Considering Self-Funding?
Superior Customer Service
- Personalized claims administration
- Direct access to assigned Claims Analyst and Eligibility Specialist
- ID cards are generated in-house
- Claims are NOT auto-adjudicated; ALL claims are reviewed in-house by experienced Claims Analysts
- Consistent 5 to 7 day claims turnaround time
- Preferred Online Services featuring claims history, EOB's and benefit information available 24/7 for all plan participants and employers
- 24/7 provider access to benefits, eligibility and claim status; our fully automated fax-back system provides written verification of benefits, eligibility and deductible satisfaction.
Flexibility & Creativity
- Choice of multiple national and local PPO Networks. Multiple networks can be implemented to ensure adequate provider access for all group locations
- Prescription Drug Card Programs with choice of multiple PBM's
- Reinsurance marketing & placement; Preferred Benefit Administrators constantly monitors the industry for changes
- Plan of benefits can be customized based on employer specifications
Competitive Pricing
- Unlike large insurance companies offering self-funded plan administration services, our administration fees are much more reasonable
- No charge for drafting and maintenance of the Plan Document & Summary Plan Description and SBC's; All Plan documents are created in-house
- PPO Savings are clearly identified and not inflated with other non-payable benefits
- No additional PPO surcharges for members residing outside of employers' geographical area
- No set-up fees or ongoing annual renewal fees
Compliance Services
- Full service ACA reporting including generation of 1095's and electronic IRS filing
- Ongoing employer education to comply with new regulations
- Government reporting
- Assistance in preparation of IRS Form 5500 and filing of 1099's to physicians
- Reinsurance filing, tracking and reporting for Specific and Aggregate claims
- COBRA administration
