OPS-SOP-015 — Group Onboarding Handoff: Sales to Operations
1. Purpose
This SOP defines the structured handoff from Sales to Operations when an employer group signs a Letter of Intent (LOI) and moves into formal onboarding. It ensures nothing falls between the cracks during the transition — every document is collected, every vendor is notified, every compliance step is tracked, and the employer has a clear go-live date before they leave the handoff meeting.
Key principle: The employer should never feel the seam between Sales and Operations. By the end of the handoff call, they have a named Operations contact, a go-live date, and a checklist of what they need to provide. Sales is out of the loop from that point unless the employer requests them.
2. Scope
Applies to all employer groups that have signed a Letter of Intent (LOI) and are being onboarded to the Unity Care Member Plan Master Trust. Begins at LOI signature and ends at confirmed go-live (first claims-eligible date). Detailed operational setup post-go-live is covered in OPS-SOP-009 (Employer Group Onboarding).
3. Trigger
This process is triggered when Sales marks a CRM opportunity as Won and attaches the signed LOI. Operations is notified automatically [TBD — CRM workflow] or manually within 1 business day of LOI signature.
⚠ TBD: CRM automation — configure Go High Level to notify Operations automatically on Won stage and attach LOI.
4. Roles
| Role | Responsibility in Handoff |
|---|
| Sales | Delivers complete handoff package to Operations. Introduces Operations contact to employer. Available for relationship questions only — not operational follow-up. |
| Operations | Owns all onboarding tasks from LOI forward. Coordinates with Allied, ProAct, Employee Navigator, Finance, and Compliance. Single point of contact for employer during onboarding. |
| Finance | Sets up billing, confirms funding account, issues first invoice, coordinates premium payment timing with trust. |
| Compliance | Reviews employer-specific compliance requirements (state mandates, union employees, CBA restrictions). Confirms plan document package is complete before go-live. |
| Allied (TPA) | Group setup in Allied system: plan codes, network access, eligibility file, Employee Navigator enrollment. |
| ProAct (PBM) | Group setup in ProAct system: formulary access, pharmacy ID cards. |
| Broker (Spartan Wealth) | Confirms broker of record, coordinates any employee communication support, provides CAA compensation disclosure. |
5. Sales Handoff Package (Required at LOI)
Sales must deliver all of the following to Operations before the handoff call is scheduled. Incomplete packages delay go-live. Operations will not proceed without a complete package.
| ✔ | Item | Notes |
|---|
| ☐ | Signed Letter of Intent (LOI) | Countersigned by authorized employer signer |
| ☐ | Employer census (final) | All employees, DOB, zip, enrollment tier, dependents |
| ☐ | Employer legal entity name + EIN | Must match payroll records exactly |
| ☐ | Authorized plan signer name + title | Signs plan adoption agreement and trust participation docs |
| ☐ | HR/benefits admin contact | Primary Operations contact post-onboarding |
| ☐ | Payroll contact | For premium deduction coordination |
| ☐ | Current plan details | Carrier, plan type, premium rates, renewal date |
| ☐ | Desired go-live date | First day employees are claims-eligible. 1/1 preferred; mid-year allowed. |
| ☐ | States with employees | Full list — needed for stop-loss licensing confirmation |
| ☐ | Union employees (Y/N) | If yes: list affected employees and CBA summary |
| ☐ | Prior claims data | If available — PHI secure. Needed for HLRA facultative review (large groups). |
| ☐ | Gradient AI pre-screen output | From OPS-SOP-014 quoting process |
6. Handoff Process
1. Package Review (Operations — Day 1): Operations confirms handoff package is complete. If anything is missing, Sales is notified within 24 hours with a specific list of what's needed. Go-live clock does not start until package is complete.
2. Handoff Call (Sales + Operations + Employer — within 3 business days of complete package): 30-minute call. Agenda: (a) introductions — Operations takes the relationship from here; (b) confirm go-live date; (c) walk employer through what they need to provide and by when; (d) explain the onboarding timeline; (e) answer questions. Sales attends for introductions only.
