Shift-Based Automation
Tracks variable-hour eligibility for 24/7 staff and auto-triggers enrollment updates. Measured hours from scheduling and time systems drive initial, standard and stability periods per employee class.
Healthcare Benefits Administration Platform
Smart, compliant, and configurable because healthcare isn't 9 to 5.
Automate HIPAA and ACA compliance for shift-based, union, and non-union staff with one SAP-native platform. Nurses, per-diem clinicians, residents, float pools and corporate staff each get the right plan menu on the right date — measured from the hours they actually worked, not the schedule they were given. Built natively inside SAP SuccessFactors, and ready for Workday, UKG, ADP, Dayforce, Paycom, any HRIS and third-party payroll your health system runs.
Variable-hour and per-diem (PRN) eligibilityClinical · non-clinical · nurses' unionHIPAA-secure verificationHospitals · clinics · health systems
Simplify Healthcare Benefits, Strengthen Compliance
In healthcare, benefits administration is critical to keeping operations compliant and employees supported. Hospitals, clinics, and care networks face rotating shifts, credentialing demands, and both union and non-union contracts—all while meeting HIPAA and ACA obligations. Benefits Reimagined is a purpose-built healthcare benefits administration platform designed to simplify this environment. HIPAA-compliant, ACA-ready, and SAP-native, it automates eligibility tracking, enrollment, and reporting — reducing errors and saving time. By connecting HR, payroll, and scheduling data, healthcare organizations can deliver reliable coverage while staying compliant and focused on patient care.
Meeting the Demands of Non-Stop Healthcare24/7 eligibility from measured hoursStaying Ahead of ACA and HIPAA ComplexityMeasurement periods · secure documentsBalancing Union and Non-Union BenefitsDual-track configurationUniting HR, Payroll & SchedulingCredentialing to deductionsTurning Benefits Data into ActionBy shift, unit and location
24/7eligibility recalculated from measured hours — nurses, technicians and clinicians who change schedules or departments stay covered without HR intervention
2tracksunion and non-union populations run side by side on one system, each on its own eligibility, contribution and retirement rules
1095-Cforms generated per employee from the monthly measurement record, with safe-harbor affordability applied per class
403(b) · 401(k)retirement vehicles for nonprofit and for-profit health systems administered from one election record, with retiree plans and Medicare coordination for the systems that offer them
A Health System's Benefits Flow, Step by Step
From the staffing office to the auditor — what happens at each step for a clinical employee, and the healthcare rule that decides it.
| Who | Where | What happens | Rule at this step |
|---|---|---|---|
| 1Staffing · HRIS | SAP SuccessFactors, UKG (Kronos) or any HRIS | Hire, credential, department, shift pattern, union code and worker type (full-time, part-time, per-diem/PRN, seasonal) arrive with the effective date. | Worker type and union code are required inbound; without them resolution falls to a default and is quarantined. |
| 2Platform | Segment resolution | Clinical vs non-clinical, per-diem, union vs non-union and facility (EIN) are resolved into one stored, dated population. | Facility override › health-system assignment › default — logged with its source. |
| 3Platform | Healthcare policy pack | Provisions the plan menu (HDHP/HSA, PPO, disability, EAP, 403(b) or 401(k)), the measurement variants, event reasons and credential document types. | Editable defaults; the nurses' agreement is gated as mandatory. |
| 4Time · scheduling | Measured hours | Regular, on-call, call-back and float hours arrive nightly; initial and standard measurement periods run per class. | Hours of service, not scheduled hours, decide eligibility. |
| 5Employee | Employee Home | Sees hours to eligibility, the menu for the current job and agreement, and the credential or dependent documents outstanding. | The same screen in the mobile app and by SMS link. |
| 6Rules engine | Eligibility | Threshold crossed → 'eligibility window opened'; stability period protects coverage earned; a transfer re-evaluates without resetting it. | Determinations store hours, period and rule version. |
| 7Employee | Enrollment | Rolling for newly eligible staff; annual window for the rest; union and non-union tracks on the same flow. | A mid-enrollment track change opens a review and a delta message. |
| 8Evidence | Document Center | Licensure and credential documents, dependent documents and union election forms requested, read by IntelliVerify, encrypted and access-logged. | Minimum-necessary access; no PHI leaves the platform. |
| 9Payroll · carriers | Integration | Deductions to Employee Central Payroll or any payroll; 834 or API to carriers and PBMs; multi-employer pension contributions per hour. | Confirmation tracked per field; missing mapping quarantines. |
| 10Compliance | ACA and audit | 1095-C per employee, 1094-C per facility EIN; every outcome stored with inputs, profile and approvals. | 'Why was she measured full-time?' answerable months later. |
One Nurse, Five Moments Healthcare HR Has to Get Right
Follow Jane Doe — a float-pool RN across two hospitals, hours that swing with census, a union at one site and not the other — from her first measured month to a plan she can explain on a night shift.
