How to Evaluate a Benefits Administration Platform

You’re about to switch benefits admin platforms. On one hand, you may be looking forward to being done with your current one. But on the other hand, who really looks forward to a seemingly endless rotation of demos, RFPs, and contract evaluations?

No one.

You can shorten the sales process if you know what you need and how to cut through the marketing and sales speak to find the vendor that can deliver. We’ll show you how to do just that below.

The Not-So-Hidden Cost of Choosing the Wrong Platform

Knowing the cost of one platform compared against another is the easy part. The hard part is understanding the cost of choosing the wrong platform.

If you’re looking to switch from an existing platform, you are probably well aware of the hidden costs that stack up when you have the wrong solution in place. We’re talking about things like:

• Added fees during the implementation and onboarding process
• Time lost to troubleshooting post-implementation
• Manual workarounds that consume staff hours
• Integration failures that require IT involvement
• A poor employee experience that turns your team off

Together, these create friction. That friction compounds if your current partner is unresponsive to questions or support needs, resulting in hours, and often weeks, of lost time waiting around for an answer.

You’re not imagining it: benefits administration is complicated. That’s exactly why the evaluation process deserves careful attention before you commit to a multi-year contract.

Start With the Problems You Need Solving Today

Just like you’d hire someone for your company, you’re hiring software to make benefits administration easier. If you’re going to invest time in a software product, start with the job it needs to do and the problems it needs to solve.

We recommend listing the tasks that create the most friction. For employers, that could be:

• New hire setup
• Eligibility changes
• Payroll deductions
• Employee questions
• Year-round life-event administration
• ACA compliance

Then turn those problems into testable requirements. “We need better enrollment” is too broad. “The system should show HR which employees have incomplete elections and allow follow-up without rebuilding a spreadsheet” is specific enough to test.

We also recommend documenting your plan structure. Knowing what packages you need, how many employment classes you have, whether you have voluntary benefits, etc., will give you a clear checklist to run down as you vet platforms. This also helps during implementation, as it lets your new vendor hit the ground running instead of waiting on clarification from you.

5 Core Capabilities of a Benefits Administration Platform

Let’s get specific about what you’re “hiring” a benefits administration platform to do. Below are five core competencies that you should judge vendors against:

• Carrier connectivity
• Payroll and HRIS integration management
• Compliance and ACA reporting
• Eligibility and rule management configuration
• Audit trail and data verification

Carrier Connectivity and Data Exchange

Carrier connectivity is one of the areas where most benefits administration platform implementations fail or run long. Prebuilt connectors to your existing carriers help. Still, you should assess how long it will take to set up new EDI connections and how you will maintain them.

Why are EDI connections such a drag? Employees enroll in October/November for plans effective January 1; almost everyone in the country is doing this at the same time, creating a massive backlog. Add in poor communication and people on vacation, and it can take weeks to get a response when carriers are inundated.

Our team at Zevo staffs an in-house EDI team that follows up daily with your carrier to ensure a timely response. Your carrier may be slow to respond, but we’ll follow up relentlessly until we get an answer and unblock your implementation.

Payroll and HRIS Integration Management

A benefits administration platform can’t exist in isolation. Look for a platform that supports a seamless sync with your HRIS so changes in one system are reflected automatically in the other, without manual intervention or exports.

We recommend asking about integration depth, not just integration availability. Surface-level integrations still require manual effort, which increases risk and adds hours to your workflow. The complexity usually lives in the edge cases, so ask:

• How does the integration handle mid-year changes?
• What happens when an employee's status changes retroactively?
• Who maintains the integration over time?

These questions will reveal whether a platform scales with your needs rather than requiring workarounds later.

Compliance Reporting and ACA Tracking

Don’t forget to evaluate compliance help. From ACA reporting to ERISA and COBRA, look for a platform that provides the documentation, audit trail, and reporting functionality you need to reduce pain here.

The ACA, in particular, can lead to severe fines long after the violation occurred. Companies routinely incur coverage and reporting penalties because of gaps in their records. Check out our guide to ACA penalties and how a benefits administration platform can help.

