Billing and COBRA Administration System

The Vendor is required to provide billing and cobra administration system shall be fully integrated with the state personnel system (SPS) workday.
- Requirement:
• Member portal with capabilities for members to view coverage, payment history, and premium due dates that allows participants to update communication preferences and direct participants to the appropriate state provided portal to remit payments.
• Instructions shall be provided in various forms, including the contractor’s website, monthly invoices, and written notices.
• Release monthly cobra billing to participants by the 3rd business day of each month.
• Create and assist with integrations required to facilitate movement of information from workday benefits to a direct billing contractor.
• Engage with the state to obtain and update health plans and approved rates by November 15 of each year for the following plan year.
• Generate and provide customized notices (e.g., cobra notices for retirees) as specified in federal and state regulatory requirements that may be amended when specified by the state, with relevant contact information directing participants to the state for assistance.
• Online employer-level account management with capabilities to access member data, view and download letters and enter new participants.
• Provide online capabilities to access downloadable reports including, but not limited to a generated letters summary, member status, paid through, plan rate renewal, and direct bill summary reports.
• Manage flexible billing frequency for participants.
• Receive a daily payment file and shall review, analyze and update participant records within one (1) business day.
• Maintain and exchange enrollment data with the state’s carriers for cobra participants at a minimum of two (2) times per week, as approved by the state.