Benefitfocus Standard RFP Responses Company Overview and History History Benefitfocus.com, Inc. (Benefitfocus) was founded on June 5, 2000 by Mason Holland, Shawn Jenkins and Doug Moreland. Benefitfocus is the leading provider of software and services for sales process management and quoting benefit enrollment, electronic billing, data exchange, and claims viewing. Benefitfocus’ products and services utilize state-of-the- art technology that is compatible with existing systems and databases. They replace paper-based and error-prone processes and allow clients to receive accurate information more efficiently and economically. Benefitfocus initially designed its flagship product, Benefitfocus eEnrollment, to accommodate electronic benefit enrollment for employer groups. BlueCross BlueShield of South Carolina was an early adopter of the technology, and signed the first contract with Benefitfocus in 2001 for electronic enrollment. Within three months, BlueCross BlueShield of South Carolina was able to begin enrolling groups using Benefitfocus’ Web interface. In 2003, Benefitfocus launched its data exchange service, Benefitfocus eExchange. Benefitfocus eExchange offers a way for companies with existing HRIS systems or third-party payroll vendors to communicate effectively and efficiently with carriers without having to use multiple applications or hire additional IT staff. In 2004, Benefitfocus launched its electronic billing application, Benefitfocus eBilling, and has been rapidly and widely adopted by health plans who see the immediate payback of delivering premium and claims bills in near real-time while eliminating the delays and costs of printing and shipping. Throughout 2006, Benefitfocus has launched three new products for the health insurance industry. These are eCDHP, a custom benefit configurator and personal health planner, eSales, a comprehensive sales process management and quoting system, and eClaims, an internet-based claims viewing system. Today, Benefitfocus works with large multi- national employers such as USAir and Michelin, as well as leading U.S. health insurance companies, to streamline benefits enrollment, eligibility, billing and data exchange. Today, Benefitfocus.com, Inc. continues to focus on solutions to serve multiple benefit administration stakeholders and to help insurance carriers close the gap between themselves and their clients in order to streamline operations and improve communication between Carriers, their Groups and the Members they serve. The Company is currently engaged by 24 Blue Cross and Blue Shield Companies across the United States and Puerto Rico, which currently serve over 40 million individual subscribers. Senior Management Team Shawn A. Jenkins, President and CEO (founder) Mason R. Holland, Chairman of the Board (founder) Jerry Lepore, Chief Operating Officer Annmarie Fini, Vice President of Client Services, eEnrollment Paul Sparrow, Executive Vice President of Sales and Marketing Nancy Sansom, Vice President of Enterprise Product Strategy Nate DaPore, Vice President of Enterprise Sales Ken Poletti, Vice President of Professional Services Group Jacques Welter, VP of eEnrollment / eSales Employee Information Benefitfocus currently has approximately 400 associates. Of these, roughly one third are in product development and engineering roles, one third in client support, and the remainder in operational, sales, and administrative roles. Locations The Benefitfocus corporate headquarters is located in Charleston, South Carolina in a new, state-of-the-art corporate head quarters. The company also has a secondary corporate office located in Greenville, South Carolina, and satellite locations in the following cities: Little Rock, AK., Philadelphia, PA., Tulsa, OK., Columbia, SC., Raleigh, NC., Kansas City, KS., Ft. Lauderdale, FL., and Baltimore, MD. Competitive Features What features of your organization distinguish it from your competitors? Benefitfocus eEnrollment is a One-to-Many platform for managing benefits. In other words, groups can manage ALL of their benefits with this product, and Benefitfocus will transmit benefit information to all of a group’s carriers, as well as the group’s payroll system. The product supports enrollment for all health, life, and disability benefits, as well as health savings accounts, wellness programs, retirement benefits, cafeteria programs, flexible spending, employee assistance programs, and other special benefit programs. Benefitfocus eEnrollment is a “rules-based” system, meaning that the application is configured specifically for a group’s rules and plan designs. This includes rates, life coverage amounts with guaranteed issue, and off-cycle change reasons. In addition, any change that is made by an employee triggers an approval task for the HR administrator. Data will not be sent to the carrier until the task has been approved. Implementation Overview Benefitfocus uses a proven five-phase methodology for implementing its solutions for a new carrier partner. To better determine the full implementation timeline and deliverables, Benefitfocus will require due diligence meetings