Learn more about our process

Beneficiary/Client Services

  • Speak with the beneficiary, plan administrator and/or any other family members regarding the life and disability insurance benefits and process, COBRA rights, Social Security eligibility and any other questions that may arise.
  • Maintain client contact information for questions related to unused vacation/final paycheck, 401(k), ESPP, COBRA, etc.
  • Obtain required information from client system pertinent to the completion of claim forms (other procedures may be implemented to obtain required information).
  • Obtain Death Certificate
  • Obtain accident reports, newspaper articles and other pertinent reports required with specific claims
  • Work with funeral homes and administrators when benefits have been or need to be assigned.
  • Fully complete (signature ready) all and any forms required including but not limited to the following:
    • Insurance company Death Claim Form
    • W-9 form
    • Waiver of Premium Claim Form
    • Claimant Affidavit (in cases that there is no beneficiary on record)
    • Proof of Birth Affidavit (when proceeds are paid to a non U.S. resident)
    • AD&D Claim Form
    • Assignment Form
  • Act as liaison with the insured filing for disability benefits. This includes going over claim filing processes, benefits, etc.
  • Process all forms with the insurance company and act as the point of contact regarding questions and any possible need for additional information.

On-Going Services

  • Assist with claims questions and disputes
  • Prepare SPDs and amendments (or review in cases where vendor produces SPD)
  • Prepare or review master contracts
  • Assist with preparation of communications material
  • Prepare Federal Filings (Form 5500 and applicable schedules)
  • Administer COBRA (for those clients who administer their own COBRA, we would provide a COBRA procedural manual that would include sample forms and letters)
  • Act as the liaison with insureds filing for LTD or life insurance benefits. This includes assistance in completing forms, explaining benefits and procedures, explaining eligibility and filing for other government benefits
  • Develop performance guarantees with insurance vendors

Funding Arrangements

  • Review current funding arrangements
  • Present proposed recommendations
  • Assist with implementation of various funding arrangements
  • Review funding agreement before signature to ensure there are no loopholes

Technical

  • Forecast budget costs for next fiscal or plan year
  • Analyze proposed renewals with vendors
  • Negotiate proposed costs with vendors
  • Price proposed benefit changes
  • Prepare management reports
  • Prepare financial accounting and annual utilization report
  • Evaluate monthly claims experience and prepare summary report
  • Prepare monthly flow chart of claims that have cleared the banking system
  • Evaluate plan of benefits and make recommendations
  • Evaluate PPO, POS, EPO and HMO networks

Marketing

  • Prescreen vendors in relation to meeting a client's needs
  • Prepare marketing specifications
  • Underwrite plans in house for comparison
  • Analyze and prepare summary management report of each vendor's proposal, including a cost summary, benefit summary, financial summary, network disruption analysis, funding arrangement analysis, performance guarantees, etc.
  • Present marketing results
  • Assist with installation of vendor(s)

Other Services

  • Keep each client informed of new and pending legislation
  • Assist in employee meetings
  • Attend special meetings as necessary
  • Assist with developing benefits information that would be placed on a company's intranet
  • Special projects (a separate charge may be assessed for highly complex projects, printing of materials or traveling to other sites)