Product Descriptions

Clarity Engage® Platform Service

Clarity Engage® Platform Service provides users with the ability to design and render various types of member communications. The following features are also included:

• Standard File & Layout types – Clarity Engage® can accept any file type and layout. Please note: some file types and layouts may be subject to increased pricing and execution timeframes.
• Data File Rules – proactive “fact check” process to ensure incoming data is complete and accurate before it is loaded into Clarity Engage®.
• Derivation – ability to take raw data and format, translate and map to what is needed within Clarity Engage® to support operational outputs.
• Content & Design Management – ability to upload and modify content and designs in Clarity Engage®.
• Program Design – strategic program design uniquely created for clients in collaboration with Clarity engagement experts.
• Daily Volumes Dashboard – readily accessible data through self-service within Clarity Engage®. Captures how a file moves throughout Clarity Engage® from creation to mailing. 
• Pathfinder – capability built within Clarity Engage® that tracks how members are engaging with calls to action through personalized URLs.
• Return Files – optional data files provided back to clients to confirm status on member communications.
• Knowledge Interface – ability for users to log in to Clarity Engage® and manage communications, access reports, hold records, and more.
• Production Control – ability to configure holds and overrides on records within Clarity Engage® to help manage quality and operations.
• Workflows – built-in processes within Clarity Engage® to manage creative through its lifecycle.
• Inference Engine – design manager tool.

The Clarity Engage® platform is continually enhanced to improve performance and user experience. While standard/included features may change from time to time, we will notify Clients of any material updates that may affect existing workflows or service delivery.

Additional non-standard features or services may be offered at the prices set forth in the applicable Service Order. 

 

ID Cards

Clarity produces healthcare ID Cards for health plans utilizing its proprietary application to enable clients to create and fulfill personalized ID Cards for its members. Supporting both digital and printed delivery options, Clarity can accommodate a range of packaging configurations tailored to meet plan and regulatory needs. 

Card Package Types

Single ID Card Packages

• Printed Single ID Card Package – One (1) full digital color 19mil+ ID Card (4/4), inserted with or affixed to a duplex letter with color text (4/4) into an envelope.

• Digital Single ID Card Package – a digital rendering of a Printed Single ID Card Package.

Dual ID Card Packages

• Printed Dual ID Card Package – Two (2) full digital color 19mil+ ID Cards (4/4), inserted with a duplex letter with color text (4/4) into an envelope.

• Digital Dual ID Card Package – a digital rendering of a Printed Dual ID Card Package.

Quad ID Card Packages

• Printed Quad ID Card Package – Four (4) full digital color 19mil+ ID Card Cards (4/4), presented as two two-card slabs, inserted with a duplex letter with color text (4/4) into an envelope.
• Digital Quad ID Card Package – a digital rendering of a Printed Quad ID Card Package.

Included Services and Components

All printed package types include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital package types include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Member Guides

Clarity produces member guides which can include pertinent member information such as benefits schedules, drug lists, claims forms and member ID Cards. Supporting both digital and printed delivery options, Clarity can accommodate a range of packaging configurations tailored to meet plan and regulatory needs. 

Member Guide Package Types

Member Guide – Book Only Packages

• Printed Member Guide – Book Only Package – One (1) saddle-stitched booklet, finished size 5.5” x 8.5”, including one (1) 4/4 digital color cover and one (1) 4/4 color interior page of the same stock, totaling two (2) sheets/eight (8) pages. No ID Cards included.

• Digital Member Guide – Book Only Package – a digital rendering of a Printed Member Guide – Book Only Package.

Member Guide with One (1) Card Packages

• Printed Member Guide w/ One (1) Card Package – One (1) saddle-stitched booklet, finished size 5.5” x 8.5”, including one (1) 4/4 digital color cover and one (1) 4/4 color interior page of the same stock, totaling two (2) sheets/eight (8) pages, with one (1) full digital color 19mil+ ID Card.

• Digital Member Guide w/ One (1) Card Package – a digital rendering of a Printed Member Guide w/ One (1) Card Package.

Member Guide with Two (2) Cards Packages

• Printed Member Guide w/ Two (2) Cards Package – One (1) saddle-stitched booklet, finished size 5.5” x 8.5”, including one (1) 4/4 digital color cover and one (1) 4/4 color interior page of the same stock, totaling two (2) sheets/eight (8) pages, with two (2) full digital color 19mil+ ID Cards.

• Digital Member Guide w/ Two (2) Cards Package – a digital rendering of a Printed Member Guide w/ Two (2) Cards Package.