with the carrier. The five phases consist of the following: 1. Discovery: Onsite and remote discovery sessions are held to review the carrier’s line(s) of business and determine the require configuration for the system. Activities include the following: Review carrier products and market Determine system access and login requirements Define group and member loading requirements Define data exchange requirements Determine platform branding requirements Develop training and support plan Create deployment plan and schedule A set of deliverable documents are created as part of the Discovery process. The exact deliverables differ according to the carrier’s needs, but the following are typical outputs from the Discovery phase: System Configuration Requirements Branding Requirements Functionality Gap Analysis Data Exchange (EDI) Requirements Joint Carrier Test Plan Deployment Project Plan 2. Development: Based upon the requirements determined during the Discovery phase, the following activities are performed: Setup and configuration of eEnrollment Creation of private labeling Development of data exchange technology 3. Joint Carrier Testing Carrier specific test plan Base application testing Defined use case scenarios Carrier branded environment File extraction testing Customization testing Feedback loop to product management Regression testing Carrier acceptance and sign-off 4. Early Adopter Pilot Phase 5. General Go-Live Implementation Responsibilities Having not completed a Discovery, the below staffing needs are simply estimates: Carrier: Executive Project Champion Project Manager Enrollment Liaison Underwriting Liaison Operations Resource Sales & Marketing Resource Dedicated Technical Resource IT Liaison Marketing Liaison Benefitfocus: PSG Project Manager PSG Director EDI Software Engineer Director of Engineering Import Engineer UI Designer Quality Assurance Testing Manager Account Development Representative Implementation Consultant Implementation Director Client Services Director Carrier Services Manager Client Services Business Analyst Training Benefitfocus provides customized training services and materials to its carrier partners. Online and classroom training are both provided. Classroom training is provided to meet the learning needs of carrier, group and broker users. Additionally, the Company uses GoToMeeting Web training tools to deliver quality training hosted by a professional trainer via the Internet and toll-free teleconferencing. Lastly, online training videos are available for self-paced training and refresher training. Specific one week training includes: Carrier Training: (three day classroom) Benefitfocus’ Methodology and Processes Training for designated Carrier Representatives: Implementation Group set-up and configuration Loading of Group data Ongoing and renewal support Carrier Membership Representative Training: (one day classroom or three to five online sessions): Carrier role application Data exchange services and joint communication Broker Training: (one day classroom) Market adoption techniques Sales fulfillment Operation and functionality of the eEnrollment Small Group application Group Administrator Training: Small Group Training Videos (45 minutes) Self-paced training videos are available in the eEnrollment application for Small Group Administrator training and refresher training for all users. Videos can be streamed online or downloaded to users’ computers. The videos cover the basic operations and functionality of the eEnrollment application. The following user guides are available online and are provided during classroom training: Group Administrator User Guide is available to view or download within the eEnrollment application. Member User Guide is available to view or download within the eEnrollment application. Carrier Membership User Guide is provided during classroom or online training sessions. Carrier Underwriter User Guide is provided during classroom or online training sessions. Carrier Reporting/Marketing User Guide is provided during classroom or online training sessions. Performance Describe performance guarantee and the measurement methodology for the following: Turnaround time for eligibility load If data is delivered in a Benefitfocus requested format, the eligibility is typically loaded in three to five business days for an initial load and implementation. In the instance of integration with a group’s payroll system (referred to as Payroll Inbound file), an eligibility file will load in approximately three to four hours. Turnaround time for eligibility load to data to third party administrators Eligibility transmission to third-party administrators is referred to as eLinks by Benefitfocus. Benefitfocus currently sends data to numerous third-party administrators. In the instance an eLink relationship already exists, the transmission frequency is typically already established. This frequency can range from daily to monthly, dependent on various factors. The load time at that particular third-party administrator would be relative to their system capabilities based on pre-established file formats. File Interface to