Administrative Support

• Eligibility Management
• Call Center Support
• Employee Self Service
• Open Enrollment
• Billing Services

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Reimbursement Plans

• Flexible Spending Plans,
• Health Reimbursement
• Medical Reimbursement
• Health Savings Accounts

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Eligibility Audits

• Dependent Eligibility Audit
• Plan Participant and Payroll
   Deduction Audit

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COBRA/HIPAA Administration

• ARRA Stimulus Notices
• Initial/General Notices
• Qualifying Event Notices
• Premium Collection
• HIPAA Certificates of
  Creditable Coverage

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Click here to download a PDF of Next Generation Enrollment’s Services

Administrative Support

Eligibility Management
Through the NGEN Benefit Management System, you will manage your organization’s benefit plans. We will track the changes made on the site and process all of the elections for you. We will also notify each carrier when an employee enrolls or terminates coverage, changes an address, salary, etc. In an effort to keep you apprised of the activity on your account, you will receive confirmation emails along the way. To use this system, no special hardware or software is required nor is there any program to download to the desktop.

Call Center Support
Let us create a customized Benefit Center for your company. We will brand this Benefit Center by having a dedicated toll-free number that will enable all calls to be answered: “<<Your Company Name>> Benefit Center, How may I help you?” Employees with questions about their benefits will be able to phone our staffed call center for support from 8:30 AM to 6 PM Monday through Friday eastern time.

Employee Self Service
Through our custom software, any size and type of company can have a paperless benefits system that allows for the enrollment of all benefit plans to occur in one place. Employees can have self-service access to enroll online at any time or over the phone via the call center during business hours.

Open Enrollment
NGE can coordinate, plan, and conduct your open enrollment. Employees can call the call center or go online to manage any updates. This will provide your organization with significant time savings and improved accuracy based upon the fact that the enrollment will be 100% paperless. NGE will use outbound calls to make sure all employees have made their elections. Once the enrollment is complete, all changes will be made with the affected carriers and information from our office will be sent to our contact in your payroll department so as to update the employee payroll deductions.

Billing Services
Let NGE take the burden of premium collection off your hands for your retirees, employees on leave, and employees on disability. You inform us of all eligible employees and applicable amounts due from each. NGE will contact each employee and give them the option to send in their payments by check or sign up for an automatic withdrawal. NGE will track all payments and inform you of any discrepancies. At the end of each payment cycle, NGE will remit a check to you for the total amount collected from each employee along with a report detailing each payment.


Third Party Administration Services

Flexible Spending Accounts and Health Reimbursement Arrangements
NGE’s FSA and HRA administration includes the following:

• Plan Documents and Summary Plan Description Creation
• Customizable Materials
• Flexibility to Manage Several Different HRA Plan Designs
• Choice of Reimbursement Methods:
   •• Debit Card
   •• Direct Deposit
   •• Check
• Web Access to Balance and Claim Information
• Monthly or Weekly Reporting
• Call Center Support

The American Recovery and Reinvestment Act of 2009 has created many new changes affecting COBRA. For a detailed Q&A on how this may impact your organization, please download our informative PDF.

NGE’s COBRA/HIPAA administration includes the following:

• Initial Notices (Capacity to Create Blanket Initial Notices)
• Qualifying Event Notices
• Certificates of Creditable Coverage
• Premium Collection and Remittance
• Management of COBRA participants during plan open enrollment
• Monthly Reporting
• Call Center Support

Health Savings Accounts
NGE has a partnership with Mercantile Bank of Michigan to provide discounted or free accounts. NGE also provides call center support for both new and existing participants to help with enrollment and answering questions regarding integrating the Health Savings Account with their insurance plan.


Eligibility Audits

Dependent Eligibility Audit
Next Generation Enrollment wants to assist your organization in ensuring that the dependents covered on your medical plan are truly eligible per the wording in your plan documentation.

A simple, cost cutting solution that does not require plan changes or increased employee payroll deductions, is a Dependent Eligibility Audit. A Dependent Eligibility Audit allows for the verification of covered dependants and the removal of those that do not satisfy the eligibility definition in the medical plan summary description.

Why Do a Dependent Eligibility Audit?

1. Reduce expenses on your Medical Plan without changing the plan design or employee contributions

2. Adhere to ERISA Fiduciary requirements, Sarbanes-Oxley, and Stop Loss Contracts

photoFrom the Mercer 2005 US National Employer-Sponsored Health Plans Survey study, it was determined that the average cost for a dependent covered under a medical plan is $1,584 per year. This statistic was calculated by surveying over 3,000 employer groups. It has also been determined that anywhere from 5% to 15% of a plan’s covered dependents are not eligible. By removing these dependents, a significant cost savings will be created.

Along with ERISA violations, there may be Sarbanes-Oxley concerns due to the financial significance of health plan costs. Paying benefits to ineligibles could increase your organization’s exposure. Stop Loss providers will audit large claims and if the claim pertains to an ineligible dependent, they will reject those claim payments.

If your company agrees that a Dependent Eligibility Audit and the ongoing tracking of employee enrollment information is critical to protecting the integrity and costs associated with your medical plan, Next Generation Enrollment presents a no-risk solution. We would love to assist your company by partnering to perform this audit.

Dependant Audit Case Study 1
• Metro Detroit Hospital
• Over 1,100 employees with 1,400 covered dependents
• 50 dependents removed at the end of the audit
• Total projected one year savings from removing these dependents was over $150,000

Dependant Audit Case Study 2
• Mid-Size Metropolitan Detroit School District
• Approximately 600 dependents
• 42 dependents eligible to be removed from the medical plan at the end of the audit
• Total projected one year savings from removing these dependents was over $150,000

Dependant Audit Case Study 3
• Manufacturing Company
• Over 700 employees with 800 covered dependents
• 86 dependents eligible to be removed at the end of the audit
• Total projected one year savings from removing these dependents was over $250,000

For more information, please download PDFs of our Dependent Eligibility Audit Brochure and Dependent Eligibilty Audit Testimonial.

Participant and Payroll Deduction Audit
Let us help you verify that the participants showing on your invoices should be covered and the payroll deduction amounts in your system accurately reflect the participant’s coverages for all benefit plans.