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Broker Information Guide 2019

1025 Old Country Rd. #310
Westbury, NY 11590
1-800-622-4131 info@paylogix.com
www.paylogix.com
CO-OP FUNDING PROGRAM
BROKER INFORMATION GUIDE
Pro-Enroll
®
Consolidated
Billing
®
Common
Remitter
®
Single Slot
Admin
Co-op
Funding
®
PLGX-1044-BRO-EXP-MAR2020
Paylogix Co-op Funding Program Broker Guide
Program Overview
The Paylogix Co-op Funding Program is a unique opportunity for brokers to provide
excellent service without additional costs. It starts with our Consolidated Billing®
service that allows multiple products from multiple carriers to be billed and paid in
one online bill. Through partnerships with over 40 benefit providers nationwide, we
are able to offer this service at no charge to the broker or the employer in standard
cases. Brokers choose to provide this service to their clients because it reduces
admin hassles and makes it easier to sell additional benefits. Carriers choose to
participate because their policy holders are billed accurately and premiums are
paid on time. The Co-op Funding program is a significant advantage for brokers
and carriers.
Imagine a TPA so good at billing & reconciliation,
that the carriers agree to cover the fees.
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Paylogix Co-op Funding Program Broker Guide
Participating Carriers
Brokers now have access to
over 125 products
through our Co-op Funding Program.
1. 5 Star Life Insurance
2. Aetna
3. Aflac
4. Ameritas
5. American National
6. ARAG Legal
7. ASPCA (Hartville)
8. Benezon
9. Boston Mutual
10. Chubb
11. College Assistance Plus
12. Combined Worksite
13. CyberScout
14. Electric Insurance
15. EyeMed
16. GradFin
17. Hyatt Legal
18. Identity & Credit Services
19. ID Watchdog
20. InfoArmor
21. John Hancock
22. Kemper
23. Legal Access
24. Legal Club of America
25. Legal Resources
26. Legal Shield
27. Liberty Mutual
28. Lincoln Financial
29. Luther Sales
30. MetLife
31. MMI Group
32. My Public Info
33. Nationwide Pet
34. Ocenture
35. Pet Assure
36. Purchasing Power
37. Reliance Standard
38. Symetra
39. Transamerica
40. Travelers
41. Trustmark
42. Unum
43. US Legal Services
44. VSP
45. Voya
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Paylogix Co-op Funding Program Broker Guide
Consolidated Billing
®
Benefits
1
Determined by providers and products included in the offering.
$
Paylogix additional services are available on a case by case basis for additional fees.
Contact your Broker Relationship Manager for pricing details.
Included Features &
Additional Available Services
Broker
DIY Tools
Standard
Co-op
Custom
Case
Multiple carriers and products on one Consolidated Billing
®
Statement
a a a
Exchange Builder
®
Premier Providers included at no additional charge
a a a
Supports multiple eligibility scenarios as defined by the employer group
1
a a a
Secure, online access to Paylogix admin system included at no additional charge
a a a
Accommodates monthly premium payments
a a a
Paylogix standard file formats accepted
a a a
Co-op Funding carriers included with carrier approval at no additional charge
a a
Pro-Enroll™ powered by Paylogix integration available
$
a a
File scheduling based on the client group payroll needs
1
a a
All payroll schedules supported
1
a a
Supports per pay period premium payments
1
a a
Third party or carrier enrollment technology integration available
$
a
All premium payment schedules supported
1
a
Custom file format support available
$
a
Paylogix offers Exchange Builder, for a set annual fee.
For more information visit
www.exchangebuilder.com
or ask your Broker Relationship Manager.
PLGX-1044-BRO-EXP-MAR2020
Consolidated Billing
®
Benefits
Included Features &
Additional Available Services
Broker
DIY Tools
Standard
Co-op
Custom
Case
Multiple carriers and products on one Consolidated Billing
®
Statement
a a a
Exchange Builder
®
Premier Providers included at no additional charge
a a a
Supports multiple eligibility scenarios as defined by the employer group
1
a a a
Secure, online access to Paylogix admin system included at no additional charge
a a a
Accommodates monthly premium payments
a a a
Paylogix standard file formats accepted
a a a
Co-op Funding carriers included with carrier approval at no additional charge
a a
Pro-Enroll™ powered by Paylogix integration available
$
a a
File scheduling based on the client group payroll needs
1
a a
All payroll schedules supported
1
a a
Supports per pay period premium payments
1
a a
Third party or carrier enrollment technology integration available
$
a
All premium payment schedules supported
1
a
Custom file format support available
$
a
As you can see, many valuable features are included in the Paylogix Co-op Funding Program.
