Significa Benefit Services fully integrated benefit platform is the foundation for our scalable, flexible and customizable plan design and administration capabilities. Unlike other TPAs and carriers, our benefit system is fully integrated so that our eligibility, claims and accounting processing allow for real-time updates and detailed data analysis.
For Members
Members of Significa Benefit Services are able to use our Self-Service program to perform the actions listed below. They may simply click on the “New Members: Register” link in our Members Area to setup their account. Once registered they may:
- View Claims Detail
- Reprint Explanations of Benefits
- Request an ID Card
- Re-enroll in a Flexible Spending Arrangement Plan
- View Medical Plan Document (if authorized by the plan)
- View the Health Reimbursement Arrangement and Flexible Spending Arrangement Summary (if participating)
For Employers
Our clients can perform many online functions to more efficiently assist their employees and communicate changes to our Client Services department. As an authorized representative for your account, you may enroll new members and view claims detail online*. Available features include:
- Review Member Coverages
- Terminate Member and/or Coverages
- Enroll New Member
- View Claims Detail *
- View Current Invoice
- View Medical Plan Document (if authorized by the plan)
*Additional security features are required to allow you to view claims detail for your employees. Please contact our Marketing Department for more information.
Online Benefit Administrator (optional service)
In addition to our own online tools, employers may find they need a benefit portal that captures all of their benefit activity with one point of entry, is easy to use and can be accessed by employees.
To address this need for enrollment aggregation as well as seamless invoicing, Significa Benefit Services has partnered with Teemwurk to provide:
- Online Benefit Enrollment
- Open Enrollment
- Carrier Integration For Eligibility Data
- Payroll Services
- Consolidated Invoicing
Teemwurk offers a friendly, rules-based benefits portal. Eligibility files are exchanged with all benefit vendors and invoicing of benefit fees is managed by Significa Benefit Services.
Information is the crux of a successful benefit program. Our comprehensive reporting services afford our clients the ability to understand the dynamics driving treatment, prevention and cost. To help employers monitor plan expenditures and evaluate benefit utilization as well as trends, we provide a number of standard reports. Additionally, our reporting capabilities allow us to “take a deeper dive” and query a number of data points in the paid claim data file.
Transparency and customization, just another way we assist employers with managing their benefit programs.
Advanced Clinical Analysis
Featuring Johns Hopkins ACG® System
Advanced Analytics features Advanced Clinical Analysis for powerful predictive modeling. Advanced Clinical Analysis integrates key analytical components, including population risk, gaps in care and episode grouping, into our data analytics applications. Advanced Analytics has integrated the Johns Hopkins Adjusted Clinical Groups® (ACG) System featuring a predictive modeling engine and benchmark data that accurately identifies members with chronic conditions, and allows users to assess plan risk and predict future costs.
Johns Hopkins Adjusted Clinical Groups (ACG) System
The Johns Hopkins ACG System offers a unique approach to measuring morbidity that improves accuracy and fairness in evaluating provider performance, identifying high-risk patients, forecasting healthcare utilization and setting equitable payment rates.
The ACG research and development team characterized by excellence in both research and practice, has been performing risk measurement and case-mix categorization for more than 30 years. Around the globe, ACG is a standard tool used by several hundred private and public insurance carriers, provider organizations, consultants and research institutes.
Contact Our Third Party Administrator Company