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Brokerage Services for CBIZ Employee Services Organization
20.
What resources do you use to analyze medical and pharmacyclaims?
We utilize Verscend Technologies to analyze medical and pharmacy claims. See full description of this in
attachment to question 19.
21.
Describe your experience managing employee claimsescalation.
Each client is assigned a CBIZ employee advocate whose responsibility is to assist covered employees and
dependents with their claims issues. The advocate will:
Collect all relevant data from effected individual
Determine any extenuating circumstances
Develop plan for resolution
Contact all involved carriers, administrators, vendors and providers
Determines possibility of successful resolution
Work through to resolution
If no favorable resolutions assist with appeal filing and process through to find judgement
Maintain case log
22.
Describe your experience assisting clients with complicated administrative issues and fosteringpositive
resolution.
All of our clients refer conflicted administrative issues to us for resolution:
We take over immediately
We contact vendor and drill down on the particulars, i.e. the who, what, where and why of it
We develop best possible scenarios for the client
We negotiate with the vendor as needed
We develop work around solutions if needed
We maintain a weekly activity log
We provide necessary training if needed
We document all final resolutions
23.
Describe experience with hourly employees and benefits administration.
A significant number of CBIZ clients have both bargaining and non-bargaining unit hourly employees.
We assist employer in preparing for any CBA negotiations to include projected modeling for plan
designs and cost
Employee advocates are assigned
Payroll practices are reviewed and benefit payroll deductions integrated into the HRIS platform
Variable hourly ACA testing practices and procedures are discussed and formalized
Customized communication and enrollment practices are developed