BenefitIQ — Carrier Portal

Feed Dashboard

Aetna Group Division · Real-time EDI monitoring · 6 active employer groups

● Systems Operational

⚠

Atlas Financial: 820 premium payment file has not been acknowledged in 28 hours. Expected monthly premium: $184,800. SLA breach — BenefitIQ admin has been notified. Case #CSE-00839 open.

Active Members

29,842

↑ 312 this month

Groups (Employers)

6

Meridian, TechBridge + 4

Premium (MTD)

$3.8M

1 payment pending

EDI Files (48h)

18

✓ 16 processed

EDI Errors

2

Needs attention

Live EDI Feed — All Groups

ANSI X12 · Real-time status

File	Type	From Group	Records	Status	ACK	Time
834_Meridian_20260316.edi	834	Meridian Corp	12,450	✓ Processed	999 ACK	2h ago
820_Atlas_Mar_Premium.edi	820	Atlas Financial	1	Received	No ACK	28h ago
834_TechBridge_Delta.edi	834	TechBridge Inc	48	✓ Processed	999 ACK	6h ago
270_Elig_Request_BCBS.edi	270	BenefitIQ	892	✓ Processed	271 Sent	8h ago
834_Northgate_OE_Batch.edi	834	Northgate	5,110	✓ Processed	999 ACK	1d ago
820_TechBridge_Mar.edi	820	TechBridge Inc	1	✓ Posted	999 ACK	1d ago

Group Health by Status

Meridian Corp

12,450 members · HDHP + HSA Gold

✓ All Clear

TechBridge Inc

8,912 members · EPO Plus

✓ All Clear

Atlas Financial

3,850 members · Premium payment overdue

Payment Due

Northgate Logistics

5,110 members · OE batch processing

OE Active

Premium Summary (MTD)

Meridian Corp$1,840,240 ✓

TechBridge Inc$921,040 ✓

Atlas Financial$184,800 ⚠ Overdue

Northgate Logistics$820,160 ✓

Total Received$3,581,440 / $3,766,240

EDI Inbound Files

ANSI X12 834, 820, 270, 837 · From BenefitIQ platform & employer groups

Files (7d)

42

Processed OK

40

Errors / Holds

2

Avg ACK Time

1.8h

⚠

BenefitIQ Admin has been notified of the Atlas 820 non-ACK. Case #CSE-00839 is open. Escalation to payment ops team at 30h if unresolved.

Transaction Log

All inbound EDI transactions

Filename	Type	Sender	Received	Records	Status	ACK Sent	Error Detail
834_Meridian_20260316.edi	834	BenefitIQ → Meridian	Mar 16 · 08:42	12,450	✓ Processed	999 ✓	—
820_Atlas_Mar_Premium.edi	820	BenefitIQ → Atlas	Mar 15 · 06:10	1	Received	No ACK	Payment ops hold
834_TechBridge_Delta.edi	834	BenefitIQ → TechBridge	Mar 16 · 10:14	48	✓ Processed	999 ✓	—
271_Elig_Response.edi	271	Aetna → BenefitIQ	Mar 16 · 08:58	892	✓ Sent	Outbound	—
834_Northgate_OE.edi	834	BenefitIQ → Northgate	Mar 15 · 14:22	5,110	✓ Processed	999 ✓	—
837_Claims_Meridian.edi	837	BenefitIQ → Meridian	Mar 15 · 22:10	3,204	✓ Processed	999 ✓	—

834 Enrollment Change Summary

Last 834 batch · Meridian Corp · Mar 16

New Enrollments

Added in this batch

124

Terminations

Effective this month

38

Dependent Changes

Add / remove

22

Plan Changes

Annual enrollment switches

410

QLE Events

Marriage, birth, LOA

8

EDI Spec Versions & Agreements

BenefitIQ Platform

Active

Sender ID: BIQ-ADM-001 · ANSI X12 5010

Formats: 834, 820, 270/271, 837 · SFTP + API

Last validated: Sep 18, 2025

BenefitIQ Clara Intelligence™

AI Layer

Clara Enroll™ · Dependent verification · ACA reporting

Claims data integration → proactive member guidance

Clara AI™ governance on all automated actions

BenefitIQ Global

Integration

Payroll-native 834 feeds · Real-time deduction sync

OE + QLE · US + 150 countries

Last validated: Jan 6, 2026

💡

BenefitIQ sends enrollment changes via both SFTP EDI and real-time API. BenefitIQ-powered dependent verification audits (deployable in 2 weeks) automatically flag ineligible dependents before 834 transmissions, reducing error rates and protecting carrier data integrity. Clara Enroll™ guides employees through plan selection before elections hit the carrier feed — reducing post-enrollment change requests.