Member Guide with Four (4) Card Packages

• Printed Member Guide w/ Four (4) Cards Package – One (1) saddle-stitched booklet, finished size 5.5” x 8.5”, including one (1) 4/4 digital color cover and one (1) 4/4 color interior page of the same stock, totaling two (2) sheets/eight (8) pages, with two (2) two-card slabs of 19mil+ ID Cards.
• Digital Member Guide w/ Four (4) Cards Package – a digital rendering of a Printed Member Guide w/ Four (4) Cards Package.

Included Services and Components

All printed package types include:

• One (1) 6×9 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital package types include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Member Kits

Clarity can create custom books and kits in printed and electronic formats. Using dynamic templates from existing documents, a variety of options can be created, such as: pre-sales kits, enrollment kits, welcome kits, Evidence of Coverage, Annual Notice of Change directories, formularies, certificates, benefit guides, or administration kits. Books and kit designs may include documents or artwork to create a consolidated bound product. Products can be personalized at a group or individual level. Materials can be printed on demand and matched with static inventories items through dynamic production manifests. 

Member Kit Package Types

• Printed Saddle Stitch Member Kit Package – Black or color duplex impressions on white 8.5” x 11” paper, printed on 11” x 17” sheets, folded and saddle-stitched, with a minimum of two (2) sheets (eight (8) impressions).

• Printed Perfect Stitch Member Kit Package – Black or color duplex impressions on white 8.5” x 11” paper with perfect stitch binding, with a minimum of twenty-four (24) sheets (forty-eight (48) impressions).

• Digital Saddle Stitch Member Kit Package – a digital rendering of a Printed Saddle Stitch Member Kit Package.

• Digital Perfect Stitch Member Kit Package – a digital rendering of a Printed Perfect Stitch Member Kit Package.

Included Services and Components

All printed package types include:

• One (1) 9×12 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital package types include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Explanation of Benefits (“EOBs”)

EOBs across all lines of business are supported, including commercial or government programs. Within Clarity’s platform, clients can create new designs and stay compliant with distribution turn-time requirements. Clients can create plan and member specific EOB templates that are combined with variable data. EOB content can be dynamically created based off business rules processing, allowing for fewer EOB templates to be managed over time.

EOB Package Types

• Printed EOB Package – Black or color duplex impressions on white 8.5” x 11” paper, with a minimum of two (2) sheets (four (4) impressions).

• Digital EOB Package – a digital rendering of a Printed EOB Package.

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Explanation of Payment (“EOP”) & Payments

Clarity’s EOP & Payment solution covers outbound provider payments and member reimbursements, and offers the following payment types: Virtual Card, ACH, and Check. Within Clarity’s solution, clients can stay compliant with distribution turn-time requirements. Clients can manage member-specific EOP templates that are combined with variable data. EOP content can be dynamically created based off business rule processing, allowing for fewer EOP templates to be managed over time.  

 EOP Package Types

• Printed EOP Package (Check) — Black or color duplex impressions on white 8.5” x 11” paper, with a minimum of two (2) sheets (four (4) impressions). Includes a perforated check. 

• Digital EOP Package (ERA/EFT) — a digital rendering of a Printed EOP Package. ERA/EFT replaces perforated check.  

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Invoices

Clarity’s platform manages Client’s invoice correspondence securely online. Invoices can be built and managed within the application. Each invoice is printed on demand in full color capability to point out pertinent information to members. Within the application, Clients can create new designs and meet distribution turn-time requirements. All changes are detailed through audit trails. Multi-channel distribution options are available to deliver invoices to enrollees in print or electronic form.

Invoice Package Types

• Printed Invoice Package – Black or color duplex impressions on white 8.5” x 11” paper with a minimum of one (1) sheet (two (2) impressions) inserted into an envelope.

• Digital Invoice Package – a digital rendering of a Printed Invoice Package.

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Letters

Clarity’s platform manages Client’s letter correspondence securely online. Letters can be built and managed within the application. Each letter is printed on demand in full color capability to point out pertinent information to members. Within the application, Clients can create new designs and meet distribution turn-time requirements. All changes are detailed through audit trails. Multi-channel distribution options are available to deliver letters to pre- and post-enrollees in print or electronic form. 

Letter Package Types

• Printed Letter Package – Black or color duplex impressions on white 8.5” x 11” paper with a minimum of one (1) sheet (two (2) impressions) inserted into an envelope.

• Digital Letter Package – a digital rendering of a Printed Letter Package.

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Utilization Management (“UM”) Letters

Clarity’s platform manages Client’s letter correspondence securely online. UM Letters can be built and managed within the application. Each UM letter is printed on demand in full color capability to point out pertinent information to members. Within the application, Clients can create new designs and meet distribution turn-time requirements. All changes are detailed through audit trails. Multi-channel distribution options are available to deliver UM letters in print or electronic form. 

UM Letter Package Types

• Printed UM Letter Package – Black or color duplex impressions on white 8.5” x 11” paper with a minimum of one (1) sheet (two (2) impressions) inserted into an envelope.

• Digital UM Letter Package – a digital rendering of a Printed UM Letter Package.

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

1095s

Clarity’s platform allows Clients to report certain information required by applicable Federal Internal Revenue Service (“IRS”) regulations to individuals who are covered by minimum essential coverage as defined by the IRS, on Form 1095-B Health Coverage (“1095-B”), for the calendar year ending December 31st in a format prescribed by the IRS. Client will provide Clarity with all data required to complete the Form 1095-B for covered individuals as defined by the IRS. The Form 1095-B’s will be created and managed within Clarity’s secure platform and each Form 1095-B will be printed together with the related IRS filing Instruction for Recipient of Form 1095-B, and mailed to the person identified in Part I of the Form 1095-B. In addition, address vehicle or cover letters will be produced dependent on member delivery and Client design preference.

Bulk PDFs of 1095-B will be created by Clarity and securely transmitted in electronic form to Client for record keeping and Client retention upon Client’s request.

Clarity’s platform also prepares the federally-required IRS XML electronic transmittal file which will enable Clarity to electronically file the Form 1094-B Transmittal form and the associated data related to Forms 1095-B, with the IRS on behalf of Client. In addition, Clarity can also prepare and file the electronic transmission for the State 1095-B requirements, if elected. In the event Clarity files such electronic transmissions for State 1095-B requirements, Client may be required to undertake some actions as are required by applicable State(s). Any such actions will be specified by Clarity. 

1095 Package Types

• Printed 1095 Package – Black duplex impressions on white 8.5” x 11” paper, together with the related IRS filing Instruction for Recipient Form 1095-B, with a minimum of two (2) sheets (four (4) impressions) and a maximum of five (5) sheets (ten (10) impressions) inserted into an envelope.

• Digital 1095 Package – a digital rendering of a Printed 1095 Package.

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Annual Notices of Change (“ANOC”)

ANOCs are mandated by the Center for Medicare and Medicaid Services (“CMS”) which requires health plans that offer Medicare to inform subscribing Medicare members about upcoming changes to their plan in advance of the upcoming plan year.

Using Clarity’s platform, Clients can create plan and member-specific ANOC templates that are combined with variable data. This approach allows for static plan-specific information to be combined with personalized materials. 

Integrated into the process is the development of opt-in site to provide members the option to choose to receive their materials electronically rather than through print and fulfillment, significantly saving printed and postage costs. Reporting on many delivery types and dates is available, including print and mail dates and electronic distribution dates to ensure compliance with the MSA. Additionally, Clarity will create and maintain a custom application for the creation, management, tracking and reporting of ANOC products.

ANOC Package Types

• Printed ANOC Package – Black or color duplex impressions on white 8.5” x 11” paper with saddle stitch binding, with a minimum of two (2) sheets (four (4) impressions).

• Digital ANOC Package – a digital rendering of a Printed ANOC Package.

Included Services and Components

All printed packages include:

• One (1) #10 envelope
• Insertion into envelope
• USPS Coding Accuracy Support System (CASS) processing for address validation

All digital packages include:

• Data Management Fee

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Notifications

Digital methods of communication Clients may choose to engage members.

Notification Types

• Email Notifications – Clarity Engage® has a built-in email engine that allows it to build email communications to be deployed upon a triggering event. 

• Text Notifications – Clarity Engage® has a built-in text engine that allows it to build SMS messages to be deployed upon a triggering event. Note: cannot be used for international phone numbers of VoIPs.

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Digital Wallet

Allows Clients to offer their members the option to save their ID Card to a digital wallet (specifically, Apple or Google wallet).

Additional components may be offered at the prices set forth in the applicable Service Order. 

 

Mobile

Clarity will provide ID Cards through API service for iOS and Android platforms that will allow cards to be viewed through Client’s web application.

Additional components may be offered at the prices set forth in the applicable Service Order.