Meeting the Demands of Non-Stop Healthcare
Healthcare never sleeps—yet benefits systems often do. With staff rotating between shifts and departments, tracking eligibility manually leads to confusion and coverage gaps. Benefits Reimagined provides automated logic designed for 24/7 operations. It dynamically updates eligibility as nurses, technicians, or clinicians change schedules or roles. This ensures that employees stay covered continuously and HR teams stay compliant without extra work. A flexible system built for constant motion keeps benefits administration as responsive as your care teams.
What the platform tracks
- Measured hours per pay period from UKG (Kronos), the scheduling system or SAP Time — including on-call, call-back and float assignments
- Initial and standard measurement periods, administrative periods and stability periods per employee class, effective-dated
- Department and role changes — ICU to ED, CNA to LPN — re-evaluated without breaking the stability period already earned
- A visible countdown on the employee's own screen: hours so far, hours needed, and the date coverage would begin
Why it matters
Jane Doe finds out she is eligible before HR does — and so does HR.
Each determination is stored with the hours, the period and the rule version, so 'why was she measured full-time?' is always answerable.
Staying Ahead of ACA and HIPAA Complexity
Between HIPAA privacy rules and ACA measurement periods, healthcare organizations juggle regulations that never stop changing. Manual tracking risks costly mistakes. Our HIPAA-compliant benefits administration platform embeds these rules directly into workflows. It automates ACA reporting for variable-hour workers, validates dependent documentation, and alerts administrators before deadlines are missed. The result is proactive compliance — no guesswork, no penalties, and a clear audit trail for every action.
What runs automatically
- ACA affordability per safe harbor (W-2, rate-of-pay, FPL) tested per class; Lines 14, 15 and 16 set from the monthly record
- 1094-C and 1095-C generated per employee and per EIN across the health system; pre-flight readiness scan before every run
- IntelliVerify reads dependent documents with OCR, checks them against the rule and encrypts them in the Document Center
- Minimum-necessary access: HR sees eligibility, not diagnoses; every document view is logged
Why it matters
No PHI in email, no spreadsheet of Social Security numbers, no December surprise.
COBRA events for separated staff flow to Direct Billing with notices generated on the event date.
Balancing Union and Non-Union Benefits
Healthcare employers often manage union and non-union staff under separate agreements. Without the right technology, maintaining equity and compliance across both can be tedious. Benefits Reimagined allows dual-track configuration—so unionized teams and salaried staff each follow their specific rules for eligibility, contributions, and retirement plans within one system. By simplifying complex agreements, organizations maintain consistency, honor contracts, and reduce administrative burden.
What dual-track means
- Plan menus, contribution formulas, waiting periods and retirement plans held per bargaining unit — nurses' union at one hospital, none at the next
- Job and pay code decide the track automatically; a transfer between facilities switches the agreement on the effective date
- Multi-employer (Taft-Hartley) plan contributions calculated per hour and remitted with the contribution report
- One audit trail records which agreement decided each case — grievance-ready
Why it matters
Equity across agreements without two systems or two teams.
Contribution changes negotiated mid-year are effective-dated; BR ReVerge computes any retroactive difference and explains it to the employee.
Uniting HR, Payroll & Scheduling
In healthcare, disconnected systems cause eligibility mismatches and payroll errors. The SAP SuccessFactors healthcare integration brings everything together — credentialing, scheduling, payroll, and benefits data flow as one. This connectivity eliminates redundancy and improves accuracy across departments. For HR teams, it means real-time updates and fewer manual corrections. Integration isn't just technical — it's operational clarity for the entire organization.
What flows, and where
- SAP SuccessFactors Employee Central: 140+ mapped fields, Intelligent Services Center events for hires, transfers and terminations
- UKG (Kronos), ADP and any scheduling or time system: measured hours in, nothing re-keyed
- Employee Central Payroll or any payroll: deductions and employer contributions out, retros computed, not guessed
- Carriers and PBMs: 834 files or APIs with confirmations tracked per field by IntelliMap
Why it matters
One record from credential to deduction.
