Eligibility Sync - How to enroll and link patients to group plans

When an employee or their dependent appears in the Eligibility Sync tab, you can enroll them in a group plan in one of two ways:

Create a new membership for the primary member.
Add the patient to an existing membership — typically used to attach dependents (spouse, children) to a primary member who is already enrolled.

Enrollment is always manual. Linking, when applicable, keeps the patient's existing chart and avoids duplicates. Follow the steps below to handle each case.

Opening the Enroll in Plan Form

Open the employer page and go to the Eligibility Sync tab.
Locate the employee or dependent row.
Click the Enroll in Plan action on the row to open the side sheet.

Adding a Dependent to an Existing Membership

This is the most common scenario for dependents: the primary member is already enrolled in the employer's plan, and you want the dependent to share that same membership instead of starting a new one.

In the Memberships section, toggle on Add to an existing membership.
In the Patient field, search and select the primary member who already holds the membership.
The Plan dropdown will only show that patient's active or deferred memberships under this employer — pick the one the dependent should join.
Choose the Seat the dependent will occupy (for example, Spouse or Child). Seats follow the rules defined in the plan, and required seats must be filled before optional ones.
Confirm the Start date. It must be on or after the employer contract start date and the dependent's benefit start date.
Fill in the dependent's information in the Patient section (or link to an existing chart — see below).
Click Save.

The dependent is added to the primary member's membership and starts being tracked under the same plan from the chosen date onward.

Enrolling a Primary Member in a New Membership

Use this flow when the patient is the primary member and no membership exists yet for them under the employer.

In the Memberships section, leave Add to an existing membership off.
Plan: Select the employer's membership plan.
Seat: Choose the seat type (typically Primary).
Start date: Defaults to the contract or benefit start rule. You can adjust it when the plan allows variable start dates.
Fill in the Patient section with the employee's information.
Click Save.

A new membership is created for the patient, and any dependents added later can be attached to this same membership using the flow above.

Linking to an Existing Patient

When the employee's or dependent's name and date of birth match an existing chart in SigmaMD, the form shows a The patient matches existing records alert listing all matching charts.

To link to one of these patients, leave the alert as is and select the matching patient from the Patient dropdown. Continuing will enroll that patient in the membership plan.
If none of the matches are correct, check Ignore and create a new patient to proceed with a new chart. This option is only available when both the name and date of birth match — strict matches must be reviewed.

Linking is especially useful for dependents who already exist in the system as patients of another household member — it prevents duplicate charts and keeps their clinical history intact under the new membership.

Creating a New Patient

If there are no matching records, or you chose to ignore the matches, fill in the Patient section:

First name, Middle name (optional), Last name
Date of birth — must be today or earlier.
Sex at birth
Mobile number and Email — must be valid and not already in use by another patient.
Assigned location and Access — set the home location and which other locations can access the chart, or mark Allowed to all locations.
Assigned clinician

If the patient has a caregiver (common for minors), check This patient has a caregiver and either select an existing patient as the caregiver or fill in the caregiver section to create a new one.

Saving the Enrollment

Click Save to complete the enrollment. The button is enabled only when the form is valid — invalid emails or phone numbers, seats that don't satisfy the plan rules, and start dates that precede the contract or benefit start will block submission.

Once saved:

The patient is enrolled in the selected plan and seat starting on the chosen date.
The employee's row in Eligibility Sync updates to reflect the active plan and clinical status.
The patient's chart is linked to the employer, so future eligibility file updates will keep their record in sync automatically.

From the Eligibility Sync row, you can also:

Remove from plan: End the patient's plan on a chosen term date. Removing a required seat ends the plan for all members of that membership.
Unlink patient: Disconnect the employee from the linked patient chart without ending the plan.
View payments: Open the patient's billing details to review payments tied to the membership.