🇺🇸United States

Errors in Enrollment and Eligibility Causing Rework and Employee Remediation

3 verified sources

Definition

Manual data entry and non‑integrated systems increase the likelihood of incorrect plan elections, dependents, or effective dates. HR must then reprocess enrollments, correct files to carriers, and handle employee complaints and exceptions.

Key Findings

  • Financial Impact: If HR spends 0.5–1 hour resolving each of 10–20 enrollment errors per month at ~$50/hour fully loaded, rework labor runs $250–$1,000 per month ($3,000–$12,000 per year), not counting potential claim disputes or goodwill concessions.
  • Frequency: Monthly
  • Root Cause: Outdated or overly complex benefits platforms; manual forms and data entry; lack of integration between HRIS, payroll, and carrier feeds; insufficient training during open enrollment.

Why This Matters

This pain point represents a significant opportunity for B2B solutions targeting Human Resources Services.

Affected Stakeholders

Benefits Manager, HR Generalist, Payroll Specialist, Employees using benefits

Deep Analysis (Premium)

Financial Impact

$3,000–$12,000 per year in HR and coordinator rework for resolving 10–20 enrollment errors per month at ~$50/hour, plus additional untracked costs from claim disputes, premium adjustments, and goodwill credits or write-offs to appease upset employees and enterprise clients. • $3,000–$12,000 per year in rework labor for correcting 10–20 enrollment errors per month at 0.5–1 hour each, plus additional untracked costs from overpaying carrier invoices due to enrollment/billing mismatches, potential claim disputes and legal risk when employees lack expected coverage, and goodwill concessions or credits granted to keep employees satisfied. • $6,000-$10,000 annually from rework + potential claim denials due to eligibility mismatches

Unlock to reveal

Current Workarounds

Background Check Coordinators and HR teams manually rekey or copy-paste demographic and eligibility data between ATS/CRM, background check platform, HRIS, and carrier sites, then track corrections and exceptions in Excel lists, email threads, and personal notes. • Dual data entry (HRIS → benefits platform → payroll), manual audit reports via Excel, phone calls to resolve discrepancies • The Compensation Analyst exports enrollment data from HR/benefits portals into Excel, manually cleans and re-maps fields, keeps separate spreadsheets to track exceptions and corrections, and then uploads flat files or manually re-keys changes into carrier portals and payroll systems; they also use email and chat to track one-off employee fixes.

Unlock to reveal

Get Solutions for This Problem

Full report with actionable solutions

$99$39
  • Solutions for this specific pain
  • Solutions for all 15 industry pains
  • Where to find first clients
  • Pricing & launch costs
Get Solutions Report

Methodology & Sources

Data collected via OSINT from regulatory filings, industry audits, and verified case studies.

Evidence Sources:

Related Business Risks

Employer Paying Premiums for Ineligible or Terminated Employees

Assuming $600/month average medical premium and 3–10 ineligible lives carried on the bill at any time, recurring loss is roughly $1,800–$6,000 per month ($21,600–$72,000 per year) for a mid‑size employer.

Missed Employee Contributions Due to Payroll Deduction Errors

For a 500‑employee firm with 2–5 missed or under‑deducted cases per month at $150–$300/month each, recurring leakage is in the range of $300–$1,500 per month ($3,600–$18,000 per year).

High Internal Labor and Overhead for In‑House Benefits Administration

Navia cites average HR employee cost of about $75,000 plus taxes, benefits, and overhead for benefits administration staff; a 1–2 FTE allocation implies $75,000–$200,000 per year in recurring internal admin cost for a typical organization.

Manual Benefits Billing Audits and Corrections Consuming HR Capacity

For a benefits team spending 10–20 hours per month on manual bill audits at a fully‑loaded HR cost of ~$50/hour, the recurring labor cost is $500–$1,000 per month ($6,000–$12,000 per year), excluding the opportunity cost of diverted strategic work.

Delayed Collection of Employee Premium Contributions

For a 500‑employee group with 5–10 cases per month of 1–2 missed pay periods at ~$150/period in contributions, delayed or at‑risk cash is ~$750–$3,000 per month ($9,000–$36,000 per year).

HR Capacity Consumed by Manual, Time‑Consuming Benefits Tasks

If 1–2 FTEs spend 30–50% of their time (valued at $75,000/year each) on low‑value manual benefits work, the effective capacity loss is ~$22,500–$75,000 per year.

Request Deep Analysis

🇺🇸 Be first to access this market's intelligence