Optional Services

Pro-Claim Plus, Inc. is proud of our commitment to our client’s satisfaction. With that commitment, we have added many valuable managed care services:

COBRA, HIPAA & DOL Form 5500 Compliance Services - PCP has a prolific and efficient system for the administration of the Consolidated Omnibus Budget Reconciliation Act (COBRA), as amended in 1985. This option allows the employer to contact PCP once a qualifying event occurs and we take it from there.

The implementation of the Health Insurance Portability & Accountability Act of 1996 has changed the way TPA’s, Insurance Companies and Employers communicate with health plan participants. PCP will take on the responsibilities and legalities in compliance with the new and ever changing legislations. Fees are implemented through a per employee/per month fee or per event.

Prescription Drug Card Program - Prescription drug card programs have historically been thought of as high in employee convenience, but more expensive than regular coverage under Major Medical. Today, with the proper plan design convenience and cost management can be achieved. It is our practice to work with each client to determine the specific plan option that best fits their needs.

Section 125 Flexible Benefit Plan - PCP offers administration for Section 125 benefits , including a Debit Card, that allow employees to pay for certain medically related expenses and dependent care expenses with pre-tax dollars. These contributions are subtracted from gross income before federal, state, social security and local taxes are calculated. Employers save on payroll taxes and participants save by incurring an increase in spendable resources. All forms and participating requirements will be handled by PCP.

Pro-Claim Plus and your Employer Funded HRA - Pro-Claim Plus HRA supports your company’s HRA (health reimbursement arrangement) to increase benefits value and create long-term, tax-free advantages for you and your employees.

The Pro-Claim HRA Advantage - Employer-funded HRA accounts are exempt from federal and state taxes, including Social Security and Medicare taxes—and contributions may qualify as a fully deductible business expense. Plus when you include an HRA plan in your benefit options, you give employees greater discretion over the timing of healthcare spending and help them offset out-of-pocket costs. Employees use HRA dollars to pay eligible expenses not covered by the medical plan—including deductibles, copays and even premiums—and they can carry over unused dollars to pay future healthcare costs.

Pro-Claim Plus HRA gives employers comprehensive support, including -

  • Debit Card
  • Customized HRA plan design
  • Systems support to manage HRA administration in conjuction with FSAs or other aspects of you self-funded medical plan
  • Eligibility administration of your HRA plan
  • Reimbursements and reporting

Employee Benefit Statements -An Employee Benefit Statement illustrates to Employees the intangible expense to Employers, e.g. the Employee sees his position as making $18 per hour when in reality the cost to the Employer is $26 per hour.

Local, Regional and National PPO Networks

Lab One – Discount Out-patient Lab Services