Carrier invoice reconciliation guides

What each carrier guide covers

• ✓Billing method - list-bill, self-bill, or the employer's choice, and what that changes about the monthly process.
• ✓What the invoice contains, field by field, and which fields you can actually join on.
• ✓Where to get it - the employer portal and the file formats available.
• ✓A three-way match walkthrough from invoice to enrollment to payroll deduction.
• ✓The discrepancies that recur with that carrier, what causes them and how to resolve them.
• ✓Retroactive handling - how far back adjustments go, how credits appear and how long they take.
• ✓The dispute path when the bill is wrong.

Guides are published carrier by carrier rather than generated from a template, because the discrepancy detail is the entire value of the page. Where we cannot document a carrier's billing behaviour accurately, we do not publish a page for it.

Coverage in progress

Medical - national

UnitedHealthcare, Aetna, Cigna, Kaiser Permanente, Anthem / Elevance Health, Humana, UMR, Oscar Health, Centene / Ambetter, Molina Healthcare, Surest

Medical - Blue Cross Blue Shield plans

BCBS is a federation and each plan bills differently: BCBS of Michigan, BCBS of Texas and Illinois (HCSC), Florida Blue, Highmark, Horizon BCBSNJ, CareFirst, Premera, Regence, Wellmark, Blue Shield of California and other member plans.

Dental

Delta Dental and its state member companies, MetLife Dental, Guardian, Principal, Ameritas, United Concordia, Cigna Dental, Humana Dental, DentaQuest, Renaissance, Beam Benefits

Vision

VSP Vision Care, EyeMed, Davis Vision, Superior Vision / Versant Health, UnitedHealthcare Vision, Humana Vision

Life, disability and voluntary

MetLife, Unum, The Hartford, Lincoln Financial, Voya, Guardian, Principal, Sun Life, Mutual of Omaha, Reliance Matrix, The Standard, Securian, Symetra, Colonial Life, Aflac, Allstate Benefits, Trustmark

Retirement recordkeepers

A related but distinct job: reconciling the deferral file and remittance against payroll rather than an invoice. Fidelity, Empower, Voya, Principal, Vanguard, T. Rowe Price, TIAA, John Hancock, Nationwide, Ascensus, Human Interest, Guideline.

HSA, FSA, HRA and COBRA administrators

HealthEquity, WEX, Optum Financial, Inspira Financial, Navia, Alight, P&A Group, TASC, Benefit Resource, Lively, isolved Benefit Services, Chard Snyder

Start with the benefits invoice reconciliation pillar for the three-way match, self-bill vs list-bill and the recurring variance types that apply to every carrier.