At
"Our biggest focus is saving time for the employer using the benefits administration platform," said Jonathan Caruso, director and Digital Accelerator lead at Sun Life. The carrier will notify benefits administrators about employees whose eligibility should be checked.
For any company with over 20 employees, at an open enrollment period, manual work on each enrollment can be "painful," Caruso said. "Decisions don't happen all at the same time, because employees will go in and complete that form, whenever they have the opportunity," he added. "Employers are constantly looking for those decisions, then they have to go back in and manually update it. Sometimes they forget it, sometimes they put the wrong amount in."
Sun Life Digital Accelerator's API implementations are freeing benefit administrators to concentrate more on their employees' experiences, according to Caruso. They also provide greater security for transferring enrollment data. The APIs include plan setup, eligibility, EOI [evidence of insurability], billing, and claims in absence.
- Plan setup – this API connects administrative systems to benefit administration platforms such as ADP, so benefits administrators don't have to manually create benefits for employees. Once benefit plans are final, Sun Life can mark it "sold" and flow any changes through automatically. This API has been live for 18 months.
- Eligibility – will flag and process changes in eligibility automatically, in real time. Still in development.
- EOI updates eligibility decisions in real-time, communicating those decisions in real-time. This drives more volume for Sun Life's medical underwriting staff, so the carrier is looking at how to adjust rules in this API for auto-adjudication, according to Caruso.
- Billing – saves time and increases capacity by automating creation of summary statements. Clients can fill out a summary and send payment that the API can process and reconcile automatically, without having to manually create a summary statement.
- Claims and absence – facilitates checks on employee salaries needed to calculate and process claims, especially concerning any employee absence. Case setup, claims status, payroll and attendance are updated in real-time. This API has been in place for two years.
Many of these APIs improve data handling and management, according to Caruso. "We realized that it's very painful for clients to pull data out of their systems, but also, they don't know how to calculate premiums well, either," he said. Carriers are seeking help meeting the new LDEx standard for data being exchanged between insurance carriers and benefits administrators, Caruso noted. Sun Life did not want to wait until the LDEx standard is finalized, to launch its plan setup
This article has been updated.
