Employers

EMPLOYERS

An end-to-end health benefits solution tailored to your business.

Beyond just claims, we’re about helping you solve your most complex employee benefit challenges and maximize your investment in your greatest asset: your people.

We understand that your employee health benefit plan is a big investment.

Whether you’re looking for a new health benefit plan administrator or to transition from a fully-insured policy to a self-funded health plan, you need a trusted partner who will take the time to understand your company’s needs and provide  innovative, cost-effective solutions that deliver meaningful results to you and your employees.

As a full-service third party administrator drawing on close to three decades of experience in the healthcare insurance industry, we build and administer health benefits plans that improve the health and productivity of your workforce while minimizing risk, lowering costs, and enhancing employee satisfaction.

As your single point of contact for managing all aspects of your employee health benefit plan, we save you countless hours of administrative time and hassle, so you keep your focus where it belongs—on your people and your business.

What Makes Us Different

We listen to your needs

We listen to your needs

We take the time to understand your company’s needs, and then we design & execute a plan that fits your business and ensures the best care possible<br /> for your employees.

We cover all the details

We cover all the details

We close even the most complex claims, reviewing each and every claim in meticulous detail and delivering fast and accurate claims decisions with empathy and expertise.

We eliminate headaches

We listen to your needs

Trying to manage your health benefits plan in-house can be complex and time consuming. Our team of experts takes care of every detail, so you don’t have to.

Combining bespoke insurance  solutions, unmatched flexibility, and industry-leading analytics, we partner with you to foster a healthier, happier, and more productive workforce. Our benefits and services include:

BROAD PROVIDER ACCESS

HUMAN RESOURCES SUPPORT

CUSTOMIZED WELLNESS PROGRAMS

PRESCRIPTION DRUGS COST REDUCTION

ROBUST DATA ANALYTICS & REPORTING

RISK-MITIGATION

FULL-SERVICE COMPLIANCE SOLUTIONS

HRA & HSA-ELIGIBLE PLANS

BROAD PROVIDER ACCESS

Gain a competitive edge by giving your employees more access to quality, affordable health coverage. We partner with several PPO vendors to enable access to broad provider networks in their vicinity, at competitive network discounts.

Our PPO partners include many with niche networks, including:

  • GHI
  • Magnacare
  • Cigna
  • Medical Mutual, and
  • Nova

HUMAN RESOURCES SUPPORT

We offer a full spectrum of exceptional member support and human resources services, including:

  • employee enrollment meetings
  • claims troubleshooting
  • pharmacy benefits management
  • enrollment support
  • cobra services, and
  • FMLA services

CUSTOMIZED WELLNESS PROGRAMS

Since every employee and industry is unique, we design a comprehensive wellness program for you based on what we believe will keep your employees and their families healthy. Our range of programs include:

  • biometric screenings
  • incentives for participation in wellness-geared activities
  • health risk assessments
  • individual health information and advice
  • and more

PRESCRIPTION DRUGS COST REDUCTION

We partner with a leading prescription benefit manager, passing on significant cost savings to your plan. We work with the prescription benefit manager to locate the lowest cost source for every maintenance drug and design your formulary to deliver the value you want.

ROBUST ANALYTICS & DATA

Our experienced adjusters and claims professionals leverage data and act quickly, making savvy decisions to close claims efficiently. We then review claims reports with you on a quarterly basis, evaluating your plan’s performance and providing you with the information you need to make the best possible decisions for your business.

RISK-MITIGATION

We protect your plan with stop loss insurance that suits your business best, reducing your costs by enabling you to set a cap for maximum liability. In plain English, this means you’ll be protected in case of unforeseeable circumstances, so you never have to fear a year with an unexpectedly high number of claims.

FULL-SERVICE COMPLIANCE SOLUTIONS

Save time, overhead, and hassle by letting us help you ensure you remain compliant with the complex laws governing healthcare insurance, including ERISA, DOL, and the Health Care Reform Law.

HRA & HSA-ELIGIBLE PLANS

We offer administration for Health Reimbursement Arrangements (HRA) for members with qualified medical expenses, as well as flexible spending account (FSA) plans that offer the benefits best suited to employee needs.

TotalPlan TPA Response to COVID-19

Your health and the health of your loved ones are important to our dedicated team. You may expect business as usual when calling,emailing, or chatting with our Dedicated Service Associates.