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.

PLGX-1044-BRO-EXP-MAR2020

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

PLGX-1044-BRO-EXP-MAR2020

Paylogix Co-op Funding Program Broker Guide

Consolidated Billing

Beneﬁts

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

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

a a

All payroll schedules supported

a a

Supports per pay period premium payments

a a

Third party or carrier enrollment technology integration available

All premium payment schedules supported

Custom ﬁle format support available

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

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

a a

All payroll schedules supported

a a

Supports per pay period premium payments

a a

Third party or carrier enrollment technology integration available

All premium payment schedules supported

Custom ﬁle format support available

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?

PLGX-1044-BRO-EXP-MAR2020

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

PLGX-1044-BRO-EXP-MAR2020

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