Scope of Services | Large Groups

I. Consultative Services:
Additional Fees Required

  1. Analyze existing benefits
  2. Analyze rate structures
  3. Analyze claims experience
  4. Analyze provider networks, contracts and discounts
  5. Analyze contribution methodology and program history f. Review contracts, plan documents, insurance policies, summary plan descriptions, bound stop loss contracts, ancillary policies and others

II. Underwriting, Risk Assessment and Product Placement:

  1. Fully-Insured and Partially Self-Funded ASOITPA and Stop-Loss Market Medical, Dental, Vision, Life, LTD, STD, Voluntary Benefits
  2. Recommendations on plan designs, carrier selections, contract levels
  3. Create cost analysis

III. Communications:
Additional Fees Required

  1. Legislative updates
  2. Create customized post cards

IV. Technology:

We will help you interface with  your carriers as it pertains to the following:
a. Human Resource Access Employee Access

  • view/ modify custom home page
  • view all company benefits
  • access rates by line of coverage.
  • search benefit booklets
  • view employee contributions
  • search company directory
  • order ID cards
  • add and terminate employees
  • conduct open enrollment
  • check payment / balance information
  • view COBRA admin system confirm release of COBRA offer letter
  • download forms
  • view employee benefit information
  • access customized reports
  • enter and view Call Center comments
  • view beneficiaries
  • link to provider network(s)
  • print pre-printed applications
  • view benefit statements view enrollment history

b. Employee Access

  • view home page
  • view company benefits
  • view contributions
  • order ID cards
  • download forms make address changes
  • make beneficiary changes
  • search benefit booklet
  • perform open enrollment
  • view dependent info
  • request HI PM certificate
  • view eligibility rules
  • link to provider network
  • link to 401 (k) plan
  • view employee handbook
  • view benefit statement
  • view enrollment history
  • print temp ID card
  • single sign-on to vendors where available
  • access educational tools
  • use decision support tools

VI. Plan Management Reporting:

b. Data Analytics
(Additional Fees Required as well as lead time for set-up and integration)

  1. Data Validation, “cleansing”, reconciling and balancing
  2. Integration of multiple, disparate data sources into one data warehouse
  3. Easy-to-use analytics software
  4. Provide customers the ability to analyze. monitor and forecast health plan costs in one location
  5. Plan modeling and forecasting
  6. Advanced Clinical
  7. Population Risk Management

VII. Compliance:

a. COBRA/HlPAAAdministration

b. 5500 Preparation and filing

i. Charge: Administered Groups $500 – Per 5500 $600 – 5500 plus electronic filing

ii. Charge: Non-Administered Groups

  • $600 per 5500
  • $700- 5500 plus electronic filing

iii. Services Includes:

  1. Analysis of prior 5500 filings
  2. Gather Schedule A & Schedule C schedules for all lines of coverage from each carrier
  3. Analyzes the reported information for carrier accuracy
  4. Signature Ready Forms
  5. Third Party Software Electronic Filing – simplified process
  6. Preparation of Summary Annual Report

c. FSA/HSA/HRA vendors perform non discriminating testing

VIII. HR Support:
Additional Fees Required

a. Support Center

  1. Policy Library
  2. HR Forms
  3. 3 Minute HR Audit
  4. eAlerts
  5. HR Checklists
  6. HR Guides
  7. Job Descriptions
  8. Q&A Database
  9. HR Best Practices
  10. Monthly Newsletter
  11. Glossary of terms
  12. HR News and Updates
  13. HRCast
  14. HR Resource Center
  15. Quick Guides

b. HR On Demand
(All of the services listed in Support and the following)

i. Ask the Pro

ii. Document Customization

iii. Employee Handbook Consultation and Development

IX. Payroll

  • Integration between benefit and payroll deductions
  • View checks and pay history online
  • 401 (k) Reporting
  • Full tax services
  • New hire reporting
  • Time-off & accruals tracking
  • HRIS Features
  • Agency & third party pay
  • Workers’ Compensation Integration
  • Reporting Capabilities
  1. W-2 Report
  2. Variable Hour Report
  3. Federal Employer Size Report
  4. Affordability Report (featuring all three safe harbor options)