Employer portal aids human resources administration

The ClaimLinx employer portal is a resource available to all clients with an SOS Solution plan. It is a key part of administering the plan, as it includes important forms and resources.

Maintaining and administering a health insurance plan can be a challenge at small businesses that do not have the staff resources or need for a dedicated person to the benefit plan. That is why we try to make it as easy as possible to work with ClaimLinx by providing all necessary documents on the private employer portal.

Owners and administrators can login to the portal at any time where they will find:

  • Plan enrollment forms
  • Administrator manual
  • Company schedule of benefits
  • Termination form
  • Member packets

Once logged into the portal, administrators will find recently updated forms under the “Other Documents” section. If you have never logged into the employer portal or need assistance logging in, contact the service team at service@claimlinx.com.

We encourage administrators to use this portal as a way to ensure they are always using the most up-to-date forms for new employee enrollment, as using out of date forms can slow the enrollment process.

Please be advised this is a service provided only to clients with a ClaimLinx SOS Solution Plan. If ClaimLinx is your insurance agent only, you do not have access to or need for these additional documents and resources.

We are constantly looking for more ways to improve our services for administrators, so if there is a document or resource you would like to see added to the employer portal please let us know.

 

We are the full service insurance benefit solution

When it comes to a true health benefit solution, the work doesn’t stop with simply changing insurance carriers or establishing a new plan. Employees understanding how to use the plan and employers seeing the differences in coverage and cost are just as vital throughout the year as they are on day one.

That’s why it’s a priority for our team to provide the following elite services for all of our clients:

  • In-person or online education meetings
  • Claims reporting and analysis
  • Consulting for prescription drug use
  • Medical claim negotiation
  • Prescription drug rebate checks
  • Online enrollment for easy renewal
  • Adjustments to the schedule of benefits

Education is one of the highest priorities at ClaimLinx. We believe employees who are more informed about insurance become better health care consumers overall. That means they are better able to use the health plan and are getting more out of it. So we offer to all of our clients for a service team member to come to the company for an education meeting at any time.

We find education meetings to be the best way for employees to hear how their new plan works and what changes they can expect. Meetings can be done on location or online as a webinar.

Throughout the year we also focus on finding more ways to save money on the health plan. Cutting initial premium costs can often be just the beginning. We take a look at the company’s actual claims data to see where adjustments can be made to improve savings. Sometimes this means making an adjustment to the schedule of benefits, moving an employee to a better plan, applying for a prescription drug discount card, or other savings strategies.

But it doesn’t stop there. To help maintain costs on claims, we partner with a medical bill negotiator to ensure all high dollar claims are being charged correctly and employers are paying the lowest cost possible. This is an included service with ClaimLinx as the third party administrator for the plan.

These continuous consulting and additional plan services that contribute to savings are only offered at ClaimLinx. Our experts are focused on constantly improving the plan for employees while ensuring the costs remain low.

 

Early 2019 insurance rates highlight a need for benefit alternatives

Inurance Consultant ClaimLinx offers employers a solution for rising health care costs

BOSTONJune 7, 2018 /PRNewswire/ — Insurance premium proposals for 2019 are rolling in this month, so far with requested rate hikes as high as 47 percent in some states. This on top of health care costs outpacing economy-wide inflation for the first time since 2010 forecasts a challenging market for business owners.

Nationwide insurance companies are citing policy changes to the Affordable Care Act, including the repeal of the individual mandate and expanded short term options, as the culprit for the requested higher rates.

Also driving up premiums are medical expenditures. They are expected to rise 2.2 percent this year, compared with 1.9 percent for overall inflation, according to the Center for Medicare and Medicaid Services.

Yet rising prices have done nothing to quell employees’ desire for improving benefits, as they’re now being used as a benchmark in a tightening job market. Employers are going to need alternative benefit solutions to stay competitive with the national unemployment rate dipping to 3.8 percent, according to the Bureau of Labor Statistics.

They’re going to need options like those offered at ClaimLinx, a full-service consultant, insurance agency and third-party administrator that specializes in guiding business owners through the insurance market with its own unique strategy for achieving the best, most affordable health plan.

ClaimLinx has pioneered a solution for purchasing health insurance that combines traditional high deductible insurance plans with a customized self-funded medical expense reimbursement plan. The resulting plan enables employers to offer top-notch benefits at a much lower cost.

Tom Quigley, National Benefits Consultant at ClaimLinx, emphasized that this has to be business owners’ first priority.

“You’ve got to be providing the best assets you can to your employees or it’s going to become your liability — no question,” he said.

