Administration Services
Enrollment/Eligibility Maintenance:
- Receive and data input all enrollment information.
- Maintain current data record of member and dependent provider selection for all prepaid coverages.
- If spouse has different last name, obtain copy of marriage certificate.
- If child has different last name, obtain copy of birth certificate or legal guardianship.
- If child is over 19 years, obtain verification of full time student status.
Employer Billing/Premium Payment/Eligibility Reporting:
- Single consolidated billing statement for all coverages.
- Ability to accept self-administered eligibility reporting with payment.
- Paperless reporting option.
COBRA Administration (Full COBRA Administration at no cost to employer):
- Notice of qualifying events to terminated subscriber and dependent.
- Maintain in system the qualifying event and COBRA termination date.
- Individual premium billing to COBRA participant.
- Premium collection from COBRA participant.
HIPAA Administration:
- PacFed is compliant with all HIPAA regulations including enrollment guidelines; coverage certification; electronic data transfer specifications and individual privacy requirements.
Ongoing Employee/Member Assistance:
- Bilingual English/Spanish Member Service Representatives.
- Assist employees and HR on member service issues.
New Dependent Enrollment
- Provide employee with change forms for adding new eligible dependent(s).
- Follow up on marriage certificate and/or birth certificate.