Eligibility & Enrollment

Our team assists with entering paper applications and other manual transactions to ensure you spend your time in the most effective ways for your business. We help with paperwork and transactions related to new group enrollments or renewals. Eligibility is tracked for each participant and dependent according to the type of plan such as medical, dental, vision, pharmacy and life. Dependents’ ages are monitored to determine termination of coverage. We also audit employer eligibility profiles against participation data and payroll information to ensure accuracy.

We offer several online tools to assist with the enrollment process and increase efficiency. Online through HealthView, employees can access enrollment applications, plan benefits and make real-time updates such as address or dependent status changes, avoiding unnecessary paperwork. Additionally, they can view their claims, look up the cost of procedures and prescriptions and print temporary ID cards, if needed. Providers have the ability to look up eligibility using our proprietary Online Provider Information System (OPIS). We also use an Interactive Voice Response (IVR) telephone system that employers, participants, and providers can use to verify eligibility and check benefits.