ARM Services

ARM provides claims administration services for all types of employee benefit plans. Our role is to provide accurate processing of claims, reporting, and service to plan participants.

ARM provides each of our services on its own, or bundled in any combination. Whatever your benefit plan needs, ARM has an answer for you. We will bring all of our knowledge and experience to custom-design and administer a plan that meets your specific goals. But it doesn't stop there. Each area of the plan that we touch is influenced by our professional staff. A staff that is dedicated to one goal – to make your plan operate effectively, at the lowest reasonable cost.

Claims Administration

Nothing is more irritating for an employee than talking to a Benefit Administrator who is not familiar with the person's plan or sounds as if he or she could care less.

ARM's Benefit Administrators are knowledgeable, friendly and resourceful individuals. They are trained and empowered to solve your employees' questions in as few steps as possible. In fact, ARM's administrators resolve 95% of all telephone inquiries on the first call and handle 90% of written inquiries within ten calendar days.

Our superior service stems from our long-standing policy of assigning one coordinating administrator per plan. We believe that this allows for a better understanding between our claim department and your benefits team. Your employees realize that we know the company plan well and feel confident that we will assist them with their individual issues.

Our claims turnaround times are consistently less than 7 calendar days. Daily audits insure financial accuracy over 99%. In recent audit reports, "Claim error percent was 0.2%, well within our corporate guidelines of 2.0%" and "ARM did an excellent job of paying claims for this client."

Plan Development

If it is well designed and executed, your plan will reward you with high employee satisfaction while keeping costs to a minimum. Likewise, a plan that does not reflect your corporate goals and culture is very costly and frustrating for everyone. ARM has the specialized knowledge needed to ensure that each aspect of your plan development is addressed and resolved. We have found that many plan sponsors are unaware of the flexibility available to them in solving their problems or addressing their special needs.

ARM works with you and your consultant to determine both schedule of benefits coverage levels and underlying plan language. We are experienced in developing custom managed care (PPO) networks that satisfy regional preferences. We listen closely to you and pay attention to detail; ensuring that the plan we develop reflects your corporate culture and achieves your financial goals.

Stop Loss Coverage

Stop loss coverage is a must to protect your company against unusually large claims on individuals, or unusually high overall claims for a given plan year. It allows you to set a budget for your plan and acts as a buffer against increasing health care costs. In short, stop loss coverage minimizes your financial risk.

Most of the plans administered by ARM carry some degree of stop loss coverage. We have years of experience in designing stop loss programs and know which carriers to approach to provide you with excellent claims service at a fair price.

One of the benefits of being self-funded is that you can change your stop loss carrier at renewal time without affecting plan participants, isolating you somewhat from the vagaries of the insurance industry.

A complete discussion of stop loss coverage is beyond the scope of this description.

PPOs

ARM can help you select the right group of PPO networks based on your needs, no matter how complex. We are an approved claims payer for dozens of national and regional PPOs with years of experience helping businesses achieve the right balance between cost and availability.

Finding a PPO network for one location is one thing; choosing PPO networks that can service several geographically diverse offices is quite another, as no national network has a strong presence in every market. ARM excels at maintaining multiple local PPO networks for all locations you may have. We will build a custom network for your plan that addresses each location's specific requirements.

Systems

Today, fairly sophistocated information systems are required for plans to run compliantly and efficiently. Your plan data will reside on an Oracle Database with "Mediclaims for Windows" from WLT Software of Florida as the claims administration application.

ARM is a leader in the use of real-time systems. We strive to make the administration of your plan easier, faster and more efficient. We provide Web-based Interface with a secure login to our clients and participants. This tool has specific applications designed to assist employers, plan participants, brokers and providers.

Eligibility

Having up-to-date eligibility records is a crucial element of a sound plan. Many of our clients have found that having ARM handle eligibility transactions with other plan service providers increases accuracy and efficiency, saving money. ARM becomes a single-source vendor for all lines in your employee benefit plan.

ARM prides itself on keeping your eligibility databases in sync. To that effect, we have developed a Web-based Client Interface feature that allows your human resources department to communicate your changes quickly and easily. We can also accommodate your changes in more traditional ways, including regular mail and fax. Regardless of the method you choose to communicate with us, you can rest assured that your eligibility records will be updated timely and accurately.

Funding

ARM will create a claim funding schedule that fits into your business plan. Most clients fund claims either weekly or bi-weekly from an Unpaid Claims Report. You may choose to have ARM make payments from your own bank account, keeping complete control of your cash flow, or you may use ARM's Claims Administrative Services Account. In the event that you choose to use our CASA, you may direct your funds to this account either by paper checks or wire transfers.

Once claims are paid, you receive a Daily Check Register that shows pertinent information regarding any payment transactions, as well as opening and closing balances in the claim fund.

Billing

Billing records have to be kept current for your plan to work smoothly. A well-designed plan typically will incorporate the products and services of several vendors (Stop loss carrier, managed care organization and potentially other insurance company products like group life and long-term disability). Maintaining databases for all these can be cumbersome, not to mention costly.

ARM will help you stay on top of your records. Thanks to our state-of-the-art systems, we will maintain billing for all your various lines of coverage through approved vendors, giving your benefits department a single point of contact. With ARM, you can be assured that your records are reliable, accurate and always up-to-date.

Compliance

Another critical aspect of a sound plan is its compliance with various federal laws. ARM has the systems in place to assure that our internal procedures comply with federal law.

In an effort to help the employer be in compliance, our usual fee structure at ARM includes COBRA administration. As an option, we can also administer all of your COBRA and HIPAA compliance requirements, freeing you from the time and responsibilities involved. ARM administers:

In addition, ARM will issue provider 1099s as required by the Internal Revenue Service and can prepare IRS form 5500.

Reports

One of the many benefits of being self-funded is having access to detailed plan utilization data. ARM will provide you and your consultant with reports that provide both detail and summary information on every aspect of plan performance. You may generate reports on line or receive them via email or on paper. If you would like to design your own additional reports, we will give you a simple data file that can be manipulated in Microsoft^® Office Excel^® to create custom reports on your own. Over time, our reports will provide the meaningful and insightful feedback you need to help you evaluate plan performance and consider meaningful changes.

Services

ARM provides design and administrative services of: