New Case Agreement

New Case Agreement
Case Name
Broker Name

First Name Last Name
Broker Rep Email
example@example.com
Velocity Rep Name

First Name Last Name
Velocity Rep Email
example@example.com
Effective Date

Month Day Year
Date
Number of Employees
Velocity Services Needed (Technology, Communication, Education) List All
Velocity Services Needed (Select all that Apply)

Technology (Employee Navigator Case Build) Communication Education (Enrollment)
Desired Case Start Date

Month Day Year
Date
Projected End Date

Month Day Year
Date
Scope of Work:

Technology - Employee Navigator Case Build
- Case Build information must be submitted on our New Case Build document
- 7 Business day turnaround is guaranteed from when all data is submitted
- Build will include
  - Class structures, eligibility, rates, pay cycles, Employee Census upload
  - Existing coverages have to be in the required formats to be uploaded and must be done before open enrollment starts
  - 3rd Party App Integrations
  - Post enrollment reporting which will include - A summary, Payroll Deduction Reports, Row based and column based reports with all enrollment information
    
    Certain carriers will take the data direclty out of Employee Navigator - speak to your Velocity Rep about who those carriers are to save time and resources
- If EDI is needed for your medical, dental and vision carriers there is an additional cost of $1,000 setup fee and $1 PEPM charge.
Communication - Texting, Email and Video Communication
- The Velocity Texting and Video Creation forms must be used
Texting:
- 7 Business day turnaround is guaranteed from when all data is received
- Text standards include
  - 3 rounds of texts
  - Standard messaging with link customization
    
    Benefits Snapshot or Benefit Guide (provided by the broker)
    
    Video
    
    Link to schedule
Email
- Generic emails mirroring the texts
- Registration emails from Employee Navigator (if you are using this platform)
Video
- Custom messaging submitted by the broker or HR
Enrollment
- The Velocity PreEnrollment Worksheet or Call must be completed
- Includes Technology and Communication (see above)
Split Agreement (Broker/Velocity)
Products to be Split (Product Name & Carrier)
"Other - Split Details"
We agree to partner in good faith to make the enrollment a positive experience for everyone involved. Velocity commits that if, for some reason, that either party desides to no longer partner together that they will release all data back to the broker and their client with 10 business days. At that point Velocity commits to deleting all person and company info of the former client.
Submitter Name

First Name Last Name
Clear
Date

Month Day Year
Date
Should be Empty: