We recognize that many clients are moving towards online enrollment systems to capture and communicate all of their employees benefit enrollments and eligibility. OCA’s flexible integration solution can connect with enrollment platforms, as it pertains to processing any OCA benefit account as well as qualifying COBRA events.
How to get started? To help streamline these processes, simply click the button below to complete our integration request form.
What is the difference between a full file and change file?
A full file contain all data from regarding the current “benefit type” for the entire population. All enrollments, changes, or terminations will continue to be presented each time the file is run. Full files can be challenging to identify any changes that need to be made.
Change files are just that. Changes files will only show changes that have taken place since the last file transmission.
OCA prefers to receive “change files” versus “full files”. By receiving change files, OCA can quickly process files without first having to determine what changes occurred. If the vendor can only supply “full files”, it will require additional development work (assuming the vendor relationship was not previously established). Depending on the scoop of work involved, additional fees may apply.
How to set up a connection with Employee Navigator and OCA
Note: The information in this guide was taken directly from the Employee Navigator help desk guide. OCA recommends you contact Employee Navigator directly to confirm if their processes have changed.
How to connect a client to the Cafeteria EN-Exchange and Exclude Plans
You still may need to select and coordinate the implementation with the vendor and sign any necessary agreements the vendor may need but after that…..
Step 1: From the client’s home page, select Cafeteria under Admin Only
Step 2: Select ‘add a service’, then from the drop down find the vendor you are connecting to, then click ‘add’.
Note: You DO NOT have to use subscriber groups. It is best practice to select “All Employees”
Step 3: There will be a screen a displaying company information. Complete any fields that have missing data.
Step 4: The next page will display brokers premier users and HR users for the company. Select a contact that you want for your primary subscription contact.
Step 5: Verify the plans that will be sent for this client. Any of the plans NOT SELECTED will send on the file. If your vendor administers your clients FSA and Dependent Care but not their Health Savings Account (HSA) then you would want to exclude the HSA.
Click on the 3 dots on the right and select “excluded benefits/plans”. Select the box next to plan if the plan should not send on the file. Leave deselected if the plan should send on the file.
IMPORTANT NOTE: If you exclude plans you may need to do so each plan year. Excluded plans DO NOT stay excluded upon renewing the plan.
What plans can be set up with OCA and Employee Navigator?
Plans that transmit on the Cafeteria EN-Exchange File.
• Healthcare Reimbursement Account (HRA)
• Healthcare Savings Account (HSA)
• Healthcare FSA
• Dependent Care FSA
• Limited Purpose FSA
• Parking Reimbursement
• Transit Reimbursement
• Private Insurance – check with the TPA to see if they support it on the file
IMPORTANT NOTE: You need to use one of these plan types or the enrollment will not send on the file. For example, a Universal plan will not send on the file. If employees who enroll in a medical plan get a Healthcare Reimbursement Account and there is not an HRA plan built, we cannot send it on file.
Plan setup considerations for HRA with Employee Navigator
Employers will need to first confirm how the OCA has setup the HRA(s) in their system and match that in EN. Based on the HRA set up, it is common for OCA to build separate HRA’s in their system if they vary in annual contribution or have separate accumulators for say deductibles or prescriptions.
With that said, if OCA has built 2 HRA plans in their system and an employee should be enrolled in both, EN cannot currently accommodate that. The system will not allow an employee to be enrolled in two HRA’s. EN knows this may impact using the data exchange and they have it on their road map to allow enrollment in multiple HRA’s.
BUT if OCA has setup more than one HRA because the HRA’s differ from one class of employees to another or from which medical plan they enroll and an EE can only be enrolled in one or the other HRA, EN can accommodate this. You would need to build two HRA’s and NOT one HRA that has multiple contingent medical plans. Yes, EN allows you to build one HRA and link multiple contingent medical plans but doing this would not allow OCA to distinguish which HRA to put the EE into in their system.
Example: Client offers a benefit package where one class of EE’s have an HRA with an ER contribution of $1000 (it integrates with Med Low plan). Another class of EE’s have an HRA with an ER contribution of $3000 (it integrates with Med High plan). The TPA builds two HRA plans in their system, HRA 1000 & HRA 3000. If you build one HRA in EN and name it HRA and enter both the Med Low and Med High plan as contingent medical plans, the system will work. BUT, and this is the key part, the TPA only sees a plan come over on their file named “HRA” and they have no idea if Sally should be put in the HRA 1000 or HRA 3000 plan.
Need More Information?
Please feel free to call us at 855-622-0777 or email firstname.lastname@example.org.