Sales to CSM Handoff- Transitions Groups

Lead Status-

• When a transition lead is created in HubSpot, a ticket should be generated to the Transition Analysis Pipeline in HubSpot.
  • The ticket should have the following information:
    • Employer name
    • Agency name
    • Current ICHRA TPA
    • Desired Transition Effective Date with benefitbay
  • For the analysis, the following enrollment data for each enrolled employee/dependent is needed:
    • Carrier Name
    • Plan Name
      • This file should be added to the Sales Sharepoint file and the link shared in the Transition Analysis ticket in HubSpot.
• Once the Carrier Analysis is completed, Transitions team will comment to the requester it is completed, mark the ticket as completed, add the analysis report in the Sales SharePoint folder for the client.
  • The analysis will determine the difficulty level of moving the policies based on carrier processes.
    • The scale is 1-3, with 1-easy, 2-medium, 3-hard.
      • Easy means benefitbay Transitions Team can complete all tasks on behalf of employees.
      • Medium means a small population of the employees will need to complete an action step for the carrier to move over the AOR/payment.
      • Hard means a large population (over 50%) of employees will need to complete an action step for the carrier to move over the AOR/payment.
    • The analysis score should be considered during negotiations of additional transition fees.
      • PLEASE NOTE: Employee action items/transition difficulty are subject to change during the process due to carrier process changes. Sales are responsible for communicating this upfront with the client when discussing the transition. Any Transitions Team member available during the meeting will also provide details and support during discussions as well.
• For groups with 100 or less enrolled, please include the Transitions Manager.
• For groups with 250 or less enrolled, please include the Transitions Manager and Director.
• For groups with over 250 enrolled, please include the Transitions Manager, Director, and VP of Agency.

Prospect Status-

• Once the client confirms, they would like to move forward with benefitbay. The client will need to provide the following information in addition to typical onboarding documents for both currently enrolled for the current year:
  • Plan Name
  • Effective Date (MM/DD/YYYY)
  • Total Premium Amount
  • Employer Contribution Amount
  • Coverage Tier
  • Member ID
    • Preferably on benefitbay Coverage Imports Template found here.
• Transitions team will complete a Project Plan for employer, upload a copy in the CSM SharePoint folder for the client, and share during the internal Sales to CSM Handoff call.
  • Project Plan will include timeline, action steps/deadlines for employer and carrier action steps needed for employees.
    • PLEASE NOTE: Employee action items subject to change during the process due to carrier process changes. Sales/CSM are responsible for communicating this upfront with the client. Any Transitions Team member available during the meeting will also provide details and support during discussions as well.

Onboarding Status-

• The Transitions team will begin to import plans into benefitbay. The import will create HubSpot tickets to ensure all action steps for the AOR/payment are completed on each enrollment.
  • PLEASE NOTE: All standard onboarding items must be completed PRIOR to Transitions Team being able to start this process. The import upload matches the benefitbay census.
• The Transitions team will work on each ticket to complete AOR/payment changes.
  • When actions steps are required of employees, the Transitions team will email the employee, wait two business days, then call the employee, and leave a voice message. After two business days, any employee not responding will be documented to provide to the CSM to provide to employer.
    • The Transitions Manager will provide an end of the week report on the transition progress for each group and provide the assigned CSM to provide to the employer group.  
      • The report will include any employees with a high risk lapse due to a lack of employees responding to communications. 
    • On the effective date of the transition, any remaining unfinished tickets will be evaluated to determine the next steps of resolution.  
      • Transitions Team will work with Assurance Team on any items that still may need to be resolved.
      • (SURVEY- In Review) CSM will gather client feedback on the transition experience to share with Transitions Manager.

For any questions, please contact your supervisor.