Level Agreements (SLAs)?

Before you evaluate anything else, you'll want to ensure that your benefits administration outsourcing vendor has met (and hopefully exceeded) their service level agreements. Service level agreement contracts differ from vendor to vendor, but we recommend you have SLAs in place that can be measured both objectively (e.g. clearly defined, measured and formulaic) as well as subjectively (e.g. I was happy with..., I was unhappy with...).

Another note on SLAs: remember that metrics alone do not quantify success. Your vendor should be engaging you in (at minimum) quarterly meetings to discuss their service performance and client feedback. These discussions can help the vendor calibrate and validate that the metrics they are reporting match up to the level of service that their clients are expecting.

What are the areas for improvement?

Next, you'll want to review the things that went right and the things that went wrong. Below are some common benefits administration scenarios to evaluate when making these considerations, broken down into three categories: pre-open enrollment, during open enrollment, after open enrollment.

Pre-Open Enrollment

  • Was the vendor responsive to questions and / or concerns raised during preparation for open enrollment?

  • Were there any difficulties with any plan design, rates and / or eligibility changes?

  • Were there any data inconsistencies that caused a problem?

  • Were there any carrier file issues?

  • Were there any dual year processing challenges?

  • Were there any payroll file processing issues?

  • Were the testing timelines long enough?

  • Did the client testing experience meet and / or exceed expectations?

  • Were all employee communications sent on time, containing the correct information?

  • Did the vendor meet your desired "go-live" date for open enrollment?

During Open Enrollment

  • Did the vendor successfully manage all aspects of annual benefits enrollment, including:
    • project management,
    • development of email communication,
    • updating of enrollment website,
    • processing enrollments, and
    • sending data to appropriate third party benefit providers and payroll vendor?

  • Did the vendor successfully administer all aspects of COBRA and direct billing, including:
    • communication,
    • billing and
    • benefit administration for COBRA eligible and direct billed employees, retirees and surviving spouses?

  • Did the vendor provide the necessary processes and administration procedures to successfully administer HSA, FSA and / or HRA programs?

  • Was the vendor's call center staffed with qualified and knowledgeable personnel that correctly respond to questions and assisted participants with benefit enrollment related issues?

  • Was the benefits enrollment technology easy to use?

  • Were the decision support tools:
    • Utilized as expected, higher than expected, or lower than expected?
    • Intuitive?
    • A value-add for employees?

  • Did the vendor provide adequate support for administrators during open enrollment?

  • Did the vendor respond quickly to any issues that arose during enrollment?

  • Did the vendor effectively address unresponsive employees during open enrollment?

After Open Enrollment

  • Did the vendor effectively collect and configure the data elements needed to comply with the Affordable Care Act (ACA) reporting requirements of IRC 6055 and 6056, including:
    • exporting data to populate the 1095 forms,
    • transmitting data to the IRS, and
    • printing/sending 1095 forms to employees?

  • Was the vendor able to deliver required reporting for all populations including actives, COBRA, and retirees for post-open enrollment analysis?

  • Did the vendor pro-actively schedule an open enrollment post-mortem for overall review and client feedback opportunities?

What were the vendor's key accomplishments?

Take time to reflect on the positives that occurred during open enrollment. During your review of the questions above, you may uncover various examples of things your vendor and their extended team members did that went above and beyond to help you reach your open enrollment goals.

A few areas to consider include:

  • Was the vendor able to accommodate changes for Annual Enrollment 20YY that were unknown during initial planning discussions?

  • Did a vendor recommendation, such as implementing a decision support tool, or performing a dependent eligibility audit, show measurable and improved results after open enrollment?

  • Did the vendor consistently do more than expected to help meet goals and respond to client needs?

Is your vendor prepared to take you further in 2019?

Your vendor may be meeting their SLAs, executing effective pre-, during and post-open enrollment administration, and delivering excellent customer service, but are they providing you with true benefits administration subject matter experts that will drive your open enrollment strategies beyond status quo?

During your evaluations, you'll want to make sure your partner offers a "benefits-wise" team with a highly trained, low-turnover staff that can address the most complex benefits issues and advise on best practices, providing unique solutions to the challenges.

Questions to consider:

  • What do similar firms in our industry category do that we should consider in our next cycle? Use this question to draw out their expertise in helping you excel against competitors in your benefits offering for talent recruitment.

  • What do your most successful companies, outside our industry in any category do that we should consider?

  • What do the leading firms in your overall portfolio do that would help meet our goal of X (urgent care utilization, good trend, employee engagement) in 2020?

  • What else should we explore as we think about our approach to the benefits plan in 2019 for 2020?

When you evaluate vendors with a forward-thinking lens, you'll be able to identify more than a vendor, but a true partner. Selecting a partner can help you not only enhance enrollment participation, but most importantly, empower employees to make informed benefits decisions.

Is your current benefits administration outsourcing partner meeting your evolving needs?  Take fifteen minutes to learn why making a switch to benefitexpress can take your benefits strategy to the next level in 2019.

Interested? Let's talk.


Post-open enrollment analysis wrap up

There you have it - our final piece of advice for HR pros looking to level up their post-open enrollment analysis strategy.  Taking a look back, we've covered:

The top five post open enrollment survey questions to ask your employees.

How to survey your key internal stakeholders around the topics of planning, execution, results, and communication to obtain a retrospective evaluation of open enrollment.

The three most important conversations you need to have with your broker after open enrollment

We wish you well in your post- open enrollment analysis endeavors, and look forward to seeing what methods are most effective for you, both this year and beyond.