Services

We Are Here To…

assist employers, health plans and plan fiduciaries navigate the numerous federal and state laws governing the delivery of health care benefits. This includes drafting necessary plan documents and plan communications, assessing fiduciary obligations, negotiating agreements, designing and implementing medical cost containment programs and developing HIPAA, ERISA and general risk management policies.

Our Group Health Plan Experience is Extensive and Includes:

 

01 — Advising group health plans on the design and implementation of cost-containment programs

  • Assisting plan fiduciaries throughout the vendor RFP process

  • Negotiating contracts between group health plans and cost-containment vendors

  • Assisting group health plans develop payment policies

  • Auditing client-facing vendor systems to assure legal compliance

  • Assisting group health plan administrators work through system integrations

02 — Advising group health plans on best practices in plan documentation and plan administration

  • Reviewing plan documents to assure legal compliance

  • Reviewing plan documents and advising on revisions to support a robust cost-containment program

  • Assisting plan fiduciaries develop plan participant communications/notices

03 — Representing group health plans and their plan participants in dispute resolution/litigation

  • Representing group health plans in contract disputes

  • Representing group health plans in medical service provider reimbursement disputes

  • Representing plan participants and covered dependents in balance billing disputes

04 — Providing risk management advice, including advice about HIPAA and fiduciary duties under ERISA

We are here for You and Your Clients.