Striking a Balance Between Quality Care and Cost Control

COBRA/HIPAA Compliance
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) sets forth a complex set of requirements in providing for the continuation of group health coverage for employees and covered dependents. The COBRA/HIPAA Compliance Services can relieve employers of the burden of the notifications and record keeping required as well as keeping up with the ever changing rules and the regulations of this law. In addition, we handle the billing and collection of premiums for COBRA plan participants and notify the Drug Card vendors of the COBRA activity.

Flexible Benefit Plans (FLEX)
A Flexible Benefit Plan allows employees to voluntarily redirect some of their pay before application of Federal, State and Social Security taxes and receive tax-free reimbursement for certain qualified expenses. Under the provisions of Sections 125 and 129 of the Internal Revenue Code, Flexible Benefit Plans can be established to cover Group Medical and Dental Coverage, Contributions to Employer-Sponsored Plans, Unreimbursed Health Care Expenses and Dependent Care Costs. FLEX can be added to any employee benefit plan. As a Third Party Administrator, we provide enrollment assistance and ongoing administrative support, including documentation, discrimination testing, reporting and reimbursements.

Fraud and Abuse Claims
PBA takes great pride in our ability to monitor claim activities, practice patterns and billing practices to detect practices that are abusive or fraudulent. We then take appropriate action to protect the plan and employee, and when necessary, use our relationship and remediate the provider.