When you discuss the specifics of your case with your Broker Relationship Manager, you can
decide which features your clients require and which level of Paylogix services will best meet
your client’s needs. If your case meets the requirements for a standard case, you may be able
to participate in the Co-op Funding Program. For more complex cases, we can discuss custom
options and pricing on a per case basis.
PLGX-1044-BRO-EXP-MAR2020
9 The broker works with their client
to assemble the necessary infor-
mation.
9 The broker completes and submits
the Paylogix Client Data Form on-
line for review.
9 A Paylogix Broker Relationship
manager reviews the client data
form with the broker before submit-
ting for approval and phase 2.
An accurate and complete Client
Data Form is necessary to proceed
with case implementation.
Phase 1: Data Gather
9 Paylogix Implementation Team
confirms information with the bro-
ker and the carriers.
9 Paylogix works with the broker, cli-
ent, and carriers to establish file
exchange protocols.
9 Target set for implementation, test-
ing and go-live dates.
Non-standard file protocols will re-
sult in additional fees and may de-
lay the implementation timeline.
Phase 2: ImPlementatIon
9 Data exchange is first tested with
the client group using the eligibility
file.
9 Billing and remittance are tested
with the client group prior to carrier
testing.
9 Carrier testing ensures that the
data format is correct and connec-
tivity is working correctly.
Changes to agreed upon file layouts
must be approved by the Paylogix
implementation team. Customized
programming requirements will re-
sult in additional fees.
Phase 3: testInG
9 Review call with Paylogix to ver-
ify online access and file transfer
schedule.
9 Paylogix notifies the client group
and the broker when the first file
is sent.
9 Paylogix Broker Relationship Man-
ager will provide ongoing updates.
Phase 4: revIew
Paylogix Co-op Funding Program Broker Guide
New Case Setup Overview
4 Phases of New Case Setup
PLGX-1044-BRO-EXP-MAR2020
If third party or carrier enrollment technol-
ogy integration is necessary, the Paylogix
implementation team will work with them
to facilitate case set up. However, if the third party
or carrier experiences a delay, or does not commu-
nicate necessary information to Paylogix in a timely
manner, it may cause delays. Brokers are encour-
aged to work with established enrollment systems
that have a positive on-time track record.
thIrD Party Delays
New Case Setup Overview
Top Causes of New Case Implementation Delays
The CDF should contain all the informa-
tion necessary for a successful imple-
mentation. New case implementation
will not proceed until this information is gathered
and verified. If any of the information changes af-
ter submission, the Broker must notify the Broker
Relationship Manager as soon as possible to help
avoid a delay. While the implementation team will
work to address the CDF changes, we cannot guar-
antee on time case set up if the CDF is incomplete,
or updated.
IncomPlete clIent Data Form
If the implementation team receives file
protocols that vary from those specified
at initial case set up, this will case a
delay. New file mapping, or custom file set up may
be necessary.
Inaccurate FIle Protocols
PLGX-1044-BRO-EXP-MAR2020
Paylogix Co-op Funding Program Broker Guide
Our Services
Brokers and their clients depend on Paylogix for the
technology and service that make benefits possible.
Allows multiple products from mul-
tiple carriers to be billed and paid
in one online bill. Provide your cli-
ents with bills that actually make
sense. Save time, money, and
hassle for your clients to be a true
benefit hero.
All the power of Paylogix in an
easy to use Broker DIY kit. Build
your tailored, employer specific
benefit marketplace. In 20 min-
utes, you can launch your mobile
friendly benefit education, commu-
nication and enrollment site with
Consolidated Billing
®
built in.
The industry standard for enroll-
ment and eligibility. Promote,
educate, and enroll in your own
custom built, mobile friendly on-
line enrollment tool. With over 10
years experience, we know how to
do online enrollment right.
