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