AFFORDABLE BENEFIT ADMINISTRATORS, INC.

Offices in

Burbank, CA

Aurora, CO

toll free 1-800-350-0148

AFFORDABLE BENEFIT ADMINISTRATORS, INC.

As a Third Party Administrator (TPA), Affordable Benefit Administrators, Inc. (ABA) specializes in the administration of self-funded and partially self-funded employer health plans.

SERVICE

Every company must deal with its customers. It is ABA’s charter to be efficient, but also friendly. Every member of our staff is committed to doing everything possible to resolve a caller’s issue, and do so with respect and courtesy.

SERVICE

An extension of our service philosophy is demonstrated by our commitment to dedicate personal representatives to answer the phone during business hours. There is just no replacement for one-on-one communication. We feel that our approach is essential to establishing trust and building a lasting relationship.

SERVICE

As important as customer service is in our industry, so is quality control. We have set stringent accuracy goals for our entire staff, with the understanding that better quality is the foundation to better customer service.

ABA – A full service TPA

o Stop-Loss Quotes

o ERISA Compliance

o Custom Benefit Design

o Plan Document Production

o SPD Production

ABA – A full service TPA

o Claims Administration

o PPO/EPO/DPO Networks

o Utilization Management

o COBRA/HIPAA Administration

o Flex Plan Administration – Section 125

Advantages of Self-Funding

Elimination of most premium tax:

In most states, there is no premium tax for the self-funded claim fund; thus, an immediate savings equal to the amount of the premium tax may be realized.

Advantages of Self-Funding

Lower cost of operation:

Employers frequently find that administrative costs for a self-funded program through a professional TPA are lower than those charged by their previous insurance carrier.

Elimination of carrier profit margin and risk charge:

The profit margin and risk charge of an insurance carrier are eliminated.

Advantages of Self-Funding

Effective claim processing:

ABA successfully provides accurate claim processing for all health plans.

Cost and utilization controls:

ABA offers numerous programs (UR, Case Management, multiple PPO’s and others) through a variety of sources rather than limiting the employer to use only the in-house programs.

Advantages of Self-Funding

Control of plan design:

The employer has flexibility in the original plan design. The employer may also redesign the plan to control plan cost.

Mandatory benefits avoided:

Some costly State mandated benefits may be avoided because self-funded programs are subject to ERISA. Mandated benefits matching an employer’s needs and philosophy are often included in the plan.

Advantages of Self-Funding

Risk management through effective stop loss insurance:

The employer may choose the amount of risk to retain and the amount to be covered by stop loss insurance.

BROKER SUPPORT SERVICES

Broker & consultant support services include:

Stop-Loss Markets Access Plan Design Support Employee Meetings Monthly Reports Commission Payment

Access to various Vendors

MEMBER SERVICES

Member Services include personal and internet access to:

Benefit Description Information

Eligibility Information

Claim Activity and Historical Information

PPO, Rx & Educational Information

PLAN SPONSOR SERVICES

Plan Sponsor Services include:

Plan Design and Support

Employee Meetings and Enrollment Support

Eligibility Maintenance and Support

Premium Billing, Collection and Remittance

Claims Administration

Utilization Management

PLAN SPONSOR SERVICES

Multiple PPO(s)

COBRA/HIPAA Administration

Electronic and Paper Forms

Electronic Reports and Maintenance

Regulatory Reference and Support

PLAN SPONSOR SERVICES

Reports provide on-line access to the standard reports. We have taken great care to prepare and archive the monthly reports in an easy to retrieve, display and print manner. Standard reports are: Aggregate Claims - Monthly Claims Funding - Monthly Detailed Claims - Monthly Division of Income - Monthly Encounters - Monthly Lag Time - Monthly

CARE PROVIDERS

Doctors and Hospitals services include electronic access to:

Benefit Description

Member Eligibility

Patient Claim History

PPO Provider Look-UP

FORMS

You can download and print various forms. Access Request (PDF) Address Change Request (PDF) HIPAA - Authorization Release (PDF) HIPAA - Authorization Request (PDF)

HIPAA - Authorization Revocation (PDF)

FORMS

Complaint (PDF)

Dental Claim (PDF)

Drug Claim (PDF)

Flexible Spending Account Claim (PDF)

Medical Claim (PDF)

Weekly Indemnity Claim (PDF)

Medical/Dental/Life Enrollment (PDF)

Monthly Eligibility Update

CONTACTS

1-800-350-0148

Thank you for viewing this Demo.

Cheryl Williams-Khoury

President