Providers – Eligibility and Claim Status
Our Value

What We Offer

Our services allow you flexibility of choice in benefit plan design, while driving down costs and enhancing the member experience. We take care of the day-to-day plan administration and give you the data you need to make decisions to continually optimize your healthcare offerings.

We’ll walk you through the pros and cons of various benefit designs based on your business objectives and needs, and we can help you optimize your offerings to employees.

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Flexibility of Choice

Your plan should be tailored to your organization's needs and risks. We can work with your HR team to design, implement, and manage a health and welfare plan that covers medical, dental, vision, Rx, and short-term disability. This includes flexible spending accounts, healthcare reimbursement arrangements, summary plan descriptions, and more.

Real Cost Savings

Our cost-containment strategies save meaningful dollars while never compromising the member experience.

Great Member Experience

Health insurance is complex, which is why our customer service team is on call to advocate for our members throughout their healthcare journey.

Data-Informed Insights

We deliver both data and valued insights that enable our clients to continually optimize their benefit plans.

Simplified Administration

We simplify the benefit process and handle the day-to-day tasks for our clients—eliminating needless complexity.

And More

From world-class customer care for members and employers to sales support for brokers, we pride ourselves in making each interaction a meaningful and positive experience.


Our Products


How it Works

Self-funding can feel like a big shift from traditional insurance products—we’re here to walk you through the process. Once your plan is up and running, we’ll handle the day-to-day and be your trusted advisor to help you make strategic decisions along the way.


Common Employer Questions

How can I determine a member's active status?

To check if a member is currently active, please login to your provider portal. Navigate to the "Eligibility" tab, where you can search for members using their ID or SSN. Alternatively, you can select "View All Eligible Members" and scroll through the list until you find the member in question.

How can I inquire about the status of a claim?

After logging into your provider portal, go to the "Claims" tab. You can utilize the search function to locate a specific claim or select "View All Claims" and click on the claim you wish to check.

How can I verify a member's benefits?

For any questions regarding eligibility you can reach out directly to our eligibility team via our Contact Us page.

How can I make modifications or additions to my benefits plan? Where can I access reports?

To make changes to your benefits plan, please login to your provider portal and navigate to the "HR Enrollment" tab. From there, you can enroll in new benefits, make adjustments, or submit a termination notice if necessary.

Reports are available on your provider portal. Simply login and visit the "Reports" tab. These reports are typically added mid-month and can be found there for your review.