Creating new plans

If you cannot obtain carrier quote files, you can manually create plans in several ways, for a given Employer Group.

Upload Medical SBCs (Summaries of Benefits and Coverage documents)

Current Plans:

• If you have carrier medical SBC files, go to the "Current Plans" tab and click the "Upload SBC" button in the upper right corner.
  • These can be large group medical or ACA/small group medical SBCs. However, if you're trying to create an ACA/small group medical plan, we strongly recommend using our Plan Library as described below.

• Drag and drop or upload SBC files from your computer.
• Review and edit benefits as needed.

Renewal or Alternate Plans:

• If you have carrier medical SBC files, go to the "RFP & Uploads" tab, then "Uploads" and click the "Upload ?Quotes" button in the upper right corner.
  • These can be large group medical or ACA/small group medical SBCs. However, if you're trying to create an ACA/small group medical plan, we strongly recommend using our Plan Library as described below.

• Drag and drop or upload SBC files from your computer. These plans will be placed in the Plan Explorer
• Review and edit benefits as needed from the Plan Explorer tab.

Create ACA Medical Plans From Our Plan Library In Seconds!

• To create ACA/small group medical from our Plan Library, go to the "Current Plans" tab and click the "Create New Plan" button in the upper left corner.

• Set Product to "Medical".
• Select your Carrier and input the plan's Effective Date.
• Wait a few moments and the "Quick Start: Search Plan Library" box will pull up any available plans that match your carrier and effective date.
  • Note: please make sure you have set your Employer Group address prior to using the Plan Library.

• If desired, you can customize the plan name.
• Review and edit benefits as desired - all are editable.

Manually Create Ancillary Plans

• Go to the "Current Plans" tab and click the "Create New Plan" button in the upper left corner.
• Select Product, Carrier, and Effective Date.
• Input as few or as many benefits as desired.
• Input employee counts and rates as desired.

 

Copying an Existing Plan

If you have an existing plan, you can create a copy of it to modify benefits/rates as needed.

• Click "Create New Plan" within either the "Current Plans" or "Plan Explorer" tab.
• Select the Product, Carrier and Effective Date.
• Within the "Plan Name" dropdown, you will see any existing plans in your Employer Group that match the Product and Carrier.
• Select the plan you'd like to copy.
• Please wait a few moments for the plan benefits to populate.
• If needed, update the Carrier.
• Review and edit benefits as desired.
• Input employee counts and rates as desired.

Custom Benefits

Custom benefits can be added to any plan, and they will display both in app and within your exports. While editing plan benefits, go to the "Custom Benefits", enter the benefit type, tap "Enter" or click anywhere, and type in the benefit value.

Please Note

• ACA medical plans can be set to be "Age Rated" or "Tier Rated".
  • Age Rated Current Plans can only accept a total monthly premium.

• Plans can also be imported from BenefitPoint CRM (see Importing BenefitPoint Accounts).