3P Administrators-Employee Benefits, Benefit Plans

Medical Plan and COBRA Administration Services

3PAdministrators specializes in the administration of "Self-Funded" Medical, dental and vision benefit plans. Our services include: obtaining and administering stop-loss insurance, developing and printing a plan document, employee enrollment, printing and distribution of enrollment cards, providing utilization review services to assure cost effective use of medical services by plan participants, issuing an explanation of benefits and payment for services provided. Click here for a flow chart of a self-funded claim. Participants can access information on their benefits and view claims through our secure web-site.

3PAdministrators is proud to be able to offer our clients a program that will educate employees and make everyone a better consumer of health care. MAP is a unique program available through 3PAdministrators. Click on the MAP link for additional information.

You can also view this MAP Video: http://24.240.192.241/delphifl/delphi_lrg.wmv

3P Administrators handles short-term disability and COBRA plans. We will review applications for short term disability to verify eligibility and effective dates. We calculate payment amounts and issue checks to the claimant while monitoring the length of the payment period.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires most employers to offer continued coverage for plan participants who no longer qualify as active participants on the plan. This federal law has gone through many changes and has numerous requirements that 3PAdministrators has followed and can handle for employers. We provide the employer with the initial notice that must be mailed to all plan participants. Election packets are sent directly to qualified beneficiaries and we monitor the election period. For those participants who choose continuation coverage, we send monthly premium notices, track timely payments, verify continued eligibility and the length of time coverage is available.

Complying with the Health Insurance Portability and Accountability Act (HIPAA) can be a nightmare for employers. 3PA has devoted a great deal of time and effort to studying this legislation to assure compliance. We will receive and review certificates of coverage for new enrollees to a plan to determine if they qualify in removing or shortening pre-existing exclusion periods. We will issue certificates to those plan participants whose coverage terminates. HIPAA security applies to the electronic data of a plan. Our network has multiple safeguards in place that more than satisfy the requirements of HIPAA. We offer education and compliance assistance to plan sponsors for both privacy and security regulations.

Online capabilities provide easy access to plan information for employers, their plan participants and healthcare providers. Employers can receive online enrollment requests from new employees and plan change information from participants. Members can view their processed claims and track the amount of deductible and out-of-pocket they have satisfied. A plan document detailing benefits available can be viewed or downloaded. Other plan-related forms are also available for downloading. Healthcare providers can have access to their patient’s benefit, eligibility and claims status information. This online service, available 24/7, can significantly reduce your human resource departments work load by answering many common questions.

Ongoing reporting is an important factor in monitoring a plan’s activity and effectiveness. 3PA provides its clients with monthly claims experience summaries showing the plan’s performance in relation to specific and aggregate contracts. Additional quarterly reports will assist in analyzing the plan on a regular basis to determine potential renewal factors or needed benefit changes. All reporting for active clients is included in the administrative fee.

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