Premium Management Technology

Mosaic Insurance Exchange provides the resources and solutions your business needs to manage prospective and ongoing account management services. Those services include e-billing and e-payment, lockbox management, premium aggregation and disbursement, audit/reconciliation and broker compensation. We have a strong track record of successful linkages to health insurance outside portal systems, including but not limited to 820 and 834 EDI.

E-Billing and Lockbox

Mosaic Insurance Exchange offers attractive electronic billing solutions to help make your financial business transactions more efficient, secure and precise. Premium funds are collected utilizing a retail lockbox capability through a Massachusetts bank specializing in such services. More than one million transactions worth in excess of half a billion dollars are processed annually through this relationship.

Mosaic Insurance Exchange provides a website that supports electronic payment processing. Authorized users log in to process member account payments. Multiple payment types (e.g. ACH pull, credit card, etc.) are supported. E-payments are integrated with the CRM system to manage the data from the website and to process payments against the account.

Eligibility Audit

Mosaic Insurance Exchange has a well-developed method for allowing clients to securely identify and validate eligible individuals, employers and members according to specific eligibility criteria. Data and documentation supporting eligibility is collected electronically or as hard copy, and added to the CRM system for concurrent and retrospective audit.

Reconciliation

The Financial Management System contains all employers, employees, individuals and dependents that have been converted to membership along with their associated brokers. This system manages the recurring billing cycles, payment processing, commission distribution and cash receipts.

Mosaic Insurance Exchange has two reconciliation methods in place― electronic and manual ―for health insurance plans that transmit electronic billing invoices to our organization.

For electronic reconciliations, the health insurance plan or state agency submits a monthly enrollment file that is uploaded and compared to Mosaic Insurance Exchange’s enrollment and payment records. An audit file report identifying discrepancies is generated and transmitted to the health plan or state agency for review and resolution.

For manual reconciliations, every month Mosaic Insurance Exchange analyzes and verifies all health insurance plan invoices to enrollment, accounts payable, and accounts receivable records to ensure that there are no enrollment transaction and/or premium discrepancies.

All enrollment transactions and premium discrepancies are documented, and the health insurance plan is contacted within two business days to discuss the method and timeframe for resolution.

Mosaic Insurance Exchange has successfully passed each health insurance plan audit without incident for over twenty five (25) years.

820 and 834 EDI

Mosaic Insurance Exchange has the expertise to securely gather, transmit, store and exchange member data, including premium payments and coverage information.

  • Premium data is transferred using secure 820 EDI interfaces.
  • Enrollment data is transferred using secure 834 interfaces.
  • Mosaic Insurance Exchange also supports alternative transmission methods, including webservices and flat files.

Broker Compensation

Mosaic Insurance Exchange can manage broker credentialing, registration, commission management and payments. Mosaic Insurance Exchange also actively engages the broker community by sponsoring and participating in broker education seminars, and managing the relationships with the unique business requirements health insurance carriers require.