Administrative Services

  • Implementation Support – 120-day timeline leveraging existing infrastructure with flexible, but methodical, practices and a single point of contact; Step-by-step implementation calls to guide you through the process
  • Member Services – Retiree Service Center with toll-free call center access; Customer service team members fully trained in Medicare products and updates to regulations; Locate a pharmacy; Access your Explanation of Benefits; Access to general benefit details; All content can be viewed with screen readers for sight-impaired members; Availability to view content in Spanish
  • Eligibility Management – Coordinate all applicable eligibility and enrollment information with the carriers and provide eligibility management services.
  • Dedicated Client Account Management Team
  • Enrollment Type Options – Group Enrollment with Opt-In/Opt-Out Capabilities; Voluntary Enrollment (Face-to-face, Online, Telephonic, Mail & Fax); Member Mailings: Craft and fulfill client’s customized announcement letters, pre-enrollment kits and welcome kits; Communication pieces custom crafted for retirees to easily understand while adhering to CMS compliance requirements.
  • Meetings – Educational, Plan Kick-off, Enrollment, On-Going Retiree Group and Wellness Initiative Meetings
  • Eligibility Scrubbing – Manage all eligibility maintenance in CMS’s approved format, so the client does not need to change their business process; Age-In and Dis-Enrollments; Customized enrollment and dis-enrollment process to meet client’s needs
  • Member Advocacy Center – Proprietary phone and software system; Customized greetings and client phone numbers; No dial-by directories, our advocates answer every call; 100% domestic with over 300 languages available. TTY compatible; All calls are recorded and stored for 10 years
  • Billing Capabilities – Direct Client – Group list billing; Split billing (Client/Member); Member Direct Bill (100% Member through ACH); Integrated HRA; LEP & LIS billing available
  • Reporting – Member Interaction Reports; Customized call Transcriptions Reports; Utilization Reporting; Customized ad-hoc reporting; Plan Document Review
  • Our Retiree Advocates are AHIP Certified; Life and Health Insurance Licensed; HIPAA Compliant; Attend Specialized Geriatric Training
  • Sampling of Retiree Services Provided – Personal information changes; Card replacements; Formulary, tier and copay assistance and exceptions; Physician and pharmacy outreach; Inbound/Outbound three-ways calls to Medicare, vendors, providers, pharmacies, and Social Security; Claims, billing and payment support; Help with filing of applications, including Low-Income Premium Subsidy (LIPS) filing assistance; Assistance with pharmacy related questions such as generic availability, prior authorizations and mail-order services; Status calls throughout the process of any open item, making sure members know their problem is of highest concern and we are working on a resolution; Completion calls to member after any issue has been resolved to ensure no additional assistance is needed

If you have any questions regarding our services, or would like more information, please contact: Nicole Allen at or Kate Beebe at