The transition to Cook Group platform will be immediate since we will lead the plan design structure.
Administration of the healthcare claims provisions as outlined in the plan sponsor’s benefit booklet, including ongoing updates or changes.
Conduct necessary claims inquiries appropriate to benefit plan provisions; coordination of benefits, pre-existing conditions limitation, reasonable and customary expense levels, and an auditing program to review claims, which appear to be excessive.
Assist the client in establishing internal claims procedures and in the drafting of claims/benefit notices to eligible participants.
Client notifications of developments in the employee benefit field, which may impact the client.
Comply with the new DOL regulations regarding appeals and their speedy and impartial resolution.