AGA will assist the employer in establishing and managing a self-funded plan with:

  • Preparation and monitoring of the Plan Document

  • Development and printing of the Summary Plan Descriptions for employees

  • Arranging the 419 (e) (3) (b) claims trust account

  • Providing access to legal and actuarial services for your plan

  • Fully automated claims adjudication

  • Enrollment and eligibility services, including timely issuance of ID cards

  • Provide a monthly executive summary to aid in management of the plan

  • Monthly automated self-funded paid claims case reports, a bank trust statement of account and check register

  • An extensive reporting package that can be customized to meet the needs of the client

  • Complete detailed analysis of the plan performance on a semi-annual basis, including consultation in trend factors, funding levels, cost control, benefit adequacy and recommended modifications or improvements on plan design

  • AGA Website capabilities for Employer and Employees to access claim information through QicLink Benefit Exchange (QBE)

  • Custom and packaged report capabilities for Employers and Brokers with online access through AGA’s Benefit Informatics

  • Preparation of the necessary government filings, such as are required by ERISA

  • Provision of form 1099 required for all providers of medical care

  • COBRA administration through COBRAhelp, a service of Worthington-Olson, or a vendor of the employer’s choice

  • Pre-Certification Review Program through Health Plan Services, Inc., Three Rivers Medical Management, Inc. or Managed Care Concepts (MCC).

  • Prescription Drug Card Program administrated by AGA through CVS/Caremark or 4D Pharmacy Management including Medtipster

  • Lab Card Program administrated by AGA

  • Cafeteria Plan Administration

  • 5500 Form Preparation

  • Affordable Care Act mandated reporting including Form 1094 and Form 1095

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