Runs on SAP BTP and AWS — one tenant per health system, HIPAA-secure, with compliance controls, checks and evidence built in.
Turning Benefits Data into Action
Healthcare HR teams sit on massive data — eligibility records, claims, enrollment trends, and costs by department. The analytics engine turns this data into insight. Interactive dashboards show how plans perform across shifts or locations, reveal opt-out patterns, and highlight underused benefits. Armed with these metrics, leaders can adjust plans strategically to boost value and reduce spend. Better data means better decisions for your organization and your people.
What leaders see
- Enrollment, waivers and plan mix by facility, unit, shift and bargaining unit — night-shift opt-outs are visible, not anecdotal
- Eligibility churn: who gained, who lost, who is one month from either — before the stability period ends
- Underused benefits by population — an EAP nobody on nights uses, a telehealth benefit the ED never sees
- Athena answers 'why' in place: which units drove the waiver rate, and what changed in the plan year
Why it matters
Plan decisions made on the unit-level facts, not the system-wide average.
Dashboards live in BR Intelligence; the ML engine forecasts eligibility and cost, the AI Insight model explains the number you clicked.
Rules of Healthcare Benefits Administration
The healthcare policy pack ships with these rules configured. Each is a setting, not a code change — and each one is evidence when an auditor or a union asks. The same engine runs the manufacturing, higher-education and public-sector and transportation packs — see the cross-industry hub.
| Rule | What it means on this page | Why it holds |
|---|---|---|
| Hours of service decide eligibility | Per-diem (PRN), float-pool and variable-hour staff are measured on recorded hours — on-call, call-back and float included — across departments and facilities. | Scheduled hours and job titles are not hours of service. |
| Stability periods protect what is earned | A month below threshold inside a stability period does not end coverage; a transfer re-evaluates without resetting the period. | Continuous coverage for a workforce in constant motion. |
| Union and non-union tracks are separate rule sets | Plan menu, contribution formula, waiting period and retirement vehicle per bargaining unit, selected by job and pay code. | The audit trail records which agreement decided each case. |
| Credentials are documents with expiry | Licensure and certification dates are tracked as document types with validity; expiry raises a task, never a silent lapse. | Evidence outlives the person who filed it. |
| Minimum necessary, always | HR sees eligibility, not diagnoses; every document view is logged; nothing is printed or emailed. | HIPAA-aligned by construction, with compliance controls, checks and evidence built in. |
| Retirees are a population | Nonprofit systems' retiree plans, Medicare coordination and self-pay run through Direct Billing on the same record. | Continuation is configured, not outsourced. |
| Multi-EIN by default | Each facility's EIN is on the record; ACA, carriers and reconciliation respect it, including mid-year transfers. | A new facility is a rule set and an EIN. |
| What stays with partners | Actuarial and pension math, underwriting and certified filing rails. | BR orchestrates and evidences; specialists calculate and file. |
Core Capabilities Built for Healthcare Workforces
Shift-based eligibility, ACA engine, HIPAA-secure verification, union modeling, payroll sync and analytics — the six things a hospital's benefits platform has to do without being asked.
ACA Compliance Engine
Applies safe-harbor methods and generates 1095-C forms automatically. Pre-flight readiness scans show what would fail before the run — per facility and per EIN.
HIPAA-Secure Verification
Uses AI + OCR to verify dependents securely and store encrypted documents — and tracks licensure and credential documents with expiry dates. Minimum-necessary access, logged views, nothing printed or emailed.
Union Plan Modeling
Dual-track logic lets you administer union and non-union plans in one system — including multi-employer pension contributions calculated per hour.
Integrated Payroll Sync
Connects with SAP SuccessFactors, UKG (Kronos), and ADP for real-time deductions — and any HRIS and third-party payroll through the same sync. Retroactive differences are computed by BR ReVerge and explained to the employee.
Advanced Analytics
ElasticSearch + Kibana dashboards visualize benefit trends and cost savings — by facility, unit, shift and bargaining unit, with Athena explaining the number in place.
Built for the Whole Health System
The benefits decision at a hospital is shared among HR, payroll, compliance and the clinicians themselves. Each gets what they came for.
