PRODUCTS & SERVICES
ADMINISTRATION SERVICES
MEDICAL, DENTAL AND VISION
FLEXIBLE SPENDING ACCOUNTS
HEALTH CARE REIMBURSEMENT
DEPENDENT CARE REIMBURSEMENT
COBRA
HIPAA
NYCRA
Rx BENEFIT MANAGEMENT
MEDICAL CASE MANAGEMENT
STOP LOSS INSURANCE
PPO NETWORK MANAGEMENT
CLAIMS ADVOCACY
EMPLOYEE BENEFIT SURVEYS
Customer Service / Claims / IT Staff
Managed Benefit Plans’ location in Northwest New Jersey provides MBP with the opportunity to hire from a very experienced labor pool. Many of the National Health Carriers have closed their benefit administration facilities in this area. Each MBP employee brings an array of different talents with an average of 10 plus years of benefit administration background.
This experience combined with Senior Management’s background in Claims, Customer Service, Sales and Underwriting enhances MBP’s ability to provide a complete package of self-funded services to employers who are currently self-funded or who are considering the self-funded option.
MBP has recruited IT personnel who have worked in the insurance/health care administration field and have a thorough understanding of what a client needs to determine how their plan is functioning. In addition MBP’s claim system permits flexibility by client need.
Most importantly, MBP is focused on Customer Service and meeting the needs of each employer group. It is MBP’s job to provide efficient benefit plan administration services so that the employer and their brokers or consultants can focus on their respective businesses.
Administrative Services Include:
Stop Loss Insurance
MBP has strong stop loss relationships. These relationships provide our clients with competitive opportunities and the option to test the market on renewal, however, we encourage the retention of in force relationships when it makes sense. All carriers must retain a minimum of an A rating.
PPO Networks
MBP retains relationships with all National Medical, Dental and Vision PPO Networks as well as many Regional Networks as required by our client’s locations. MBP has established electronically transmission with our National Networks and we are working toward EDI with all networks that are transmitting claims data electronically.
MBP completes GEO zip code studies and or provider disruption studies so our clients have a better understanding of the availability of providers and facilities in their areas.
MBP provides a National PPO overlay in addition to the employers primary PPO Network. Our claim system will search the providers of the National PPO once it is determined that the submitting provider is not in the Primary Network. If the provider is located in the National Network a discount is achieved.
MBP partners with an out of network claims negotiating organization. Once the MBP system has determined that the claim is not in either the primary or national overlay network the claim is sent in an overnight electronic transfer to be negotiated. If successful the claim will be adjudicated at the reduced fee.
MBP employs all industry methodology available to provide the employer with the tools to reduce the cost of their employee’s claims while maintaining or enhancing the quality of services received.
Rx Benefit Management
MBP has a strong partner relationship with Eckerd Health Services (EHS). EHS is a leader in the Pharmacy Benefit Management Industry. EHS has been awarded several Customer Service Excellence Awards. They contract with over 54,000 national pharmacies. MBP enjoys a competitive discount off AWP (average wholesale pricing) for both retail and mail order prescriptions. EHS provides an excellent website designed toward each employers' specific Rx benefit plan at www.ehs.com. EHS provides monthly, quarterly and year end reports with plan modification suggestions for our clients renewal consideration.
MBP employs the services, at no cost for our clients, of PBIRx a pharmaceutical consulting firm that provides an annual analytical overview for the client’s consideration.
As Rx claim costs are trending higher each year MBP works to provide the tools necessary for our clients to make intelligent Rx decisions that work for both management and their employees.
Medical Management
MBP knows the importance of providing quality assistance with the management of potential high dollar claims and the confidentiality that is required. MBP partners with proven leaders in this field. Each medical management company provides Utilization Review, Medical Claims and Disease Management, and the opportunity to acess a 24-hour nurse help line/information library through MBP. Each received four accreditations from the American Accreditation HealthCare Commission/URAC for Utilization Management, Case Management, 24 Hour Telephone Line Triage and Health Information and Independent Review.
MBP provides relationships to assist with Diabetes and other chronic disease support including connections to EAP’s
Flexible Benefit Plan Administration
MBP works together with the employer to provide all necessary educational material for each employees review and consideration.
MBP prepares enrollment and claim forms
MBP provides administration and payment of submitted reimbursements coupled with customer service support including Direct Deposit, if desired, for employee reimbursements.
Claims Advocacy
MBP provides assistance for fully insured Benefit Plans whose employees are having difficulty obtaining closure on a submitted medical claim. MBP employs a professional team that will intervene on behalf of the employee. Our team member works with the employee and insurance carrier uncovering the problem, and in doing so providing the needed support to create a resolve to the open issue. MBP always works within the guidelines of protected health information.
Employee Benefit Surveys
As health care costs continue to escalate year after year employers look to increase their employees share in the cost of the Benefit Plan. However, employers sometimes are unsure where and how to share the increase. MBP has created a survey that can be distributed anonymously to employees queering them on the effect increases in cost or decreases in plan options would be received. These answers will provide the employer with the information they need to make informed decisions.
Managed Benefit Plans, Inc. is continually looking to provide value added services for our clients.
To discuss any or all of the above Administrative Services please contact
MBP at: 1-800-450-0081 and ask for the Sales Department.
