As your employee base grows and Health Care Costs continue to increase, making the most of your financial resources is a top priority for you and your business or organization. The Preferred Group is here to help you administer your benefits, with Self-Funded plans, third-party administrative services, and claims support.  Self-Funding not only could mean a way to save precious benefit dollars, but will give you the options to customize your plan to fit your organizations demographics.  Give yourself some more time to spend on the things that matter most to your business or organization.

Advantages of Self-funding

• Self-Funded plans are not subject to premium taxes
• Self-Funded plans are exempt from state mandated benefits
• Claims may be paid as they are incurred
• Self-Funding allows the employer to choose the most efficient plan administration
• Self-Funded plans free the employer from having to pay monthly premiums

The Preferred Group acts as an agent with regard to payments of certain benefits for companies that choose to utilize our expert administrative services for self-funded dental plans.  With a Self-funded dental plan, the plan sponsor, the company initiating the plan, sets the parameters of the plan internally.  The Preferred Group is responsible for the following services:

• Adjudication of claims (within seven days)
• Coordination of benefits processing
• Maintain eligibility file
• Accumulate dental history
• Handle appeals
• Provide checks & explanation of benefits
• Prepare monthly and annual reports
• Process pre-determination of benefits
• Obtain stop-loss coverage, if required
• Full accounting

The Preferred Group will aid the plan sponsor in the design and initiation of the plan, and in any revisions the plan sponsor deems necessary.  PGP will ensure that all reviews meet the criteria set forth under the Employee Retirement Income Security Act of 1974 (ERISA), if applicable.

As per the initial agreement, The Preferred Group will pay plan benefits by checks drawn on a benefit plan account.  The Preferred Group will deposit to such account, each day on which checks are drawn, a draft on the account of the plan sponsor in an amount equal to the sum of the checks drawn on that day.

The Preferred Group does not insure nor underwrite the liability of the plan sponsor under the plan.  The plan sponsor retains the ultimate responsibility for claims made pursuant to the plan.

Cobra

The Preferred Group offers Cobra administration for a number of clients.  This is an administrative function to ensure compliance under the Consolidated Omnibus Reconciliation Act of 1985.  This federal regulation provides for continued coverage of group health benefits under certain conditions after an employee’s termination (both voluntary and involuntary.)  Preferred Group Plans, Inc. performs the following functions:

• Print and mail invoices to covered individuals
• Receive payment from covered individuals
• Forward payments to appropriate insurance companies
• Full accounting of payments billed and received

 

A Commuter Reimbursement Account, allowed by § 132 of the Internal Revenue Code, allows employees to have their parking and commuter mass transit expenses deducted on a pre-tax basis. Employees can deduct up to $230.00 per month for parking costs and an additional $230.00 for utilizing mass transit.

As an employer, you will save 7.65% matching FICA for each dollar that is placed in a Commuter Reimbursement Account.  This savings will offset the administrative costs of the program and will help you maximize your employee retention by offering your employees this tax savings program.  Your employees can save 30 to 40% on their tax burden by utilizing the CRA which results and a win-win situation for both the employer and the employee.

How does it work?

Employees who want to participate in the Commuter Expense Reimbursement Account can make monthly elections for both parking and mass transit and those elections may be changed each month.  This amount is reduced from the employee’s income prior to taxes. When commuter expenses are incurred, employees will submit a completed claim form along with appropriate supporting documentation for reimbursement.  Employees cannot be reimbursed more than the balance in their account.  The employer also has the option of offering the Pre-Paid Benefits Card  for these expenses.

When employees use our Pre-Paid Benefits Card to pay for qualified transportation costs at a merchant accepting MasterCard  location, funds are automatically deducted from the pre-tax dollars in their Commuter Reimbursement Account. Employees can view their account online at www.thepreferredgroup.com to keep apprised of charges, contributions, and current balances for the remaining plan year.

 

The Preferred Group can assist your employee association, union trust fund, and employer group with the establishment and ongoing maintenance of a Heath and Welfare Fund Benefit Plan.  We will consult with your organization to help determine the best benefits for the available funds.  Self funded benefit plans offer significant advantages over insured plans in both flexibility and cost containment for such employee benefits as dental, vision, prescription drug, flexible supplemental health, legal and other insured or self-insured benefits the trustees or employer may wish to offer. 

Why Use a Fund Administrator?

Fund administrators have significant degree of specialized expertise, technical and professional staff and computer capability required to administer a wide array of benefits.  The Preferred Group will aid the Trust in plan design and implementation of the plan, as well as the incorporation of revisions as requested or required.  By using the Preferred Group as your professional fund administrator you will lessen the liability to the trust.

Unlike other TPA’s The Preferred Group provides all of the administration services.

• Design of benefit plan
• Adjudication of claims
• Maintain eligibility
• Process collections from employers
• Prepare reports to trustees
• Consult with trustees
• Maintain fund database
• Retain actuaries, accountants and attorneys as required
• Other specialized services upon request

 

 

 

 

 

The Prepaid Benefits Card makes the Preferred FSA, HRA and CRA easier to use by reducing the manual claim submission process with a swipe of the card.  This means that plan participants will be more satisfied with their benefits and more likely to use them.

The Prepaid Benefits Card gives participants more access to their FSA funds and they are more likely to enroll in the plan, and contribute more in the plan in subsequent years.

Employers can offer the Prepaid Benefits Card for the Preferred FSA, HRA and CRA.

The advantages of the Card to you as an employer are:                                   

• FICA Tax Savings – implementing the Prepaid Benefits Card has resulted in increased employee participation, as well as increased annual election amounts year after year. Employers have seen immediate increases of 20 – 40% in participation, and annual contribution increases ranging from 10 – 50%. That translates into significant FICA tax saving that in some cases, can pay for the program.
• IRS Compliance – Advanced auto substantiation technologies can verify the eligibility of many transactions, minimizing the need to request receipts from the cardholder. Letters requesting receipts are sent only when necessary.

The advantages of the Card to your employees are:

• Cash flow friendly – cardholder spending accounts (e.g. FSAs) are directly debited for

eligible expenses, eliminating “out-of-pocket” cash payments and then waiting for reimbursement.

• Convenient and easy to use – eliminates claim forms.
• Simple to track – balances are available online 24/7 – this detailed tracking can be used

to predict more accurate (and increased) annual election/salary reduction amounts in subsequent years.