Eligibility that runs itself
- Measurement periods per class, effective-dated
- Dual-track union and non-union rules
- Ticket intelligence via BR Resolve
Deductions that reconcile
- Deductions to Employee Central Payroll, ADP or any third-party payroll
- Multi-employer contributions per hour
- Carrier invoices reconciled four ways
Evidence, not assurances
- ACA readiness score before every filing
- PHI never leaves the platform; access logged
- HIPAA-secure, compliance evidence built in hosting
Answers at 3 a.m.
- Hours-to-eligibility countdown on their own screen
- Athena in English and Spanish
- Mobile app for the break room, not the desk
Generic Benefits Software vs. a Healthcare-Built Platform
Most benefits software was built for a salaried, single-site, single-agreement workforce. A health system is none of those.
| Moment | Vertical specialist or generic HCM module | Benefits Reimagined |
|---|---|---|
| Per-diem (PRN) and float staff | Treated as exceptions; eligibility estimated by HR. | Measured on recorded hours of service across departments and facilities, with a visible countdown. |
| Variable-hour staff | Hours imported quarterly; eligibility decided in a spreadsheet. | Measured nightly from the scheduling system; initial, standard and stability periods per class, with the employee's own countdown. |
| Union and non-union | One plan menu; exceptions handled by HR by hand. | Dual-track configuration per bargaining unit; transfers switch agreements on the effective date, audit-logged. |
| ACA | Year-end export to a filing vendor. | Monthly record, safe harbors per class, 1095-C per employee and 1094-C per EIN, with a pre-flight readiness scan. |
| Dependent documents | Emailed PDFs in a shared inbox. | IntelliVerify reads, checks and encrypts; only exceptions reach a person, every view is logged. |
| Scheduling and time | Manual import of hours. | UKG (Kronos), ADP and SAP Time connected; on-call, call-back and float hours counted as worked. |
| Payroll corrections | Retros re-keyed after a late transfer. | BR ReVerge computes the retro and explains the paycheck impact to the employee. |
| Employee questions | A benefits hotline open 9 to 5. | Athena at 3 a.m. from the employee's own record, with a source and the next step. |
Athena on the night shift
Meet Athena: the Assistant That Works Your Hours
Care teams do not ask benefits questions during business hours. Athena answers from the employee's own measurement record, plan documents and union agreement — at 3 a.m., in the break room, in English or Spanish — with a source, and never enrolls anyone.
- "How many more hours until I'm eligible?" — the measured total, the threshold and the projected date from the rules engine
- "I float to Northside next month — does my plan change?" — the agreement that applies to the new job code, and what re-opens
- "Do I lose coverage if my hours drop?" — the stability period she has already earned, cited to the plan document
- "Which plan covers my son's therapist?" — the network check from the plan documents, plus IntelliSuggest's ranking with reasons
- For administrators — "who becomes eligible next month and at which facility?" — the list, the EIN and the notices due
How many more hours until I'm eligible for medical?
Athena · from your recordYou've averaged 136 hours a month over the last 12 months — above the 130-hour threshold. Your measurement period ended August 31, so you're eligible October 1. Enrollment opens September 3 and closes September 30. Want a reminder?
Sources: Eligibility rule v12 · measured hours Sep 2025–Aug 2026 · Plan document — Eligibility, p. 4
Set a reminderShow my hours by month
I float to Northside in October. Different plans there?
Athena · from your agreementYes. Northside is non-union, so your plan menu changes to the standard track: four medical plans including an HDHP with an HSA, and a 403(b) with match instead of the multi-employer pension. Your pension credit at St. Mary's is preserved. I can show both menus side by side.
Compare both menusAsk HR
Ask about your benefits…
Why Healthcare Organizations Choose Benefits Reimagined
Compliance Confidence
Stay HIPAA- and ACA-compliant with automated monitoring and reporting — measurement, affordability and 1095-C per EIN, with the evidence stored.
Reduced Admin Effort
Eliminate manual eligibility tracking and paper-based approvals. Hours arrive nightly; documents are read by IntelliVerify; only exceptions reach a person.
Employee Clarity
Empower staff with clear, mobile-accessible benefits information — an hours-to-eligibility countdown, plan menus for their job, and Athena at any hour.
Operational Accuracy
Sync HR, payroll, and scheduling for error-free benefits delivery — SuccessFactors, UKG (Kronos), ADP and carriers on one record.
Scalable Design
Adapt to growth across hospitals, clinics, and regional health systems — a new facility is a rule set and an EIN, not an implementation.
Data Insight
Use analytics to enhance decision-making and cost efficiency — waivers by shift, churn by unit, underused benefits by population.
