Benefit Plan Design and Cost Analysis
Let us design a health care plan tailored to meet your needs. We will secure the networks and
ancillary providers to make the plan easy for the employees to use and cost effective for the
Plan Document Review and Drafting
Integrity Administrators will draft your Plan Documents, or review your existing document,
for government compliance. We also prepare Form 5500 and Form1095C on behalf of employers, as required.
Summary of Benefits and Coverage
Under the ACA law, group health plans are required to provide consumers with a concise document detailing, in plain language, information about health plan benefits and coverage. This summary of benefits and coverage document helps an employee better understand their coverage and allows them to easily compare different coverage options. Integrity Administrators can prepare these forms for you.
Consolidated Billing Administration
Integrity Administrators can process the monthly premium billing and remittance to the proper carriers,
PPOs, and any miscellaneous service vendors. All the billing information is then consolidated into
customized monthly reports for the employer.
Full Claims Payment Adjudication
Your Plan Document determines the amount allowed, the patients responsibility, and discount
amount. Integrity Administrators will use this information and initiate the claim payments.
An Explanation of Benefits (EOB) and remittance advice are created and sent out to the
employee and provider immediately following full adjudication of the claim.
PPO Network Access and Non-PPO Claims Negotiations
In addition to direct PPO contracts, Integrity Administrators are also partnered with national claims discount negotiators
for Non-PPO providers.
Precertification and Eligibility Status
To ensure proper care is provided to our members, provider offices can obtain precertification
when required and eligibility status, so that the employee receives their intended care on schedule.
Utilization Review and Large Case Management
Our affiliated Utilization Review and Large Case Management companies provide skilled case managers to work closely
with patients who have severe or chronic illnesses. The case managers advocate on the patients behalf with the various
healthcare providers. They ensure services provided are meeting the patient’s needs both in and out of the hospital to
achieve the best outcomes.
Integrity Administrators works with disease management providers to improve a patient’s
quality of life. The goal is to improve the long-term health of the members.
Prescription Benefit Management (PBM)
Integrity Administrators partners with the best national Pharmaceutical Benefit Managers to
offer customized prescription benefit plans using local pharmacies and mail order services. We
design our pharmacy benefit plans to meet the individual needs of our clients using insightful
cost saving solutions for self-funded plans, as well as other types of plans.
Health and Wellness Programs
Integrity Administrators stands by the numerous studies on effective Health and Wellness Programs. In these studies
it has been discovered that medical costs are lower when providing wellness advocacy programs in the workplace.
Wellness Programs are encouraging physical fitness through gym memberships, regular exercise, nutritional coaching,
weight loss programs, smoking cessation courses, on-site health screenings and flu shots.
Integrity Administrators can eliminate the employers' burden by completing the required compliance services.
This includes for COBRA, collecting premiums from the employee, enrollment assistance, as well as monitoring
and reporting to employers.
Plan Management Reporting
Using our management system, we monitor and provide reports so you know how your Plan's benefit dollars
are being used. Our performance reports include:
Phone 800.562.9383 Fax 916.921.3383
Contact Integrity Administrators, Inc. for more information at 1.800.562.9383 or use the Contact Us tab.
- Monthly Aggregate & Specific Excess Loss Reports
- Benefit Analysis Reports
- Claims Lag Study
- Eligibility Reports
- Provider Payment Analysis
- Hospital Utilization Statistics
- Diagnosis Analysis
- Weekly and Monthly Claims Check Registers
- Provider Comparison Analysis
- Loss Ratio Reports
- Length of Stay/Place of Stay Reports
- Ineligible Claims
- Co-Payment and Deductible Analysis
Integrity Administrators, Inc.
EXCELLENCE IN THIRD PARTY ADMINISTRATION