Quote Types & Pricing Paths
This is the default quoting option and should be pursued whenever possible.
Full Quote
Medical groups generally need at least this participation percentage.
50%
This percentage is the maximum active COBRA enrollment threshold before exception review may be required.
10%
Groups with this many eligible employees require a health plan renewal.
100+
This state cannot be quoted by TriNet.
New Mexico
This quote type is used when medical information is available but Workers' Compensation information is missing.
Rapid Quote
All returning TriNet clients require this approval before pricing review.
Credit Exception Approval
Employees must work at least this many hours per week to be benefits eligible.
30 hrs
Claims reports are required for open-market groups with this many enrolled employees.
100+
A California law firm must submit this document before it can be uploaded to TPP.
Professional Liability Application (PLA)
This quote path requires Executive Director approval and is typically used when very little information is available.
Preliminary Pricing
Any union workforce requires this document before legal review can occur.
This Salesforce tool is used to review participation, COBRA metrics, census information, and document status.
Unified Configure Price Quote (UCPQ)
These two reports are required when claims documentation is needed.
Month-by-Month Utilization & Enrollment Reports and Large & Ongoing Claims Reports?
These are the three required KYC checks.
Property Location Validation
Legal Name Verification
Trade License Verification
If Health Plan Pricing declines a prospect, the deal automatically pivots to this solution (knowledge check)
OMS
Unlike Union Review, this review must be submitted before pricing but does not require approval beforehand.
EPLI Review
This question is the primary COBRA discovery question asked during RFP review.
Has anyone been removed from coverage in the last 90 days?
A prospect has 150 eligible employees but only 80 enrolled employees in an open-market plan. This document is required, but claims reports are not.
A renewal.
A prospect's legal business name in TPP does not match Secretary of State records, and the headquarters address appears suspicious. According to KYC procedures, what should occur next?
Submit for legal review due to multiple KYC red flags
A startup has no medical coverage, no Workers' Comp coverage, a complete employee census, and dependents confirmed. This is the correct quote type.
Full Quote
A Virgin Medical Group with missing dependent information requires this action before pricing.
HPP Exception Request?
Go -1 through 4 about what each census election code represents
-1: Declined
0: Opted Out
1: Employee
2: Employee + Spouse
3: Employee + Children
4: Employee + Family
Explain the following:
1. Fully Insured
2. Self-Funded
3. Level-Funded
Fully Insured: The insurance carrier takes the financial risk and pays claims.
Self-Funded: The employer takes the financial risk and pays employee medical claims directly.
Level-Funded: A hybrid model where the employer makes fixed monthly payments but still assumes some claims risk, with the potential for refunds or additional costs based on claims experience.
A prospect is headquartered in Alaska with 45 WSEs and wants TriNet-sponsored medical coverage. What is the likely outcome?
HPP will generally decline the quote due to state restrictions and size.
Alaska-headquartered groups under 51 WSEs are restricted