Eligibility Management and Rule Configuration

Your eligibility rules are likely more nuanced than a simple full-time versus part-time distinction. Employers with 500-2,000 lives sit in what we call the “messy middle.” They have more complex needs than those of smaller employers, but that doesn’t necessarily mean they are ready for enterprise software (yet). Often, we see companies with waiting periods, hours-based eligibility, or location-specific requirements, so you’ll likely need a platform that allows you to update eligibility logic without constant vendor support tickets.

Audit Trails and Data Validation

When employees, auditors, or regulators ask questions, you need a record of what happened and when. That record should cover elections, eligibility changes, approvals, and communications.

Zevo Benefits, for example, runs validation checks through a proprietary feature called Data Patrol, which catches mismatched SSNs, missing dependents, and incorrect coverage codes automatically as data moves through the system. For a company managing benefits for a few hundred to a couple thousand employees, that level of automation can mean the difference between catching an error in minutes and discovering it later through a penalty.

Don’t Forget the Employee Experience

When selecting a benefits administration platform, consider more than HR teams. You also need to ask about the employee experience.

• Customizable and brandable portal: Look for a platform that offers a brandable, customizable employee portal that fits seamlessly with your employer brand. With Zevo, you can customize colors and logos to make employees feel at home, and add custom disclosures and HTML links.
• Painless self-service during enrollment: Is enrollment easy to navigate? Can employees save their progress and return to it before finalizing elections? Zevo allows you to do all of this and more. Once completed, employees will receive a PDF confirming their elections (which, of course, you can customize).
• Communication channels for HR teams: Look for a platform that lets you customize portal messaging and automate communications to employees through the enrollment deadline. Zevo allows you to set conditional messages based on employee activity and elections.

Zevo Benefits does all of the above. Employers get enterprise-level configurability (without the enterprise price tag) while employees get a smooth experience every year during open enrollment.

Where Should AI Come Into Play?

As AI adoption accelerates, many platforms are laying AI features onto their existing capabilities.

The problem with leaning on AI for benefits administration, though, is that the margin for error is slim with regulated data and changes that reach payroll and carriers. One mix-up could mean painful data cleanup or a massive fine.

There’s no doubt: AI can be powerful. We envision a world where AI can generate reports, build EDI connections, and help HR diagnose and solve employee issues. But you cannot sacrifice accuracy and control over your data for convenience. We recommend looking out for the following:

• A product that keeps a human in the loop where it matters most; nothing that changes coverage, pay, or carrier data happens without a person's approval.
• Checks for any output that AI produces.
• AI providers that don't retain your data and never use it to train models.
• The ability for HR and employees to always know when AI is involved.

At Zevo, we’re committed to these tenets, which is why we thoughtfully introduce AI features and rigorously test them before they reach a customer. Make sure to ask vendors how they think about AI safety and data governance before you commit.

Questions to Ask Vendors

The demo will always look perfect. You need to understand the limitations of the platforms you review and assess how well they can adapt to your needs. Below are five we recommend prioritizing:

• EDI connections: Which of our current carriers do you already have direct EDI connections with, not just generic EDI support? If there's a gap, how long will a new connection take?
• ACA reporting: Walk us through ACA reporting end-to-end. What does your platform produce automatically, and what does our team still do? (Manual steps raise your exposure to 4980H(a) and (b) penalties and late-filing penalties.)
• Implementation: What's your typical timeline for a company our size, and what are the most common reasons clients run over? (Six weeks and six months are very different commitments.)
• Open enrollment support: What does support look like during open enrollment? Who do we contact if something breaks at the end of the window, and what's the response time?
• Billing reconciliation: How does reconciliation work month to month? Walk us through what our HR team does after carrier invoices arrive. (You want a five-minute export, not a five-hour project.)

Questions like these cut through the surface-level shine of a demo and reveal what life with a vendor is really like.

Download Your Guide to Choosing the Right Benefits Administration Platform

The right benefits administration platform isn’t the one with the most features, the best AI technology, or even the biggest logos on the homepage.

It’s the platform that silently and tirelessly works in the background; the platform that arms your team with the data you need to make better decisions; and the platform that makes open enrollment a breeze for you and your employees.

Download our guide to choosing the right benefits administration platform.

In this free guide, you will learn:

• What features to look for
• What to ask potential vendors
• How to evaluate your options
• Which vendors are best for today’s employers

Fill out the form below to get your copy.