Four Healthcare Stories — and One on Another HRIS
Every story runs on the same engine, enrollment flow and audit trail; only the healthcare pack's rules apply.
Measured across two hospitals
Jane Doe's hours from UKG (Kronos) are combined across St. Mary's and Northside; the 12-month average crosses 130 and Athena tells her the morning the threshold is met.
Eligible October 1, notified September 3.PRN aide in initial measurement
A per-diem CNA is in her initial measurement period; her Employee Home shows hours so far, hours needed and the projected date — no call to HR.
Day 61 of 90, countdown visible.Transfer switches the agreement
A resident moves between facilities; the job code switches the track from the union agreement to company policy on the effective date, with pension credit preserved and the audit entry citing both.
Two agreements, one record, one trail.Medicare coordination without a spreadsheet
A retiring clinician at a nonprofit system moves to the retiree plan; Medicare coordination and the self-pay premium bill run through Direct Billing with the subsidy applied.
Continuation configured, not outsourced.SAP SuccessFactors · Workday · UKG · ADP · Dayforce · third-party payroll
The same health system on Workday
A health system whose HR runs Workday sends the same worker type, union code, facility and hours. The healthcare pack measures, tracks and files identically; the BR Intelligence view by facility, shift and bargaining unit is the same screen.
See SuccessFactors & HRIS SyncTransform Healthcare Benefits Administration with Benefits Reimagined
Benefits Reimagined gives healthcare organizations a scalable, secure solution for managing benefits across diverse workforces. Automate compliance, simplify eligibility, and connect your systems in real time — all within a HIPAA-secure, SAP-native environment. Bring your bargaining agreements, your measurement rules and three anonymized clinicians — we'll run them live.
HIPAA-secureVariable-hour ACADual-track union rules
Healthcare Benefits Administration FAQs
It's the management of eligibility, enrollment, and compliance for healthcare employees across hospitals, clinics, and health systems — including the variable-hour measurement, union agreements and HIPAA obligations that make healthcare different from a salaried workforce.
By automating shift-based eligibility, ACA tracking, and HIPAA-secure reporting within one SAP-native platform. Measured hours arrive from the scheduling system, eligibility is recalculated automatically, and the compliance evidence is stored with each decision.
Yes — all data handling meets HIPAA standards, with compliance controls, checks and evidence built in. Dependent documents are read by IntelliVerify, encrypted at rest, and viewed only under minimum-necessary access with every view logged. No PHI is emailed or printed.
Absolutely. It syncs with SAP SuccessFactors, UKG (Kronos), and ADP — plus Workday, Dayforce, Paycom, any HRIS and third-party payroll through the same HRIS Sync control plane. Hours flow in nightly; deductions flow out to the payroll of record.
Yes. You can configure dual plan logic for equitable benefits management. Each bargaining unit is a rule set with its own plan menu, contribution formula, waiting period and retirement plan; job and pay code select the track automatically, and transfers switch it on the effective date.
Through initial and standard measurement periods configured per employee class, with administrative and stability periods applied by the rules engine. On-call, call-back and float hours are counted as hours of service, and the employee sees their own hours-to-eligibility countdown.
Yes. Contributions are calculated per hour from the measured record for each covered bargaining unit and remitted with the contribution report, alongside the health system's own 403(b) or 401(k) for non-union staff.
Each facility's EIN is carried on the employee record from SuccessFactors or the HRIS. ACA reporting produces a 1094-C per EIN and assigns each employee-month correctly, including transfers between facilities mid-year.
One Employee Home with what is pending and by when, the plan menu for their current job and agreement, a hours-to-eligibility countdown, IntelliSuggest rankings with reasons, and Athena — on the desktop or the mobile app, in English or Spanish.
They are separate populations in the healthcare policy pack: clinical staff carry credential document types with expiry, shift and per-diem measurement variants and, where applicable, the nurses' agreement; non-clinical staff run on company policy. Both share one record, one enrollment flow and one audit trail.
403(b) for nonprofit systems and 401(k) for for-profit systems — plus 457(b) where offered — administered from one election record, with multi-employer pension contributions for unionized units calculated per hour and remitted with the contribution report.
Yes. The 'employer = provider = payer' situation changes data boundaries, not the model: HR sees eligibility, not claims; provider-navigation programs are configured as benefits with their own document and consent rules; and every access is logged.
Explore Benefits Reimagined Today
Coverage that follows the clinician from shift to shift and site to site — measured, compliant, explained, and never dependent on a spreadsheet.