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How APIs are changing the game for benefit administrators, employers and employees

By Melissa Christian | January 25, 2023

The use of APIs is increasing rapidly to enable the fast, accurate and secure exchange of data between systems, vendors and carriers.
Benefits Administration and Outsourcing Solutions

The world of HR and benefits administration is taking a giant step forward. Thanks to the use of application program interfaces (APIs), the way HR and benefit systems connect and share information is evolving rapidly. Data can now be exchanged quickly and easily without the need for clunky file feeds.

What is an API?

Every time you use an app for social media, send an instant message or check the weather on your smartphone, you're using an API. An API is a set of functions and procedures that allows applications to talk to each other. APIs enable the power of connectivity by exchanging data quickly, accurately and easily between systems — all through a secure process.

Why APIs are a game changer

Unlike sharing data from system to system with cumbersome file feeds, APIs allow data to be exchanged in (or near) real time. When you place an order on your favorite coffee bar app from your desk, you can walk across the street and, within minutes, your grande oat milk latte is waiting for you. Plus, the best part is, you’ve already paid through your app! The system already knows your preferences and payment information because these data sets are stored and communicated through an API.

In the world of human resources and benefit program administration, the use of APIs is a very exciting step forward. Think about your new hires: How long do they have to wait before they can pick up a prescription covered by your benefit plan once they begin employment? Should an employee be diagnosed with a serious disease, will they know you have a special wellbeing program that can help them?

Through APIs, you can get new hires to the pharmacy quickly and ensure your employees know about time off, employee support and second opinion programs available to them during challenging times. Incorporating APIs into benefits administration and healthcare delivery will significantly enhance the employee experience, making your carefully curated benefit programs even more valuable.

Here are the key areas where we see APIs as a game changer in administration for carriers, employers and employees:

  1. 01

    Vendor coverage data

    APIs present a huge opportunity to deliver eligibility and coverage data more cost effectively and securely by replacing physical batch eligibility files. This not only increases the speed at which enrollment data are updated with vendors but also increases agility when system changes need to be made on either side.

    In 2021, WTW disrupted the carrier eligibility reporting space with the release of our standard Coverage API solution. We applied our expertise in the benefit space to our focus on technology to launch an application that would have the largest impact for carriers and benefit professionals alike. By developing a standard approach, we have enabled any carrier to use the application for any benefit. This allows for real-time retrieval of data for subscriber, employment, dependent and coverage details.

    With our approach, carriers control the timing and frequency of updates to their system according to their business rules. Through this method, the cycle time for initial enrollment data and subsequent changes to be updated in the vendor’s system is significantly reduced, greatly improving the employee experience.

    Making coverage and eligibility data available to carriers via an API not only improves the employee experience but also offers a streamlined and cost-effective solution for employers. It shifts responsibility for deriving group mapping to the carrier that already owns the development of account structure. Previously, employers would incur costs from the carrier and benefit administrator when additions or changes to structure were required. With our API, all the raw data needed for the carrier to apply its own account structure are made available — drastically reducing the time to implement plan design changes and eliminating the need to pay for updates in both systems.

    Through our implementation work with national carriers and consulting relationships with national account representatives, we’ve learned that WTW is the only benefit administrator with a standard coverage API live in production.

  2. 02

    Human resource information system (HRIS) and payroll data

    HRIS and payroll data have a big impact on the employee experience. For some employees, the time it takes for their new hire event to process through all the various stages and systems can be challenging, especially for those who encounter an emergency or have a sick child as they are starting a new job. Applying standardized APIs to exchange HRIS data in real time can greatly expedite the sharing of information and access to benefits.

    This category relies heavily on HRIS systems/vendors to develop standard APIs that can integrate with benefits administration systems to retrieve and load data. WTW stands ready and willing to take the next step in HRIS API integration as we continue conversations with applicable vendors.

  3. 03

    Self-service integration and employee engagement

    Easy access to carrier information can enhance the self-service experience through targeted vendor communications, such as year-to-date claims, progress on deductibles and out-of-pocket maximums, wellness credits, registration status and required actions. This can enhance your participants’ ability to gather information about their benefits and be engaged consumers of the plans and programs you provide. Real-time access to benefit information enables employees to make smarter decisions throughout the year as well. Leveraging APIs in operation on the back end, your employees can quickly access the information they need so they get the right care at the right time.

    For example, many employees can forget to take the necessary step of registering with their healthcare navigator. Integrating an API to receive real-time registration status allows direct reminders via text message and email as well as the opportunity to engage employees with online alerts within the self-service experience. These simple nudges to act can go a long way in setting up employees to be able to utilize their benefits and programs effectively and successfully.

    WTW has successfully integrated multiple vendor APIs to support actionable alerts. We are continuing conversations with additional vendors to support healthcare navigation, engagement hubs, point solutions, voluntary benefits and financial services.

    Want to learn more about WTW’s vision for integrating your point solution ecosystem? Download our summary at the end of this article.

  4. 04

    Administrative processes

    APIs can also be very helpful in supporting and improving administrative tasks for a faster and more streamlined participant experience.

    Previously, near- or real-time Electronic Evidence of Insurability (EOI) approvals were supported by limited vendors via a web service. API data sharing is a more modern technology that provides the same user experience. WTW currently supports EOI approvals via API, as the number of vendors able to support near- or real-time EOI approvals continues to grow.

    Using APIs to perform verifications related to our direct billing and direct deposit processes not only improves administrative efficiency but also supports our overall data security and risk mitigation priorities. Automated Clearing House and credit card direct bill payments as well as direct deposit account data are validated using APIs, letting participants know immediately if they need to enter a corrected account number or card number to proceed. We also validate account ownership by accessing national databases of bank account information to validate the name of the account owner to ensure it matches the name of the participant being billed or receiving a pension payment. If the names do not match, we can take additional steps to confirm the identity of the individual, thereby mitigating the risk associated with account transactions.

Moving forward

APIs are the future of data exchange; the rest of the world is using them to transfer information and complete such everyday interactions as buying coffee, checking social media and even banking activities. It’s time HR and benefits administration jump on the bandwagon and integrate APIs into all aspects of daily data sharing instead of the current batch data file feeds to enhance both the employee and the plan sponsor experience. WTW is committed to innovating and engaging with vendors so that, together, we can deliver the best possible employee experience at every stage of the benefit journey.

Download our summary
Title File Type File Size
Integrating your point solutions ecosystem PDF 1.1 MB

Customer Experience Director, Benefits Outsourcing
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