Alternative Insurance Resources, Inc. provides a comprehensive administrative services package to each of its clients. It is our objective to provide our services in such a way that minimizes administrative burden of plan management for our clients.
Group Medical and Dental Plans:
- Initial enrollment and communication
- Development of Plan document and Summary Plan Description
- Aggressive negotiation of stop loss terms
- Electronic enrollment
- PPO Management
- Claims Adjudication
- Toll-free customer service
- Electronic Claims
- Periodic plan reporting and analysis
- COBRA Administration
- Internet member access to claims information
- Coordinated FSA Administration
- In house precertification, case management and utilization review
- Pharmacy Benefit Management
- Bill Negotiation
Our periodic management reports are designed to be more useful to management in making critical decisions regarding plan performance, plan design, and financial planning.
We customize reporting packages to meet the unique needs of our clients.
Our claims management system is fully integrated with our FSA, HRA, COBRA, Dental, and workers compensation systems.
- Stop Loss (Reinsurance) with or without AIR as an administrator
- Group Life and AD&D Insurance
- Long and short-term disability
- Claims payment
- Arrange survellience
- Arrange loss control services
- Arrange legal services
HRA & FSA Processing:
- Small and large groups
- With or without FlexCard access to benefits
- Plan design and communication
Customized drug card programs:
- Copayment based programs
- Deductible & coinsurance plans
- Discount only arrangements
- With or without AIR as administrator
AIR offers professional COBRA administrative services to clients with or without AIR as TPA for the core benefit plan:
- Cost effective - AIR's pricing policy is designed to create an affordable alternative to an otherwise burdensome process;
- Convenient - We handle the majority of the work; from mailing notices to tracking eligibility dates, to billing and collection of premiums;
- Regulatory Compliance - Many steps are required for proper COBRA compliance;
- Record Keeping - Payments are collected and posted to participant's history and reviewed monthly. Any necessary letters or notifications are posted to history;
- Communication - COBRA participants are often former employees that are not always happy. We handle all of the communication necessary and keep you informed;
- Experience - We process more qualifying events in one month than some companies will process in years.
Outsourced Health Plan Components:
PPO Networks – We are not affiliated with any single organization. This gives us the flexibility to work with any organization that best meets the needs of our clients.
Utilization Management - AIR utilizes the professional services of Phoenix Care Management, with staffing in our offices, for utilization management, precertification, and disease management services. Services include catastrophic case management, discharge planning, concurrent review and retrospective reviews.
CareHere! - Designed for groups with as few as 100 employees in a single geographical location, Carehere provides “on-site” medical clinics for its clients. With a physician on site, Carehere is able to produce significant cost savings to the employer while improving healthcare and, more importantly, the wellness of the employees or the organization.
Pharmacy Benefits: AIR offers relationships through PartnersRx and Pharmacare. Both networks offer the optimum level of access and cost control necessary in today’s market.