Bring the Power of Paylogix to your
company. The fully integrated front
to back office TPA benefits billing
and administrative software solu-
tion. Premium Solutions is a host-
ed application that provides more
flexibility and opportunity than the
traditional client-server model.
With over 20 years experience, we
have seen it all. Bring your compli-
cated benefits billing problems to
Paylogix and we will make it pos-
sible.
Premium
Solutions
Custom
Solutions
Your clients save time and money
with the Paylogix secure, online
benefit administration portal. A
one stop shop for HR to access,
update, and pay for all the ben-
efits that are part of their Consoli-
dated Billing
®
statement.
Benefit
Administration
Consolidated
Billing
®
Pro-Enroll
®
Exchange
Builder
®
PLGX-1044-BRO-EXP-MAR2020
Paylogix Co-op Funding Program Broker Guide
We will contact the carrier on your behalf to request that they join the Paylogix Co-
op. If they agree to join Co-op, the carrier will cover the fees for their products to be
included in your client’s Consolidated Billing® service. If the carrier is not interested
in participating, we can still function as the TPA and they can still be included in your
client’s Consolidated Billing® Service. However, the broker will be responsible for
covering the fees.
what IF my clIent wants to use a carrIer that Is not
Part oF the PayloGIx co-oP FunDInG ProGram?
FAQ
If you would like to avoid the additional charges, you might look for a suitable alter-
native product from a carrier that participates in the Paylogix Co-op. There are now
over 125 products available through these carriers and more are added each year.
A up to date list can be found on our website, or by contacting your Broker Relation-
ship Manager.
Some brokers choose to pass the fees along to their client. If you choose to do this,
please know that you remain responsible for paying Paylogix fees, regardless of any
arrangement you make with your client.
how can I avoID excess Fees?
We support the following pay-
ment methods to make it easy
for your clients to pay their
premiums:
Payroll deduction
ACH Bank Draft
Back-up Funding
Direct Deposit
what Payment
methoDs
are avaIlable?
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Paylogix Co-op Funding Program Broker Guide
About Us
At Paylogix, we are changing what it means to be a TPA.
WHO WE ARE WHAT WE DO
Paylogix is a licensed and bonded Third Party In-
surance Administrator. We move money and data
related to health and welfare benefits. But we
are much more than an ordinary TPA. Founded in
the worksite benefits arena, we have been an in-
suretech pioneer for over 20 years. We specialize
in developing technologies specifically to simplify
the administration of payroll deducted benefits.
We have the proven experience, reputation and
endorsement of every significant insurer in the vol-
untary payroll deduction market.
Our trademarked Consolidated Billing
®
& Common
Remitter
®
services set the industry standard for ser-
vice and simplicity enabling solutions that no single
insurer can provide. Our web based solutions offer
real time access for our business partners includ-
ing: Employers, Brokers, & Insurers. Our managed
payroll deduction service provides unmatched flex-
ibility for secure client data exchange, file formats
and business rules. We make it easy to get paid.
PLGX-1044-BRO-EXP-MAR2020
Learn more about our
legacy of innovation at
http://www.paylogix.com/about-us/history
Read about our latest
achievements at
http://www.paylogix.com/the-paylogix-post/front-page
Paylogix Co-op Funding Program Broker Guide
Key Expertise
With over 20 years of specialized insurance industry
experience, we have seen it all.
Year after year, Paylogix and our employees have been
recognized with industry awards from Employee Benefit
News, The Employer Healthcare & Benefits Congress, and
others. We care about developing our talented Paylogi-
cians because that is how we deliver innovative solutions
to our clients.
Invented in 1996 by Paylogix’ founder and president, Rich-
ard Pfadenhauer, our Consolidated Billing
®
service revolu-
tionized the industry. Over 20 years later, we are still devel-
oping new and better ways to move money and data.
We don’t just know how to do billing, we invented the
industry standard.
thInk you know bIllInG?
awarD wInnInG talent & tech
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Paylogix Co-op Funding Program Broker Guide
Learn More
We take care of the complicated
work, moving data and money, so
that brokers and carriers can focus
on what they do best.
The best in the business
trust Paylogix for:
Learn more about how
we make it possible at
www.paylogix.com
Enrollment
Billing
Administration
Premium Collection
Custom Solutions