Dental & Vision Institute

Monthly Goal Progress

$0

of $0 goal

0%

achieved

0%

$0$0

Plan Mix

Dental

Vision

Recent Enrollments

Name	State	Plans	Total/mo	Payment	Date

⚠ Failed Payments

All payments up to date

Possible duplicate found. A subscriber with this SSN, DOB, and state already exists.

Subscriber Information

First Name *

Middle Initial

Last Name *

Date of Birth *

SSN Last 4

Gender *

Email *

Phone *

Address

Street Address *

Address Line 2

City *

State *

ZIP *

County

Coverage

Number of Adults *

Number of Children

Effective Date *

Agent *

Dental Plan Selection

Vision Plan Selection (optional)

Payment Information

Card Details

First Name

Last Name

Phone Last 4

State

Payment Status

Name	Phone	State	Dental	Vision	Total/mo	Payment	Agent	Date	Actions

Payment Records

Customer	Plans	Amount	Status	Retries	Actions

Name	Email	Role	Status	Deals	Revenue	Commission	Actions

Generate & Send 834

Date Range

Include Failed Payments

Saved 834 Files

Filename	Generated	Records	File Size	Status	SFTP Sent	Download

Export History

Date	Records	Filename	Status	SFTP Sent

Reconciliation

Total Expected

$0

Total Collected

$0

Variance

$0

Renewal Alerts

30 Days

60 Days

90 Days

Customer	Policy ID	Monthly	Next Bill Date

All 834 EDI enrollment files generated and saved on the server

834 EDI Files

Filename	Generated	Records	File Size	Status	SFTP Sent	Download

Stripe Configuration

Publishable Key

Secret Key

Webhook Secret

Webhook Setup: In your Stripe Dashboard → Webhooks, add endpoint: https://YOUR-DOMAIN/webhooks/stripe — then paste the Signing secret (whsec_...) above.

SMTP Configuration

Host

Port

Username

Password

SFTP Configuration

Host

Port

Username

Password

Remote Path (folder on their server where files go — leave blank or use / if unsure)

EDI / 834 Configuration

These values appear directly in the 834 file envelope and segment headers. Get the correct values from Renaissance (or your carrier contact).

Sender ID (ISA06 — 15 chars max)

Sender Qualifier (ISA05)

Sender Legal Name (N1*P5)

Sender EIN / Tax ID (N1*P5 — FI qualifier)

Receiver ID (ISA08 — 15 chars max)

Receiver Qualifier (ISA07)

Receiver / Carrier Name (N1*IN)

Carrier EIN / Tax ID (N1*IN — FI qualifier)

Group Number (REF*38 / REF*1L)

General Settings

Plan Administration Fee ($/plan)

Agent Commission %

Vision Commission %

Monthly Goal ($)

Alert Email

Automation

Nightly EDI Generation

Auto-Retry Failed Payments

Renewal Alert Emails

Key	Name	Created	Last Used	Status	Actions

Audit Log

User

Action

From

To

Timestamp	User	Action	Details	IP

Member support requests submitted via the member portal.

Date	Name	Policy ID	Subject	Contact	Status	Action
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Change Password

Current Password

New Password

Confirm New Password

Requirements: minimum 8 characters. Avoid reusing your current password.

Dental & Vision Institute

Dashboard

Enrollment Complete!

Dental & Vision Institute