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EDI Processing

EDI Processing

Seamlessly connect between Members, Employers, Issuers, HealthCare.gov, and Third Party Administrators.

EDI Processing Highlights

Individual On-Exchange Enrollments

Be it 209 payment redirects, pre-audit processing, effectuations, reinstatements, cancellations, baseline validation or direct/in-direct enrollments through healthcare.gov, our platform supports all aspects for individual on-exchange enrollments. We greatly simplify the effort between you, your brokers and applicants for effectively communicating with healthcare.gov.

Individual Off-Exchange Enrollments

Our platform works seamlessly with on and off-exchange enrollments and your organization. Whether you prefer to work with EDI 834, flat files, web-services, spreadsheets or other formats, our professional services organization can tailor the system and interfaces to meet your needs.

SHOP Enrollments

Our platform simplifies SHOP by enabling your staff to view and manage enrollments from our easy to use enrollments interface.

Off-Exchange Small Group Enrollments

Store group information, such as employer contact information, classes, waiting periods, coverage end dates, locations and departments, as well as member information that includes plan elections and transaction histories. We also process member additions, deletions and changes requested by brokers, employers, and employees through their own secure logins.

Large Group Enrollments

Administer group open enrollment, manage employee benefit plans, and transmit membership data transfer in multiple file layouts, including the 834-file format. Our professional services staff will work closely with you in building and coordinating data communications between our platform and yours.

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