Additional Health and Welfare Services
With ADP Health and Welfare Services, you have the option to choose from among several additional services to help you save time and money.
ADP Employee Self Service
Your employees want convenience, clarity and accessibility in an HR solution. For them ADP delivers solutions like Employee Self Service, an easy-to-use Web-based portal that puts HR-related information at their fingertips, as well as the ability to update their personal information online. We provide an easy way to view their benefit plans online, 24 hours a day, 7 days a week.
Business rules and decision support tools are built right in, minimizing the need for call center support. This service frees up your staff’s time, while giving your employees increased control over their personal information.
Employee Self Service delivers the convenience that your employees will appreciate.
Participant Service Center
As part of your ADP Health and Welfare solution, your organization can benefit from call center support. ADP's Participant Service Center provides support to more than 2.3 million callers each year, answering basic questions from how to access care for a sick family member to complex employee benefit issues.
Our clients come to think of ADP's Participant Service Center as a natural extension of their own HR departments. ADP realizes that, to your employees, the voice on the other end of the line represents your company, so our customer service representatives are trained to understand your company's unique culture.
Features
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24/7 access to online service.
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Callers are directed to the most appropriate service representative based on their question or service need.
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Callers are greeted personally and given accurate answers by Client Service Representatives based on information provided through intelligent pop-ups such as the caller’s name, company and benefit plan.
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ADP utilizes a knowledge base that locates answers to participant questions quickly, and a case management system for documenting and reporting the types of questions asked.
When calls are routed to our Participant Service Center, your benefits administration staff can focus on your organization's strategic initiatives, even during open enrollment, when they typically face high call volumes.
Advocacy Services
With today's health and welfare programs becoming increasingly more difficult for employees to understand, the burden on HR to resolve health plan issues is amplified. Through ADP's Advocacy Services, specially trained experts can help employees resolve healthcare coverage and care disputes, such as:
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Enrollment discrepancy resolution
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Claims dispute mediation
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Coordination of benefits discordance resolution
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ERISA/HFCA adherence and conformity
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Medical case review
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Qualifying event appeals
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Prescription drug formulary appeals
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Reasonable and customary disallowance issue resolution
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Medical necessity advocacy
ADP's advocacy team consists of individuals with medical, health plan, mediation, research and client service backgrounds. With ADP’s advocacy team on your employees’ side, your HR staff no longer has to spend valuable time researching health care issues. In addition, employee productivity is increased because questions are answered more quickly.
Dependent Audit Services
With the costs of healthcare skyrocketing each year, organizations like yours are looking for more ways to control costs. Ensuring that your benefits are being offered only to eligible dependents as defined by your benefit policies is key.
Auditing dependent data to request proof of dependent status is an intensive manual effort. With ADP Dependent Audit Services, our team of dedicated professionals acts on your behalf, requesting proof of dependent status based on the type of audit you choose. We image all documentation, provide follow up with the employee and produce a standard report for your benefits team to review and make a determination. Additionally our service includes customer service support to answer your employees’ questions about the audit.
Available services include:
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Full Dependent Audit – Audit all employees who have dependents enrolled in employer-sponsored benefit plans
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Full-Time Student – Audit the current status of all dependents currently flagged as full-time students
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Overage Dependents – Audit all dependents who are over the maximum age for dependent coverage; request verification of student status or disability
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Family Status Change – Audit all FSCs to add or drop dependents from coverage
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Special Events – Audit of a special group or population (e.g., domestic partners or acquisitions)
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Dependent Add – Audit new hires or newly added dependents at open enrollment
Interested in learning more? Contact us or call 1.800.CALL.ADP, ext. 411 (1.800.225.5237, ext. 411).