DELIVER LATEST INFORMATION ON HEALTH CARE REFORM

• Provide guidance on requirements and notices
• Summarize key compliance deadlines and delays
• Email special alerts when requirements change
• Provide annual checklist for each year’s requirements

RESEARCH AND ANALYZE CLIENT’S GROUP BENEFITS NEEDS AND PHYSICIAN NETWORKS

• Review current plans and level of satisfaction
• Determine key person’s objectives
• Collect census

SURVEY THE MARKETPLACE FOR APPROPRIATE PLANS AND CARRIERS

• Analyze available carriers and plans
• Evaluate and compare plans inside and outside of the Health Insurance Exchange
• Confirm that key person’s physicians are in proposed network

PRESENT PLAN ALTERNATIVES THAT MEET CLIENT’S BENEFITS AND BUDGETARY NEEDS

• Prepare presentation
• Explain plan differences

DEFINE ELIGIBILITY

• Explain requirements for group coverage
• Identify acceptable waivers
• Review participation requirements

PREPARE MASTER APPLICATION, SUPPORTING DOCUMENTS AND EMPLOYEE ENROLLMENT

• Assemble group application, which defines the terms of the plan
• Include eligibility rules supplied by group with the application
• Collect enrollments completed by each employee, defining the employee’s status and named dependents

EDUCATE EMPLOYEES ABOUT THEIR PLAN

• Install the plan upon acceptance by the carrier(s)

PREPARE AND MAINTAIN WRAP SPDS AND WRAP PLAN DOCUMENTS

• Prepare Wrap Summary Plan Description to comply with ERISA requirements
• Prepare Wrap Plan Document to comply with ERISA requirements
• Provide amended Wrap Documents in the event of any changes to ERISA-required provisions or material changes to plan information and benefits
• Provide distribution guidelines for Wrap SPDs

SUPPORT EMPLOYEE BENEFITS AND HR NEEDS

• Be available to respond to questions regarding the plan, claims and eligibility
• Keep clients ahead of the curve by notifying them of changes to the law regarding issues that will directly impact their businesses
• Provide HR and benefits monthly newsletter and online HR library
• Provide summary of major required health plan notices
• Provide customer support throughout the plan year related to matters such as enrollment changes, claims and insurance I.D. cards
• Provide support when COBRA issues come up (or mini-COBRA needs, depending on your state)

HELP WITH OPEN ENROLLMENT ISSUES

• Provide support at open enrollment time, including explaining choices and assisting enrollment

FACILITATE RENEWAL AND ELIGIBILITY VERIFICATION

• Provide explanation of renewal
• Design plan alternatives in line with budget and priorities