Health Plan Revenue Growth Opportunities

Dual eligibility and Low Income Subsidy outreach, retention and other member management for Medicare Advantage plans.
SSI outreach and enrollment for Medicaid managed care plans.

Services for Medicare Advantage Plans

PremiumAssist^SM Dual Eligibility Outreach & Retention Service helps determine potential eligibility of Medicare Advantage plan members for Medicare Savings Programs, assists those eligible to apply (each year), and enables plans to get (and maintain) higher capitation from the Centers for Medicare & Medicaid Services as a result.
SNP Member Re-determination Service helps special needs plans for dual eligibles optimize member management through proactive Medicaid re-determination of their existing members. Specialized reporting helps plans meet CMS requirements for both pre- and post-enrollment Medicaid verification.
Member Complete^SM results from a partnership with the National Council on Aging. Member Complete combines advanced technologies and applications that allow us to offer members information on community programs for which they might qualify.

Best Benefits^SM for the Aged, Blind and Disabled helps Medicaid managed care health plans identify members with disabilities and assists in the Supplemental Security Income application process. When done in states that pay higher capitation rates for the disabled populations, this increases income to those members and increases capitation to the plans.

Best Benefits^SM Medicare Conversion Service for Small Employer Groups is the complete solution for commercial insurance plans to the challenges of Supplemental Security Income/Social Security Disability Income enrollment for their disabled members and the opportunities of Medicare conversion.

2012 Federal Poverty Level calculations are shown by family size, broken out into annual, monthly and hourly terms, and also presented in multiplied form (120%, 135%, 150%, 200%, 250%, 300%, 350%, and 400%).