Avalon Benefit Services is a full service Third Party Administrator (TPA) founded to help employers save money in their benefit program.
We specialize in handling, in a precise manner, the everyday routine claims submitted to assure that errors are reduced to the absolute minimum level, that claims are thoroughly researched to pay only the lowest acceptable price and that unnecessary services and charges are eliminated from the program. Of course, strict adherence to the employer's Benefit Plan is our guide, and the use of sound procedures developed through the rigorous test of more than ten years of claims administration experience is our method.
We are keenly aware that 80% of all claims dollars are generated by only 20% of the covered population. We gear our procedures to attack potentially large claims before the dollars are spent by collaborating with the patient, the patient's family and the attending physician to alter the care planned and provide less expensive services in a less expensive location when it is feasible for the medical condition being treated.
Administration of self-funded plans, including:
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- Short-Term Disability
Administration of Health Reimbursement Arrangements
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Administration of Medical Expense Reimbursements Plans
Administration of Health Savings Account Plans
Benefit Plan Consulting
Administration of COBRA requirements
Administration of Flexible Spending Accounts
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Preparation of the 5500 Form
Shopping the market for Stop Loss Insurance
Shopping for Preferred Provider Networks
Arranging Disease Management programs
Communication of benefit programs to employees
Arranging of Employee Assistance Programs
On-Site Physician Treatment Centers
Implementation of cost-effective physician office services, including prescription drugs, at the employer's site. This service applies employers to with 150 employees and above or cooperating employers with a combined census of 150 employees.
Implementation of worksite wellness and incentive programs.
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Click here for a sample of a Wellness Program.
Our philosophy is simple in principle: To be the very best at controlling our clients' self-funded claims payments without significantly impacting the out-of-pocket expenses of their employees.