Sending Enrollments to Carriers: Carrier Setup, Enrollment Files and EDI

Purpose

After enrollment closes, the carriers need to know who enrolled in what. UZIO can produce that for each carrier in the format the carrier accepts: a PDF enrollment form, a carrier-specific Excel file, or a full EDI feed (the electronic 834 enrollment file most large carriers use). You choose the format per benefit on the proposal, release the enrollment package, and then either download the files and send them on, or let the EDI feed deliver them. This article covers all three formats and the weekly enrollment file you use to reconcile.

Who can do this: the client's broker, their agency, and account managers linked to that broker.

Before you start

• The proposal is Approved and enrollment has been released. See Tracking Enrollment and Releasing It When Open Enrollment Ends.
• You have confirmed with each carrier's account manager which format they accept.
• For Excel or EDI, the carrier's template (and for EDI, its companion guide) has been loaded into UZIO. UZIO's account management team does this for you from the carrier's specification. Ask them early: it is not a same-day task.

Choose a format

Set up a carrier Excel template

1. Open the approved package and click Carrier Enrollment Setup.
2. Select the product category the template was loaded for, for example HRA.
3. Click Edit, then choose the template under Select Template.
4. Fill in the group response fields that appear, for example a billing location. More fields appear if you offer several plans or classes in that benefit, so gather all the carrier's group information before you start.
5. Save.

To start again, click Remove and repeat the steps.

Set up an EDI feed

1. Open the approved package and click Carrier Enrollment Setup.
2. Select the product category and choose Electronic Data Integration as the integration type.
3. Select the carrier's template.
4. Enter the carrier's group codes in the fields that appear.
5. Click Save.

Carrier files then generate automatically on the schedule agreed with the carrier.

Set the rest and release to carriers

For each plan you can also set the waiver form and any carrier-specific custom attributes. When every product line is set up, click Release Enrollment Package to share the enrollments with the carriers.

Get the files

When a file is generated, UZIO emails you "Enrollment File Generated for client", with the file name, type, and date.

1. Open the client and click the Enrollment Files tile.
2. Click Carrier Format Reports.
3. Click Download under Actions. You get a zip file with the carrier files, one set per carrier.
4. Send the files to each carrier over a secure channel.

For an EDI feed, track each file's progress (generated, delivered) on the Carrier File Tracking tab.

Reconcile with the weekly enrollment file

Where it is set up, UZIO also produces an enrollment file every week with all current submitted and approved enrollments for your clients. It contains census-style employee details, enrollments by benefit, and beneficiaries where employees named them. Use it to reconcile, inside your agency or with your client or the carrier, so that the carrier's records and UZIO stay in step.

Common problems

**I got "File Generation Failed for client".** The email lists the errors. They are usually missing data the carrier's template requires, such as a group code, or an employee field. Fix the data in the client's setup or the census, and the next scheduled run picks it up. If the error names the template itself, see Still stuck? below.

The zip file will not open. Use the client's EIN as the password.

The template I need is not in the Select Template list. The carrier's template has not been loaded for this client yet. Ask UZIO's account management team to load it.

A carrier says an employee is missing from the file. Check that the employee's enrollment was submitted and approved before the file was generated. Enrollments still in progress or pending approval are not included. Compare with the weekly enrollment file.

Still stuck?

Carrier templates, companion guides, EDI connections, and PDF mappings are set up by UZIO, not in your portal. For a missing template, a failed file that names the template, or a new EDI connection, please reach out to us at support@uzio.com or call +1-571-601-1752. Send the client name, the carrier and benefit, the file name and generation date from the email, and the carrier's file specification if this is a new setup. Do not attach the enrollment file itself.

Related articles

• Tracking Enrollment and Releasing It When Open Enrollment Ends
• Building a Benefits Proposal and Sharing It With Your Client
• Your client's view: How enrollments reach the carriers