Jay Hammond

Director of Sales

PLEXIS’ Enhanced Premium Billing Administration

Intelligent Automation Reduces Manual Workloads for Individual and Group Premium Billing

In the rapidly-evolving healthcare industry, intelligent automation is key to reducing enterprise costs within the premium billing process. PLEXIS recently expanded its premium billing administration to better support group policy administration as well as enhanced individual policy capabilities including flexible invoice rules unique for each enrollment.

PLEXIS’ automated, fully-featured premium billing capabilities include flexible billing options for premium calculations, billing frequency, billing for multiple plan types such as medical, dental, life, disability, rider plans, etc. PLEXIS’ core administrative platform offers a fully-automated premium billing and accounts receivable system with the built-in scalability to grow with your business.

Expanded Flexibility for Premium Calculations

New enhancements for individual policies include selective due date options, guaranteed premium rates, and multiple combinations of tiered pricing for premium calculations. Each new functionality decreases manual workloads and maximizes business efficiencies and cost-savings.

A new “Smart Factor” functionality significantly reduces manual configurations. The premium run calculation now automatically identifies individuals who are affected by a new pricing factor and systematically applies the new factor to them.

A new guaranteed rate configuration adds a valuable offer for clients who wish to guarantee a rate for a specific amount of time even if rates are increased during that time period. Guaranteed rates provide a competitive advantage for sales teams.

The “Composite Tiers” enhancement expands the possible combinations of tiered pricing for premium calculations for both life and standard premium billing. This may include combining a family tier rate schedule with postal code factors or an age/gender rate schedule with smoker/non-smoker user defined factors.

Another enhanced premium billing functionality saves time for customer service teams by quickly clarifying which pricing factors were utilized in premium calculations.

Agile Premium Billing Solutions:

  • PLEXIS provides flexible premium billing administration for individual or group policies
  • Minimal configuration steps to add a new member/enrollment
  • Unique invoice frequencies and due dates for each enrollment
  • Retroactive processing for mid-period adds and mid-period terminations
  • Individual premium policies include guaranteed premium rate configurations
  • Easy access to past/present billing history and open receivables
  • Easily exclude eligible members from billing or apply different rates for subscribers/dependents
  • Easily apply multiple coverage tier rates with user-configurable grace period settings


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