Premium Payments

820 remittance tracking · Payment reconciliation · ACH + Wire

⚠

Atlas Financial — March Premium OVERDUE (28h). Expected: $184,800 · Payment method: ACH · BenefitIQ Case #CSE-00839 open. If unresolved by Mar 17, coverage suspension notices will be generated automatically.

March Premium Due

$3,766,240

Received

$3,581,440

Outstanding

$184,800

Payment Rate

95.1%

March 2026 Premium Register

All employer groups

Employer Group	Group ID	Lives	Premium Due	Payment Method	820 File	Status	Received Date
Meridian Corp	GRP-AET-29401	12,450	$1,840,240	ACH	820_Meridian_Mar.edi	✓ Posted	Mar 14
TechBridge Inc	GRP-AET-88122	8,912	$921,040	ACH	820_TechBridge_Mar.edi	✓ Posted	Mar 13
Northgate Logistics	GRP-AET-55210	5,110	$820,160	Wire	820_Northgate_Mar.edi	✓ Posted	Mar 12
Atlas Financial	GRP-AET-71840	3,850	$184,800	ACH	820_Atlas_Mar.edi	⚠ No ACK	Overdue 28h

Eligibility & Enrollment

Member roster · 834 processing · 270/271 real-time · QLE management

Active Members

29,842

↑ 312 this month

OE Elections (MTD)

8,420

Annual enrollment

QLEs Processed

48

Mar 2026

270/271 Queries

892

Real-time response

Member Roster Summary

Group	Active Members	Pending	Terminated	Dependents	Plan
Meridian Corp	12,450	124	38	4,820	HDHP HSA Gold
TechBridge Inc	8,912	48	12	2,410	EPO Plus
Northgate Logistics	5,110	22	8	1,840	PPO Classic
Atlas Financial	3,850	14	6	1,200	HDHP HSA Gold

Recent QLE Events

From BenefitIQ & BenefitIQ platform

Sarah Chen — Meridian Corp

Birth

Dependent added: Emma Chen, Feb 14 · HDHP → HDHP+1 · Deduction updated via BenefitIQ payroll sync

David Liu — Meridian Corp

Marriage

Spouse added: Lisa Liu, Mar 5 · Plan tier update · 834 change file received

Priya Sharma — Meridian Corp

Termination

Effective Mar 8 · COBRA notice issued · 60-day election window open

Marcus Johnson — Meridian Corp

New Hire

Enrolled Mar 10 · 30-day OE window · 834 file sent by BenefitIQ

Group Accounts

Employer group management · Plan configurations · Contract terms

MC

Meridian Corp

Group ID: GRP-AET-29401 · 12,450 members · Healthcare industry

Plans: HDHP + HSA Gold, PPO Classic · Renewal: Jan 2027

Active

Since Jan 2020

TB

TechBridge Inc

Group ID: GRP-AET-88122 · 8,912 members · Technology

Plans: EPO Plus, HDHP Lite · Renewal: Mar 2027

Active

Since Mar 2021

NL

Northgate Logistics

Group ID: GRP-AET-55210 · 5,110 members · Logistics

Plans: PPO Classic, HMO Basic · Renewal: Jun 2027

Active

Since Jun 2022

AF

Atlas Financial

Group ID: GRP-AET-71840 · 3,850 members · Finance

Plans: HDHP + HSA Gold · Renewal: Apr 2027

Payment Due

Mar premium overdue

Plan Catalog — Aetna Group Plans

All plans available to employer groups through BenefitIQ

Plan Name	Type	Enrolled Groups	Total Members	PEPM	Network	Status
HDHP + HSA Gold	HDHP	Meridian, Atlas	16,300	$148/mo	Aetna Open Choice PPO	Active
PPO Classic	PPO	Meridian, Northgate	14,892	$342/mo	Aetna Open Choice PPO	Active
EPO Plus	EPO	TechBridge	8,912	$275/mo	Aetna Select	Active
HMO Basic	HMO	Northgate	1,240	$198/mo	Aetna HMO	Active

