Health and Welfare
 
Services

Scalable solutions and services.

 

Eligibility Maintenance and Billing Capabilities

  • Maintenance of all necessary information — personal, general, coverage and eligibility spans
  • Retrospective additions and terminations
  • Timely and accurate identification card preparation
  • Unlimited plan and coverage changes with complete history
  • Multiple levels of eligibility breakdown — by group, division, department or area
  • Maintenance of premium and rate data
  • Premium reconciliations
  • Tracking of commissions

Successful Managed Care Programs

  • Pre-admission Review Certification
  • Large Case Management
  • Built in Maternity Management programs
  • Demand Management
  • Disease Management
  • Nurseline
  • Health Information Website
  • Health Risk Assessments

Premium Operational Performance

  • Extensive system and data reporting capabilities
  • Broad range of statistical reports to monitor plan performance
  • Regular quality review testing
  • Data integrity commitment
  • On-line repricing data for numerous Preferred Provider Networks (PPOs)
  • Internal auditing

RDS Medicare Subsidy

  • Coordination of RDS reporting requirements between Zenith American, the PBM and Medicare.

HIPAA Compliance

  • Privacy
  • High tech security
  • 834 & 837 files
Coordination with PPO Vendors & PBM's across the nation.

Pension Plan Administration

Zenith American Solutions offers defined benefit and defined contribution pension plan administration.
Our services include:
 
  • Application and inquiry processing
  • Production of benefit checks and FTEs
  • Tax filings
  • Other government required notices and reports
  • Annual reports of individual and group statistics
  • Assistance preparing plan documents, amendments, and summary plan descriptions
  • Detailed work history with contribution reporting
  • Annual benefit statements
  • Zenith American supports a broad range of withdrawal services including trust-to-trust transfers, participant loans, and hardship withdrawals
  • Discrimination testing
  • 100% quality review of all pension transactions
  • Age 70 1/2 search
  • Annual death index search
  • Annual disability reviews