*Please note: the “Time in Each Status” are estimates only. Definitive times generally depend on how quickly carriers respond and how promptly brokers and employers are able to clarify issues as they arise throughout the process.

Frequently Asked Questions

I want to set up a new EDI connection. How can I start that and what information is required?

If you’re interested in setting up a new EDI connection for one of your benefits, you’ll need to complete an EDI request so we can review and start gathering the information needed to set this up with your carrier.

>> Request a new EDI Connection here

The typical information needed for a new EDI connection includes:

• A Submitted EDI Request Form
• Policy Number
• Carrier information and Carrier Contact
• Data Discrepancy Contact

How long does it take to set up a new EDI connection?

Your Sun Life EDI connection will be live within 10 business days of your implementation being complete. We will automatically take care of getting your employee’s latest enrollment information over to Sun Life. Ongoing, the feed will send weekly on Monday mornings and include changes to employee’s Sun Life elections (i.e. new hire, terminations, qualifying life events) that have occurred in the portal since the last file was sent. Any changes made in the portal on Monday will be sent in the following week’s file. Changes sent on the feed typically take 24-72 hours to fully process in Sun Life.

Maxwell strives to offer a best in class experience across our platform, including streamlining the process for setting up EDI connections and integrations with carriers and partners. As consistent with industry standards and work required with your carrier, EDI connections for non Sun life carriers can typically take about 45-90 days to get up and running. Our team is dedicated to get your connection up and running as soon as possible through the work done on gathering requirements, testing with carriers and supporting your success to go live.

• Please note: For Sun Life benefits, once your portal is released to you, even though a Live EDI connection may not appear in your portal, we will automatically take care of getting your employee’s latest enrollment information over to Sun Life. The 60-90 day timeline will apply for medical plan EDI connections and all non-Sun Life benefit EDI connections.

>> You can learn more here about working with Sunlife + Maxwell and EDI.

What do I need to know about my non-Sun Life EDI feeds? 

As consistent with industry standards, all non-Sun Life feeds take about 45-90 days to get up and running. In the meantime, you will want to be aware of the following:

• All discrepancy reports are set to be filtered through your designated “Data Discrepancy Contact”. They will be contacted when we need clarifications between what is in your carriers system and what information we have in the Maxwell portal. 
• Ensure you are updating carriers with your new enrollment data following open enrollment and as well as any ongoing updates to this information until the feed is live. Our reporting capabilities make it easy to pull this information from the portal.  Our About Reports article outlines which report will suit your specific needs best. 
• You will be notified by the Maxwell EDI team prior to any non-Sun Life feed going live, so that you know you can stop caring for portal updates with carriers manually. 

What is my role during implementation?

The EDI team is here to help streamline the process for setting up EDI connections with your benefit carriers and will do most of the work directly with your carrier. But you may be able to help!

In the case there are clarifications between the data in your carrier’s system and the information we have in the Maxwell portal, the designated “Data Discrepancy Contact” will be contacted to review these discrepancies and will receive any discrepancy reports. Ensuring the data accuracy will create a smoother testing process during your EDI connection setup.

Why might my EDI connection take longer than expected to set up and go live?

If you’re requesting a new EDI connection towards the end of the year, it’s helpful to keep in mind that this is a peak time for your insurance carriers, especially when it comes to managing renewals and setting up new EDI connections. During this time, you may see a longer timeline for setting up new feed implementations since testing can take additional time and is still a crucial step in a successful connection.

What is a data discrepancy contact?

When setting up and managing an EDI connection, data accuracy between Maxwell and your insurance carrier is especially important. In case there are clarifications between the data in your carrier’s system and the information we have in the Maxwell portal, the designated “Data Discrepancy Contact” will be contacted to review these discrepancies and will receive any discrepancy reports.

• Note: Discrepancies for live feeds are rare but often result from manual updates made in the carrier system and not in Maxwell. We encourage clients to review weekly reports from your carriers and conduct routine audits of your carrier bill.

How frequently is the EDI Status showing in my portal updated?

You can view the status of your Live and In progress feeds from the EDI & Integrations tab under Settings in your portal. This status is updated on a daily basis. If you have additional questions, you can reach out support@maxwellhealth.com.

How will I know when my EDI connection is ready to go live?

You will be notified by email from the Maxwell EDI team prior to any EDI connection going live. We’ll make sure to notify you so that once your connection is live, you know you can stop caring for portal updates with carriers manually.

When the connection is live, you will also see an updated status of “Connected” in the Settings > EDI and Integrations area of your Maxwell portal. This is also where you can view the feed schedule and the last sync date if applicable.

My requested EDI connection is not yet live, how should I handle new enrollments and changes with the carrier?

If your EDI connection is not yet live, you should ensure that you are updating carriers directly with your new enrollment data once it is updated in Maxwell. This includes following your open enrollment as well as any ongoing updates until the EDI connection is live.

Maxwell’s reporting capabilities make it easy to pull this information from the portal.

>> Check out the About Reports article which outlines which report will suit your specific needs best.

I’ve requested a COBRA file but I don’t see this on the Current EDI Feeds dashboard?

The Current EDI Feeds tab will only show EDI connections with your benefit carriers, it does not include COBRA file connections. If you’ve requested a direct connection with a vendor for your COBRA file, you’ll see that listed under the Current Integrations tab.

• Reminder: Maxwell does not act as a COBRA administrator, but you can use Maxwell to manage qualifying events that result in an active employee becoming eligible for COBRA coverage. Learn more about Managing COBRA Events in Maxwell.

My file is already live and it’s about to renew, will I see anything different on the Current EDI Feeds dashboard?

Each year when your benefits are renewing in Maxwell, any live EDI connections for those products must also be renewed. This EDI renewal process is essential to making sure that renewal elections are sent electronically to carriers in a timely and accurate manner.

The status for your existing live EDI connections will not change in the Current EDI Feeds dashboard, but you may want to learn more about the renewal process.

>> Check out more detail on the EDI Renewal Process here