Standard Operating Procedures
35 SOPs across 12 operational domains · All documents in Draft status pending approval
01Plan Operations — TPA & PBM
OPS-SOP-001
Weekly Medical Claims Funding (Allied TPA)
OPS-SOP-002
PBM Invoice Processing (ProAct)
OPS-SOP-003
Monthly Premium Invoice Reconciliation
OPS-SOP-004
Dispute & Recoupment
OPS-SOP-005
Eligibility Management
OPS-SOP-006
Stop-Loss Reporting & Reimbursement
02Vendor Invoice Control
OPS-SOP-007
Pre-Authorization Audit Cycle
OPS-SOP-008
Consultant Engagement Playbook
OPS-SOP-010
Vendor Invoice Control & Payment Authorization
03Employer Onboarding & Admin
OPS-SOP-009
Employer Onboarding
OPS-SOP-011
Ongoing Employer Administration
OPS-SOP-012
Employer Offboarding & Plan Termination
OPS-SOP-013
Employer Offboarding & Plan Termination
04Sales
OPS-SOP-014
Prospect Intake & Quoting
OPS-SOP-015
Sales to Ops Handoff
05Marketing & Ad Compliance
OPS-SOP-016
Ad Creative Review & Legal Approval
OPS-SOP-017
Content Publishing & Compliance Sign-Off
06Trust & Captive Governance
OPS-SOP-018
Trust Funding Flow & Escrow Management
OPS-SOP-019
Protected Cell Setup per Employer
OPS-SOP-020
Fiduciary Fee Review Process
07Compliance Calendar
OPS-SOP-021
Annual Compliance Deadline Calendar
OPS-SOP-022
SPD/SBC Production, Review & Distribution
08SPD / SBC & Regulatory
OPS-SOP-023
Participating Employer Compliance Checklist
OPS-SOP-024
Annual Compliance Renewal Cycle
09Finance & AP
OPS-SOP-025
Invoice Approval Chain & Payment Tracker
OPS-SOP-026
GL Structure & Monthly Reconciliation
10Member & Benefits Admin
OPS-SOP-027
COBRA Administration (Varipro)
OPS-SOP-028
FSA/HSA Administration (HealthEquity)
OPS-SOP-029
Member Issue Escalation & Resolution
11Risk & Actuarial
OPS-SOP-030
Gradient AI Onboarding Risk Screening
OPS-SOP-031
Reserve Monitoring & Actuarial Trigger Rules
12Data Security & Governance
OPS-SOP-032
PHI Access Controls & Redaction Protocol
OPS-SOP-033
BAA Registry & Breach Response
OPS-SOP-034
Approval Authority Matrix & Decision Thresholds
OPS-SOP-035
Document Version Control & Retention