What started as a small idea in Cincinnati about cutting costs on health insurance has grown to a nationwide service with offices in Boston and North Conway, NH. In 2017 ClaimLinx helped business owners save an estimated $3.2 million.

John Moore, President of the manufacturing company Ohio Metal Products, changed his company’s benefits plan to the ClaimLinx solution because of increasing costs and even more limited options.

“Our company has saved tens of thousands of dollars,” Moore said. “ClaimLinx can provide the benefits that we want, not what the insurance company suggests.”

Contact: Whitney Faber, (617) 892-4655
wfaber@claimlinx.com
www.claimlinx.com

View the published press release.

What is an employer-sponsored, or self-funded, plan?

Note: The below information refers only to a ClaimLinx Simple Option Solution plan. There are other types of self-funded plans that these details would not apply to. 

As our members know, the ClaimLinx SOS plan uses a different type of strategy for providing the health insurance benefits employees need. It combines two types of insurance coverage: a traditional insurance plan with a major carrier for primary coverage and a self-funded Medical Expense Reimbursement Plan (MERP) for secondary coverage.

See how these two levels of coverage work together so an employer can provide better benefits at a lower cost. But what exactly is a self-funded plan and how does it make benefits less expensive for the company?

A self-funded plan, also referred to as an employer-sponsored plan, is one in which a company pays directly for medical services.

In the case of a ClaimLinx SOS plan, an employer pays only for qualifying services according to a MERP determined at the beginning of the plan. Following its effective date, all medical claims are processed by ClaimLinx as a third party administrator and are paid with funds directly from the company.

Using an employer-sponsored plan allows companies to continue to provide benefits at a lower cost because they are no longer prepaying for services to an insurance company in the form of premiums. Insurance carriers charge for a plan under the assumption that every employee will be using large amounts of services. In most cases, that just is not true.

Instead employers can purchase a high deductible plan and pair that with a MERP. That way they are only paying for services actually rendered to employees.

In addition, because ClaimLinx provides a full customized schedule of benefits with a member ID card, members should not be required to pay up front for services and wait for a reimbursement (excepting special circumstances). Claims are processed and payment is sent at a later date directly to providers. This means members should experience the same conveniences as with a traditional insurance plan.

In its simplest terms employer-sponsored, or self-funded, plans are those in which qualifying medical services are paid by the company.

All of this is made possible using a 60-year-old tax code that allows companies to deduct medical expenses for its employees. What it means for employees, though is that their employer can provide the benefits they need at a cost the business can afford.

 

HSA vs HRA vs MERP

If there is one thing rising costs can provide, it’s creativity. Business owners all over are taking this opportunity to reevaluate not only from whom they purchase their health insurance, but also how they purchase it. But what are the pros and cons of all these different solutions?

First, some quick definitions:

  • HSA (Health Savings Account) – A tax-deductible savings account for medical expenses only. Contributions can be made by the plan subscriber or by an employer.
  • HRA (Health Reimbursement Arrangement or Account) – An agreement where an employer reimburses an employee for qualified medical expenses not covered on a company’s standard insurance plan.
  • MERP (Medical Expense Reimbursement Plan) – An arrangement where an employer pays providers directly for qualified medical expenses not covered on a company’s insurance plan.

All these alternatives have one big thing in common: they allow businesses to raise the deductible on their group health insurance plan. It’s the fastest way to lower that initial sticker price on the company health plan while still providing some sort of benefit.

So what’s the difference between them?

HSAs seem like the easiest way to provide cash on hand for employees. But these plans often require employees to invest in the account as well employers, and once the funds are in the account they can only be used for medical expenses. For most, estimating how much to put into the account is tricky business. Invest too much and employees feel the account is a waste, but invest too little and the account isn’t serving its purpose, which is to provide tax-free dollars to improve the plan benefit.

So perhaps you move onto an HRA – a seemingly simple way to give employees company dollars for medical services rendered. Many employees never ending up using this benefit though. For many, the filing process for reimbursement seems complicated and arduous. Others simply forget the benefit is there because of the extra processing requirements. So at the end of the day, employees are really only experiencing the high deductible health plan.

Finally moving onto a comprehensive MERP. These plans can enable employees to get back that feeling of full coverage. Because the employer is paying the provider directly for services, the employee does not have to pay for them upfront. There is still a second level of processing for the medical claims but it is not left up to the employee exclusively to sift through paperwork and requirements. All of this is done through an outside third party administrator.

All in all, there are a lot of options out there for health insurance now. That’s why it’s important you have someone to help you look at and weigh all the options.