Case Setup
- Establish Administrative Procedures
- Case Operations
- Reporting Requirements
- Special Administrative Requirements
- Administrative Service Agreement
- Customize Enrollment Form
- Preparation of Standardized Plan Document/Summary Plan Description (optional service)
- Set-up Accounts and Plan Data
- Program Data Interfaces (if necessary)
Participant Data
- Enter Participant Elections (initial enrollment and ongoing)
- Edit Participant Data Due to Termination and Change in Family Status Forms
- Generate and Mail EOB's to Participants
- Generate and Mail Verification Forms to Participants (optional service)
- Provide Claim Forms
Reimbursement Account Claims Processing
- Enter Claims
- Process Claim Reimbursements Semi-Monthly (Weekly Reimbursement - optional service)
- Mail Checks to Direct Pay Participants
- ACH Monies to Direct Deposit Participants (optional service)
- Reconcile Accounts
Reporting
- Produce Check Listing Items Report
- Produce Check Listing Amounts Report
- Produce Total Plan Report
- Produce Status Report
- Produce Participant Statements (semi-annual)
Communication with Plan Participants
- Resolve Participant Claim Issues
- 800# Service for Plan Participants
- Toll-free Participant and Client Inquiry
- Website Access to Account Balance and Claim Payment Information
Discrimination Testing under Section 129(d)(7) and 125(b) (optional service)
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