third party administrators and Group See response above for more information. File interfaces are dependent upon the eLink and can range in form from an 834 format, proprietary 834 formats, PDF, fixed width, comma delimited, etc. These file formats are established in the discovery meeting with the third-party administrator. Interface quality assurance Benefitfocus has a dedicated department for all eLinks. Such positions within this department include project manager, data analyst, and engineers. The data analyst/project manager is responsible for joint carrier testing with the third-party administrator before the eLink is live. This can involve multiple rounds of testing until a “clean round” has been completed. Upon go live of the eLink there are various measures that can be put in place to for quality assurance, such as: quarterly reconciliations, email confirmations, and error reports. Service/Call Center – Performance guarantees Call abandonment rate – 5 percent Average speed to answer call – 30 seconds Call-back turnaround time – 4 hours 24-hour call resolution – 90 percent of calls are resolved on initial call Specify your staffing requirements of Group for the implementation effort Benefits Expert – The Benefitfocus implementation consultant will work with a contact(s) within the group to answer all benefit discovery questions. This information will be used to complete a comprehensive benefits document that will then be used to design the enrollment application with all applicable rules and benefit enablements. Payroll specialist and/or Payroll IT – The Benefitfocus payroll project manager will work with a contact(s) within the group to assist in integrating the group’s payroll system with the Benefitfocus enrollment application. This information will be conducted in the discovery meeting. Such items to be discussed will be review of file specifications, frequency, customizations, categories, and other factors. Technology support – The Benefitfocus payroll project manager will work with a contact(s) within the group to secure a medium for secure file transfer. This is usually in the form of a secure FTP site. This contact can advise if requirements for implementing this. Customer Support What are your customer service center hours? Standard Customer Service Hours are 8 a.m. to 6 p.m. EST (Monday – Friday). Standard Technical Support Hours are 8 a.m. to 6 p.m. EST (Monday – Friday) with 24x7 support to respond to ensure system availability. Extended Hours during peak enrollment periods are 8 a.m. to 8 p.m. EST (Monday – Friday). Reports Provide a sample of your monthly, quarterly and annual standard reports. eEnrollment provides a large set of standard reports, including benefit summary and detail, employee census, record change, transaction history, HR Toolbox, and data export reports. All reports can be produced in HTML, PDF, CSV, and Excel formats. Web interface features allow the user to filter, sort, and determine reporting columns dynamically. In addition, the creation of custom reports can be provided as an add-on service. A separate Web reporting server running Actuate Report Server is used to generate these reports. End users can create reports on demand or schedule them to produce at a recurring time and date. The client can run reports at any time. The following reports are available in eEnrollment: AD&D Transaction History Basic Work Beneficiaries Benefit Comparison Benefit Detail Benefit Refused/Cancellation Benefit Summary Cancer Transaction History COBRA Detail COBRA Summary Custom Information Dental Transaction History Dependent Census Dependent Changes Direct Deposit Transaction History Direct Deposit Emergency Contact Employee Benefit Summary Employee Birth Date/Retirement Eligibility Employee Census Employee Direct Deposit Employee Survey Detail Employee Survey Summary Flex Transaction History Hired Employees HR Attribute Changes HRIS Census HRIS Changes Life Event Life Transaction History Login ID Medical Transaction History Military Open Enrollment vs. Current Benefits Payroll Attribute Changes Payroll Census Payroll Changes Personal Transaction History Relationship Change Student Terminated Employees View-only Benefits Detail View-only Benefits Summary Vision Transaction History Voluntary Dental Transaction History Voluntary Life Transaction History Voluntary Short Term Disability Transaction History W4 Transaction History W4 Work Transaction History HIPAA Compliance Describe your system’s approach to HIPAA compliance. Benefitfocus follows the HIPAA compliance guidelines for Security and Privacy and maintains strict controls to ensure all Protected Health Information (PHI) is kept confidential and secure. These controls include the following: Externally, firewalls and strict access control lists are utilized to only allow Web traffic to the Web servers. Benefitfocus has an appointed Director of Security, Privacy & Compliance that deals with all HIPAA related issues. All new and existing Benefitfocus associates receive annual Security and Privacy Awareness training to keep them up-to-date on the policy and procedures that Benefitfocus