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