Why Choose Migdon Allen Associates

Some businesses think it does not really matter where they buy their insurance. But this misconception could be costing them money, service and protection. Health Insurance is one of the largest expenses that an employer pays and it is increasing at a rate significantly higher than most other expenses. Therefore it is imperative for an employer to evaluate the many options available to provide the most cost effective health insurance possible..

How can we help you with your benefits?

Plan Implementation:

MAA will be available for any on-site enrollment/implementation meetings to introduce members to a new plan, or to provide continuing member education on existing programs.

Routine Services:

MAA routinely provides the following services to its clients. This is a general listing, which is not restrictive in nature, as MAA is eager to assist clients with all facets of their healthcare needs.

• Assemble a Request For Proposal and market all health care plans at renewal to make certain the plan option currently being provided is best suited for the client.
• Review current benefits to ensure plan designs are meeting the client's needs.
• Facilitate negotiation meetings with health care providers to obtain most favorable rate action.
• Negotiate renewal savings and/or implement cost effective plans, while maintaining or exceeding benefit levels.
• Provide claim and funding reports at regular intervals to keep clients informed of claim trends and high level claims.
• Provide guidance and expertise regarding benefit and pricing negotiations specific to health care.
• Upon request, meet with employees to resolve any misunderstandings and answer questions to facilitate the most effective use of the health care plan.
• Coordinate implementation of new benefit programs, providing timelines of events to take place, and responsibility tracking lists.
• Coordinate, facilitate, and participate in enrollment meetings.
• Oversee prompt delivery of materials and the return of enrollment applications.
• Provide assistance to members and administrators with claim inquiries that cannot be rectified via normal channels.
• Meet one-on-one with any members who have claim problems that have not been rectified and need one –on-one attention.
• Verify dependent eligibility due to age restrictions or qualifying event status if member has been erroneously terminated from plan(s).
• Review billing discrepancies.

Renewal Process:

Usually six months before the contracts expire MAA meets with the client to describe the current marketplace and the different kinds of plans available and the funding mechanisms available. The report then details preliminary ideas on how benefit plans can be redesigned in the most cost effective way. The approximate percentage savings are listed for each plan design change recommendation. MAA and the client then identify which of the recommendations make the most sense and MAA prepares a comprehensive explanation of each of these potential changes. MAA then meets with the Client to review the proposed changes in detail, making certain that the client agrees to these specific plan design changes. MAA then makes themselves available for any meetings to provide expert advice specific to the plan design changes and the cost associated with these changes.

Claims Administration:

The Account Representative would assist a member with an escalated claim issue, should the member not receive an adequate response. The Account Representative would intercede by contacting the insurance company on behalf of the member and in some situations (with the members permission) contact the physician for additional information. The Account Representative is also available to help interpret the explanation of benefits received by the insurance carrier. In certain circumstances the Account Representative would assist the member with a formal appeal.

Plan Document Review:

MAA conducts a thorough review of all plan documents including the contract as they pertain to the following:

• Deductible and Coinsurance
• Copayments
• Overall Plan Design
• Benefit limitations
• Dependent Age
• Eligible Dependents
• Waiting Periods
• Effective date of terminations
• Billing
• Premiums
• Additional costs or fees not previously indicated

MAA does not offer legal advice and therefore we recommend that your attorney review the contract for the legal implications.

Overall, customer satisfaction is the key to our livelihood. So, serving you is our most important job! Call us today at 800-272-6771 Ext. 7231 and we will help you sort through your insurance options.