The carrier bill, reconciled

The carrier bills what its file says; you owe what your enrollment says. The two drift at every hire, exit, and life event, and unreconciled drift is money: the terminated worker still invoiced is the oldest leak in benefits.

RuleJoin enrollment to the invoice in both directions, every month. A worker on only one side is the finding, whichever side it is.

Nevernet the difference and move on. A small net can hide a leak and a credit canceling out; the report names workers, not just totals.

◆ The reconciliation, May 2026by carrier, differences named below.

Carrier	Enrolled premium	Invoiced	Difference
Medical, MedCo	214,650.00	215,108.00	-458.00
Dental, DentalCo	41,300.00	41,300.00	0.00
Vision, VisionCo	12,840.00	12,395.00	445.00
Total	268,790.00	268,803.00	-13.00

The net is 13.00 and the net is meaningless: it is a 458.00 leak and a 445.00 timing difference nearly canceling. The report names both: one terminated worker MedCo is still invoicing at 458.00 a month, and one May hire correctly enrolled whom VisionCo has not started billing. One is money back; the other is a bill coming. Sample values are illustrative, never client data.

◆ Why both directionseach side of the join catches a different failure.

Side	What it catches
Invoiced, not enrolled	The leak: exits and dropped coverage the carrier file has not processed. Recurring money until caught.
Enrolled, not invoiced	The surprise: new coverage in transit. Not a saving; a bill that will arrive, possibly retroactively.
Both, different amounts	Tier and life-event mismatches: the family upgrade one side missed.

A worker present on only one side is exactly what an inner join silently drops, which is why this reconciliation is built on a full outer join, the same honesty mechanism the labor cost report uses for unassigned money.

◆ The monthly rhythmreconcile before paying, chase with names.

The invoice lands in the invoice fact, the join runs against that month's enrollment, and the differences report goes to whoever pays the bill, with worker names and categories attached. Leaks become credits on next month's invoice instead of write-offs at year end, and the reconciliation history becomes its own record of how clean each carrier's file runs.

Use case

Problem

Carrier invoices are paid as received, so exits keep getting billed and coverage changes surface as year-end surprises.

What we build

The invoice fact joined to daily enrollment in both directions, monthly, with differences categorized and named.

What you get

A checked bill: leaks recovered as credits, in-transit charges anticipated, and a per-carrier cleanliness history.

Is anyone on your carrier bill no longer on your payroll?

We ship the two-sided reconciliation that answers by name, monthly.

Talk to us

Terms on this page

full outer join: A join keeping rows from both sides whether or not they match. The finder.
leakage: Premiums paid for people no longer enrolled.
in transit: Correct new coverage the carrier has not begun billing.
life event: A qualifying change, marriage or birth, that moves tiers mid-year.
retroactive billing: A late charge for coverage back to its true start.
net difference: The total gap. Meaningful only after the sides are named.
credit: The recovered leak, applied to the next invoice.