Employees do not read benefit guides. They ask questions.
Most of what an employee needs is not a claims dispute. It is a quick, correct answer about whether something is covered, before a small question becomes a large problem. That is a different service from claims advocacy, and it has to exist at the hour the question occurs rather than during open enrollment.
The same questions, in the same order, every year.
None of these require a benefits background to answer well. They require access to the plan documents, the network and someone who will pick up.
Is this covered, and what will it cost me
Asked before a visit, a procedure or a prescription. Answered correctly, it prevents a surprise bill and a dispute later. Answered with “check your booklet,” it becomes both.
Is this provider in network
Directories are imperfect and facilities employ out-of-network practitioners. Checking properly takes a few minutes and saves an appeal.
My card, my dependent, my deductible
ID cards, adding a newborn, what counts toward the deductible, whether a spouse’s plan pays first. Routine, high-volume, and exactly what HR should not be spending its week on.
Around the clock, and escalating to a person when it should.
Employees have benefits questions in the evening and at weekends, because that is when they are dealing with their own lives.
Our chat, at any hour
Always-on chat access handles the common questions immediately and hands off to a named person when the answer needs judgment rather than a lookup.
A person on your account
The customer service seat on your service team knows your plan. Employees are not routed into a general queue to explain their plan to a stranger.
Busiest week covered
Real-time support during open enrollment, when question volume peaks and the deadline is least forgiving.
The cheapest time to answer a question is before the claim.
Fewer disputes
A question answered before a visit is a denial that never happens, an appeal nobody writes and a balance bill nobody has to contest.
An HR team that gets its time back
For an HR department of one, this is the single largest recovery of hours available in a benefits program.
A plan employees trust
Satisfaction with benefits tracks access to answers more closely than it tracks plan richness. Employees forgive a deductible. They do not forgive being unable to get a straight answer.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
Bloomfield Hills, MI 48304
248.370.8853
719.425.2649
281.404.5670
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