Total Capital Planning: Group Health Insurance for Small Business

Total Capital Planning is a family business. Since 1979 we have helped small businesses explore and manage their group health insurance and employee benefit needs.

We have regularly served on a number of carrier advisory councils; including 2009 Empire Blue Cross Blue Shield Enterprise Advisory Council. We have also been recognized by United Healthcare in 2010 as United Advantage Gold and in 2011 as United Advantage Platinum.

Over the years we’ve served a broad range of businesses and industries, ranging from one-person organizations to groups with hundreds of employees. Ours is a client service business. We have refined our processes to minimize the amount of time our clients spend administering their group insurance plans. Since 2004, we have been developing systems based on Salesforce.com CRM to streamline plan administration. We have customized the customer relationship management and workflow automation to match our already established structured process.

With each member application that we receive, our systems automatically communicate information about plan benefits, forms needed for plan administration, links to provider networks with hints on how to search those networks, information about value added services like Rx mail order and gym reimbursement benefits included on your plan and more.

By being proactive we reduce the number of calls to our office and the amount of time needed to administer your group benefits. Using highly customized automated emails; we keep the group benefits administrator up to date on the status of member transactions, and explain benefit details to the employees along with any forms needed for plan administration. These emails also contain links to search provider networks, information about value added services included on their plans, and much more.

We facilitate communication and dispute resolution between insurance carriers, vendors, providers and clients whenever claims problems arise.

Claim specialists are available to review denials of treatment to determine the appropriateness of a decision, or appeal for approval, or to provide a comfort level to employees having a difficult time understanding their responsibilities under the insurance plan, or to expedite claims payment, and to provide clarification on a medical billing and claims issues.

We offer employers the ability to manage the entire process of open enrollment online using a rich suite of administration tools. The Employee Benefit Portal and Open Enrollment Wizard determine which plans to expose, when and to whom while calculating an employee's date of eligibility and their cost per pay period for each plan offered. Transactions performed through these online decision making tools tie in to our workflow automation and our proactive benefits communications allowing for instant, easy communication and accurate completion of member transactions.

We are able to avoid errors in plan administration and reduce the time needed to complete each task with Salesforce.com CRM. Structured workflows automatically assign workflow tasks to the right person at the right time within our organization. With advanced exception reporting and dashboard analytics we are able to successfully manage the work of our team in real time.

	Clients are contacted generally at least two months prior to their renewal dates to ensure the most cost effective and comprehensive coverage for their business is chosen. .
	Rather than spending valuable time sitting on hold and fighting insurance companies, we will serve as an advocate and work to resolve your claim disputes. .
	Late payment and reinstatement assistance will ensure coverage is not inadvertently cancelled. .

	Highly customized automated emails keep the group benefit administrator up to date on the status of member transactions and communicate benefits and forms needed for plan administration to the employee; reducing time spent on inquiries about the status of plan changes. .
	A rich suite of online administrative tools contains all the forms a client may need – from member enrollment forms to group contact updates. .
	Transactions performed through the Employee Benefit Portal automatically feed back to the broker office, allowing for instant, easy communication and accurate completion – no more headaches!

	The Employee Benefit Portal and its Open Enrollment Wizard allow employees the ability to make open enrollment elections online, view and manage benefit information, and more. .
	Employees have easy access to online tools to help them determine which insurance networks will allow them to continue to see their trusted doctors. .