3. Compliance Review (Operations — within 3 business days of package): Compliance reviews the package for: union employees, complex states, CBA restrictions, any Gradient AI red flags requiring actuarial review. Green light required before legal documents are issued.
4. Legal Document Package (Operations — within 5 business days of green light): Operations coordinates with Legal Counsel (Dickinson Wright) to issue:
- Plan Adoption Agreement (employer-specific)
- Trust Participation Agreement
- Employer Plan Document (SPD, SBC) — employer-specific versions
- BAAs (Allied, ProAct, Gradient AI if applicable)
All documents routed to authorized employer signer for execution.
5. Vendor Setup (Operations — in parallel with legal docs):
- Allied: Submit group setup request (plan codes, network, eligibility file format, Employee Navigator enrollment). Allied SLA: [TBD] business days.
- ProAct: Submit group setup request (formulary assignment, pharmacy card issuance). ProAct SLA: [TBD] business days.
- Employee Navigator: Confirm group added to trust-level feed (or separate feed setup if required — confirm with Kim James).
- Varipro (COBRA): Notify of new group addition. Varipro SLA: [TBD] business days.
⚠ TBD: Employee Navigator feed setup — confirm single trust-level feed vs. $750/group separate setup with Kim James (Allied).
6. Finance Setup (Operations + Finance — within 5 business days of LOI):
- New vendor/employer added to Acumatica (Vendor Add/Change form if not in system)
- First premium invoice issued — amount based on final census and approved composite rate
- Payroll deduction instructions sent to employer payroll contact
- Funding flow confirmed: employer premium → trust account → Allied escrow
7. Employee Communication Package (Operations — 10 business days before go-live): Operations prepares and sends the employer HR contact:
- SPD and SBC (employer-specific)
- Enrollment instructions (Employee Navigator login / paper enrollment)
- ID card timeline
- Pharmacy benefit instructions (ProAct / Leaf Health)
- DPC clinic information (if applicable — Exodus Health locations)
- All required participant notices (see OPS-SOP-021)
8. Go-Live Checklist (Operations — 3 business days before go-live): Operations confirms all items below before declaring go-live ready:
- All legal documents executed
- Allied group setup confirmed (eligibility live)
- ProAct group setup confirmed (pharmacy live)
- Employee Navigator enrollment complete
- First premium received in trust account
- Allied escrow funded
- Employee communication package distributed by employer HR
- ID cards ordered / timeline confirmed with employees
If any item is incomplete, Operations escalates to the relevant vendor or employer contact immediately. Go-live is delayed only as a last resort.
9. Go-Live Confirmation (Operations): Operations confirms go-live date to employer, Leadership, and Finance. CRM updated to Active. Handoff to ongoing operations (OPS-SOP-001 through 006 for claims, PBM, premiums, etc.).
7. Timeline Summary
| Milestone | Target Timing | Owner |
|---|
| LOI signed | Day 0 | Sales |
| Package review complete | Day 1 | Operations |
| Handoff call | Day 1–3 | Operations + Sales |
| Compliance green light | Day 1–3 | Compliance |
| Legal documents issued | Day 3–8 | Operations / Legal Counsel |
| Vendor setup initiated | Day 3 | Operations |
| Finance setup + first invoice | Day 1–5 | Finance |
| Legal documents executed | [TBD — depends on employer turnaround] | Employer + Operations |
| Employee comm package distributed | 10 days before go-live | Operations → Employer HR |
| Go-live checklist cleared | 3 days before go-live | Operations |
| Go-live | Agreed date (1/1 preferred) | Operations |
Minimum lead time: 30 days from complete handoff package to go-live is the operational minimum. 45–60 days is preferred, especially for groups with complex state requirements or mid-year enrollments.
8. References
- OPS-SOP-014 — Employer Prospect Intake & Quoting
- OPS-SOP-009 — Employer Group Onboarding (Allied/ProAct setup detail)
- OPS-SOP-012 — Member & Benefits Administration
- OPS-SOP-021 — Annual Compliance Deadline Calendar (participant notices)
- OPS-COMP-006 — Master Compliance Framework