Duties of Broker of Record

DUTIES OF BROKER OF RECORD

(HEALTH, DENTAL, LIFE, SHORT-TERM AND LONG-TERM DISABILITY INSURANCE)

“SHOPPING” THE CASE ON RENEWALS

Unfortunately, health insurance rates keep going up. Every year at renewal time, if warranted, we supply a full spreadsheet showing alternative carrier rates as well as specific changes that can be made with your own plan to offset some or all of the increases. We stay on top of the marketplace so you don’t have to.

Remember, when you purchase a group plan directly from an insurance carrier, they have absolutely no incentive to introduce the competition as an alternative.

PHYSICIANS SEARCH

In the managed care environment, an important element in the decision making process revolves around the physician network available through each carrier. We are able to assist our clients by generating a computerized report showing specific physician participation with various carrier networks, thus helping to assure client satisfaction.

BILLING DISCREPANCIES/ADMINISTRATION PROBLEMS

Even the most efficient administrator has problems from time to time with billing and enrollment changes such as additions and terminations. It is our role to act as a liaison with the insurance company to assist in prompt resolution of problems in this area.

TROUBLE-SHOOTING PROBLEM CLAIMS

Even with the highest caliber major medical carriers, claims reimbursement issues exist, especially when subscribers go out of network. It is our responsibility to assist in determining where the problem exists (i.e., lack of employee understanding of the terms of coverage, insurance carrier’s error, or incorrectly filed claims) and to assist in problem resolution.

Although we can guide employees through the claim process, it is their responsibility to attempt to solve the problem themselves. We intercede after employees are unsuccessful in resolving problems on their own.

Duties of Broker Record

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USUAL AND CUSTOMARY REIMBURSEMENT ISSUES

Claims reimbursements out of network are sometimes cut back based on reasonable and customary levels. We are sometimes able to negotiate with the various carriers to get additional reimbursement.

EMPLOYEE RELATIONS

If employees are unclear about specific benefits, we can help to clarify them. We assist employees in understanding what benefit services are covered and at what levels.

KEEPING CLIENTS UP TO DATE ON CHANGES IN THE MEDICAL INSURANCE INDUSTRY

We keep clients advised of changes in the medical insurance marketplace. We inform clients of new products and plan enhancements that are introduced as well as pricing changes. The best carrier today mat not be the best carrier in the future.

OUR CLIENT COMMITMENT

At Schneck Consulting LLC, we pride our business on our excellent client services. Our staff members are pleasant, kind, and courteous and it is their responsibility to provide all of our clients with a speedy resolution to any administrative, billing, claims, or specific benefit issue that arises. We provide the expertise and assistance required by our clients to meet their employee benefit goals and objectives.

THERE IS NO CHARGE TO THE CLIENT FOR THE SERVICES OF A GROUP INSURANCE BROKER. ALL SERVICING FEES ARE PAID DIRECTLY FROM THE INSURANCE COMPANY TO THE BROKER.

Gosia K. Schneck

Schneck Consulting

11 Highview Lane

Yardley, PA19067

215-321-1772