Custom Health Benefits Solutions to Fit Your Client's Needs

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The Pinnacle Difference

Pinnacle handles your unique administration requirements and enables you to avoid the hassle of unnecessary paperwork.

We know that the job we do is critical to the relationships our brokers have with their clients, which is why we make working with us incredibly seamless.

Our dedicated sales team has extensive knowledge of the self-funded health benefits marketplace and understands how needs vary from company to company. As industry experts, we are available to train, develop and assist brokers with new business enrollment. While obtaining new business is vital, we work hard to help brokers maintain and satisfy their existing customer relationships. We provide excellent customer service, a complete portfolio of third-party administration (TPA) services, and consultation. From presentations to enrollment and reporting, we are available to assist when and where you need us. Additionally, we provide brokers the tools, reporting and analytics to develop strategies to reduce health care costs.

We have programmers, developers and infrastructure support housed internally, and work with proprietary systems that enable us to provide greater functionality with customization of services and a wide range of tools. We’re also one of the few TPAs with a co-location and, we run complete annual disaster recovery training, so you can rest assured that your data is secure and operations will continue in the most unexpected situations.

Health Benefits Administration

Let us simplify your health benefits administration with personalized plan designs, competitive network solutions, innovative cost management programs, and integrated disease management and wellness options that fit your needs and budget.

We’re Experts in:

  • Benefits Administration
  • Claims Administration
  • Eligibility & Enrollment
  • Customer Service

 

We’re Experts in:

  • Benefits Administration
  • Claims Administration
  • Eligibility & Enrollment
  • Customer Service
  • Health Care Networks
  • Health Management
  • Cost Management
  • And Much More…

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  • Health Care Networks
  • Health Management
  • Cost Management
  • And Much More…

Online Tools

Our brokers have secure access to our proprietary online tools to retrieve health benefit information. Our online tools provide access to reports, updates to profile information, eligibility and enrollment, and secure payments.

 

PERC

PERC is a free tool available to our brokers and employers to easily access and update their health benefits information. We offer one-on-one program training so you can begin accessing your plan information immediately and understand how to maximize all that this resource has to offer.

Driven by the unique needs of our brokers and employers, our proprietary online health benefits tool can be customized to provide access to the information and reports you need most.
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Key capabilities include:

  • Update and add employee information
  • Terminations on an individual basis or multiple terminations
  • View claims details and status
  • Request duplicate explanation of benefits (EOBs)

Key capabilities include:

  • Update and add employee information
  • Terminations on an individual basis or multiple terminations
  • View claims details and status
  • Request duplicate explanation of benefits (EOBs)
  • Review employee eligibility history
  • Generate detailed reports
  • Print temporary ID cards
  • Query reports for in depth health benefit data analysis

 

  • Review employee eligibility history
  • Generate detailed reports
  • Print temporary ID cards
  • Query reports for in depth health benefit data analysis

 

HealthView Online for Plan Participants

We make managing your employee benefits easier by giving your employees convenient access to their health benefits information via a secure, easy-to-use online tool. HealthView is a free tool available 24 hours a day, seven days a week. Empower your employees to stay in control of their health benefits with this online tool.

With HealthView, employees can:

  • Look up claims status and history
  • Order a replacement ID card
  • Review explanation of benefits (EOBs)
  • Look up providers

With HealthView, employees can:

  • Look up claims status and history
  • Order a replacement ID card
  • Review explanation of benefits (EOBs)
  • Look up providers
  • Download forms
  • Search within a plan document
  • Email customer service
  • Update contact information

 

  • Download forms
  • Search within a plan document
  • Email customer service
  • Update contact information 

Online Enrollment for Employees

By eliminating paper forms, we simplify the enrollment process with easy, online enrollment. The online enrollment application enables employees to make their own health benefit elections via a convenient and secure online form.

Key capabilities include:

  • Selecting benefit plans based on employee eligibility criteria
  • User friendly, online screens that guide employees through the open enrollment process from start to finish
  • Real-time employee updates such as: change of address, marital status, dependent information, and dependents status
  • Links to provider websites
  • Review of company-specific plan documents
  • Election of voluntary, optional products

Provider Tools

Our Online Provider Information System (OPIS) makes it easy for health care providers to access patient information and speed up front office processing. Our easy to use online tool provides instant access to patient eligibility, deductibles, claim status, benefit plan information and more.

Reporting & Business Intelligence

Pinnacle offers comprehensive reporting to provide direct oversight to help you take control of your client's health care dollars. Our state of the art reporting solutions, allow brokers and health benefit managers to conduct health trend analysis from an easy-to-use, web-based platform. We work with you to tailor programs that maximize appropriate utilization and generate the most cost-effective benefit solutions.

By evaluating your analytics, you can:

  • Learn more about the health of your workforce
  • Understand the true benefits of your plan and wellness strategy
  • Pinpoint chronic health conditions
  • Develop a better understanding your employee population

Customer-Centric Approach

We have more than 20+ years of experience in delivering exceptional service. Pinnacle handles your unique administration requirements and enables you to avoid the hassle of unnecessary paperwork. 

We Offer:

  • Bilingual service
  • Fast and accurate and claims processing
  • Dedicated account managers
  • In-house service representatives
  • HIPAA compliance
  • Regulatory and compliance assistance

One-Stop Solutions

In addition to third-party administration services, we provide you with a full-suite of customizable solutions to match your comprehensive health benefit needs. You can customize your solutions, or we can seamlessly integrate with your vendors.

Our comprehensive offerings enables employers to avoid having to work with multiple vendors. We also have the flexibility of seamlessly integrating our solutions with your vendors.

 

Customize your experience by choosing the solutions you need:

See what Pinnacle can do…

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