Reconciliation

Enrollment vs. premium vs. roster · Monthly close · Discrepancy management

Roster Match Rate

99.2%

↑ vs last month

Discrepancies

24

Pending resolution

Premium Variance

$3,240

0.09% of total

Last Full Recon

Mar 1

Discrepancy Queue

Items requiring review or correction between BenefitIQ and Aetna systems

Group	Member	Type	BenefitIQ Data	Aetna Data	Status
Meridian Corp	Emma Chen (dependent)	QLE	Added Mar 14 · HDHP+dep	Not yet applied	Pending
TechBridge	R. Kaur (employee)	Address	Updated: 240 Oak St, Austin TX	Old address in system	Pending
Northgate	J. Torres (employee)	Termination	Terminated Feb 28	Still active in system	Pending
Meridian Corp	T. Washington	Plan Change	PPO → HDHP (OE election)	✓ Applied	Resolved

Integration Health

BenefitIQ → Aetna data pipeline

Enrollment Pipeline

LiveBenefitIQ 834 daily batch00:00 UTC nightly

LiveBenefitIQ payroll-native QLE syncReal-time API

Live270/271 eligibility verificationReal-time <2s

Financial Pipeline

Live820 monthly premium files1st of month

Live835 claims remittanceWeekly batch

ErrorAtlas 820 — ACK pendingCase open

Claims Feed (835/837)

Claims remittance · EOB data · Clinical feeds back to BenefitIQ

Claims (MTD)

18,420

Total Paid

$2.1M

Avg Claim

$114

835 Files Sent

6

835 Remittance Files Sent to BenefitIQ

835 File	Group	Claims Count	Total Paid	Sent To	Status	Date
835_Meridian_Mar1.edi	Meridian Corp	4,812	$840,420	BenefitIQ SFTP	✓ ACK	Mar 10
835_TechBridge_Mar.edi	TechBridge	3,210	$480,100	BenefitIQ API	✓ ACK	Mar 10
835_Northgate_Mar.edi	Northgate	2,840	$320,880	BenefitIQ SFTP	✓ ACK	Mar 10
835_Atlas_Feb.edi	Atlas Financial	1,204	$184,200	BenefitIQ SFTP	✓ ACK	Feb 10

💡

835 remittance data flows back to BenefitIQ, where employees can see processed claims in their MyBenefits dashboard and use the “Claim Choice” feature to reimburse from HSA/FSA accounts. The closed-loop data pipeline eliminates manual EOB lookups for members.

Plan Configuration API

Aetna · Auto-push plan designs, rates & rules to BenefitIQ · Real-time sync · Industry-first

💡

The Plan Configuration API is an industry-first connection that lets Aetna push plan designs, rates, benefit structures, and eligibility rules directly to BenefitIQ — eliminating manual data entry, reducing configuration errors, and keeping plan data in sync automatically year-round. When rates change, BenefitIQ is updated before the next enrollment cycle opens.

Plans Live on API

31

Across 8 group accounts

Last Sync

2h ago

All plans in sync

Rate Updates (YTD)

4

All auto-synced

Config Errors

0

vs 12 last year (manual)

Live Plan Catalog — API-Managed

● Live

Plan Name	Type	Groups	Last Rate Push	Sync Status
Aetna HDHP + HSA Gold	HDHP	6	Jan 15, 2026	✓ Synced
Aetna PPO Classic	PPO	8	Jan 15, 2026	✓ Synced
Aetna EPO Select	EPO	5	Jan 15, 2026	✓ Synced
Aetna Dental Preferred	Dental	8	Jan 15, 2026	✓ Synced
Aetna Vision Plus	Vision	8	Jan 15, 2026	✓ Synced
Aetna HDHP Basic	HDHP	3	Mar 2, 2026	▲ Rate updated

API Capabilities

LivePlan design & benefit structure push

LiveRate table synchronization

LiveEligibility rule transmission

LiveEnrollment billing API reconciliation

LiveEOI decision notification API

LiveMember portal SSO handoff

Q3 26Provider directory real-time API

Rate Change Workflow

1

Aetna pushes updated rates via Plan Config API

2

Clara Intelligence auto-detects impacted groups & flags conflicts with existing eligibility rules

3

Admin reviews staged config — approves with one click

✦

Plan data live in all employer portals before next OE