–Digital Solutions–

Dental Benefit Automation Application

Client: Healthcare Provider
Industry: Finance & Insurance
Deliverables: Customized web solution 

The Challenge

In order to comply with the new regulations defined by the Affordable Care Act, all existing Benefit Certificates and Riders needed to be redeveloped, filed and approved by the state. With the creation of new corporate forms for the new benefits, all groups needed to be moved to the new benefit structure beginning with 2014 renewals. Each group had to be processed through a Group Wide Change (GWC) transaction to update the group records with the new benefit package – a very time-consuming process due to the large volume of GWCs that needed to be managed. A large health care provider needed a better way to update and automate this information. It was determined that the first task to be tackled was automating the Dental Tab of the Online Benefits Information Manager.

The Solution

The Lochbridge team determined that the best solution was to create a tool that aggregates dental benefits and give employers one source for all pertinent information. To automate the Dental Tab, Lochbridge designed and implemented a Dental Data maintenance application for the creation or modification of new or existing Dental Benefit Certificates. This improved the staging of them for contract assembly and rendering by downstream applications. By establishing one point of contact for all health insurance wellness programs (medical, dental and vision), Lochbridge made it easier for employers to manage offered health plans while simultaneously lowering their administrative costs. This solution helped stakeholders by giving them a single statement of benefits that combines their health care plan with their dental plan.

  • One complete list of benefits
  • Health Care Reform compliant
  • Providing customer information quickly