has set up to ensure HIPAA compliance. The training class is taught twice a month and associates attend based on their start date. Benefitfocus performs nightly backups of the data; tapes are removed offsite to an Iron Mountain facility weekly. Authentication How will users access the system? Authentication with the Benefitfocus applications is typically provided via a traditional username and password pair, although the applications also support authentication via Single Sign-On integration. When the default Benefitfocus authentication method is used, passwords are encrypted via Triple-DES with a one-way hash at the point of entry. That is, the password information is never decrypted. The encrypted values are stored and compared in their encrypted state. By default, the Benefitfocus applications use the following password rules: Passwords must be between 6 and 15 characters in length Passwords must contain at least 1 number Passwords cannot have more than two of the same characters in a row Clients can choose to have their passwords expire at set intervals (e.g. 30 days) Accounts are locked out after 5 failed logins If desired, these password rules can be modified or extended for a particular client through custom rules. Group members and other users receive a secure login ID and temporary password to log into the system for the first time and are immediately prompted to choose a new password. Administrators can reset passwords, but they are never able to view a user’s current password. All passwords are masked upon entry, and no passwords are ever transmitted from the server to the browser. Authorization Authorization is provided via two mechanisms. The first is role-based permissions. Within the eEnrollment application, users in the member role are restricted from accessing screens, data, and functions other than those explicitly granted to the member role. For example, a member cannot view HR administrator screens and cannot retrieve carrier level data. However, members can see member screens and summaries, as well as member functions, such as Enroll or Cancel Benefits. The second type of authorization is data segregation. The data is segregated according to both the role and the group membership. For example, members can only access the data for themselves, and HR administrators can only access the data that belongs to their group, or subset of the group. Single Sign-On Benefitfocus has implemented single sign-on solutions for many of its partner carriers. Two primary methods can be used for implementing Single Sign-On: Benefitfocus proprietary method: Uses a secure, URL-based mechanism to exchange sign-on information between the Benefitfocus Web application and the carrier’s Web site(s), including handling single logout and keep alive functions. Security Assertion Markup Language (SAML): an XML-based industry standard for exchanging authentication and authorization information between trusted security domains. Product Release Schedule Benefitfocus’ application development philosophy calls for relatively short coding cycles. Thus the annual release calendar includes four releases, one per quarter. This is essential due to the rapidly changing needs or our customers. Since we are a software-as-a-service provider, as opposed to a custom software shop, we are challenged to constantly update and improve our functionality. It is common for new carriers or groups to have specific needs that are not already supported and we must be able to quickly add to or adjust the functionality in support of those needs. All Benefitfocus products use the same release dates. Each cycle includes five and a half weeks of total testing, which includes developer testing, feature/issue testing, user acceptance testing, as well as performance, parallel, and regression testing. As a general rule, the release cycle consists of the following phases: Requirements and discovery are completed at least two weeks prior to the beginning of the coding period. Technical design and effort estimation is completed during and after discovery and requirements but prior to the start of the coding period. Developer coding is generally scheduled for five to eight weeks. During coding, developers are expected to coordinate two forms of quality assurance, in-cycle testing, and peer review Two weeks of internal testing follows coding. At Benefitfocus, we pursue a philosophy that calls for developer participation in the testing effort. In addition to testing by developers, testing is performed by a Product Management associate, as well as other associates from departments such as Carrier and Client Services. One or two weeks of carrier testing follows internal testing. This period is set aside to offer our partner carriers and certain high profile groups the opportunity to perform joint testing of changes prior to deployment of new code. This period of testing occurs concurrently with the first weeks of development for the next release. Carrier testing is an optional activity that is determined by the needs and desires of carrier’s; therefore, may or may not be performed on a given release feature.