Direct Pay

Direct Pay lets you set up and manage member Direct Pay payments so members (retirees) can continue health coverage with their former employer after retiring. Member payments often come from withholdings from the member's pension checks, however, members may also make payments directly to the fund office by check or submitting an ACH or credit card payment through the Member portal.

The member Direct Pay screen contains two tabs: one for Member Entitlement (see Direct Pay Entitlements) and one for Payments (see Apply Direct Pay payments).

Before you can apply a payment to a member, the member must first have at least one Direct Pay entitlement set up in the system. An entitlement defines the payment amount and the benefits awarded to the member for Direct Pay payments. After the member's entitlements are set up, you can post payments to them and make payment adjustments as needed.

There are two methods available for posting a direct payment to an entitlement—Balance Forward and Period Based. Your system is set up to use one of these two methods. Period Based payments are posted to specific periods and eligibility is granted for the periods paid for. Balance Forward payments are posted without regard to time period and eligibility is granted from the earliest period paid.

You can use the Direct Pay Detail report function to:

Report on members who owe payments
Report on payments made for reconciliation purposes
Generate statements showing payments made or due
Report on members enrolled in certain options