Delivering Value Beyond Expectations

Third-Party Administration of Health & Welfare Funds and Pension Plans

  • Optimum Administration of Health and Welfare Funds
  • Seamless, End-to-End Administration of Pension Plans
  • Maintenance of Fund financial records and payment of Fund expenses
  • Effective Coordination with Fund/Plan Professionals and Benefit Providers
  • Efficient Claims Processing and Responsive Customer Service

Amalgamated Employee Benefits Administrators has a longstanding reputation as one of the most competent third party administrators (TPA) of health and welfare funds and pension plans. Our reputation is based on having all the right resources in place to effectively manage our clients’ benefit programs. That includes having highly qualified TPA professionals, leading-edge technologies, and proven systems that enable us to provide the most efficient, cost-effective, flexible and customized benefits administration.

From health and welfare funds, including medical and dental benefits, to pensions and supplemental coverage administration, Amalgamated serves diverse organizations as a reliable business partner committed to the highest standards of service quality.

Amalgamated Employee Benefits Administrators’ TPA Services Include:

  • Billing and collection of employer contributions
  • Maintenance of enrollment and eligibility; including vendor eligibility interfaces and COBRA Administration
  • Comprehensive claims administration of medical and dental plans (i.e., claims adjudication, quality control, pre and post-payment audits and utilization reporting including electronic data interchange, EOB Issuance, overpayment and recovery, subrogation and high dollar claim review)
  • Responsive to fund/plan participants’ inquiries relating to eligibility, claims, premiums, ID cards, and COBRA status
  • Coordination and communication with trustees, fund professionals, participants and fund benefit providers (i.e., BlueCross BlueShield, MagnaCare, GHI, Aetna, etc.) relating to: eligibility and claim resolution, data integrity, ongoing eligibility and monthly payments
  • Regulatory reporting (i.e., Medicate Part D – Certificate of Credible Coverage and HIPAA Certification, as applicable)
  • Handling of appeals (i.e., preparation, documentation, presentation, receiving of final determination, communicating resolution)
  • Pension eligibility determination, application processing and benefit calculations in compliance with all plan documents
  • Maintain detailed records on current pensioners (including demographics pension type, benefit amounts, withholding, if any, and spouse information, if applicable)
  • Timely issuance of monthly pension benefits
  • Maintenance of employment history, participant demographics, detailed pension credit accrual for active and terminated vested participants
  • Preparation of annual valuation data for Fund’s actuary
  • Maintain financial records (i.e., accounts payable and receivable; bank reconciliation; monthly receipts and disbursements; trustee meeting financial reports; 5500, 990, 1099 and assistance with annual audits)
  • Maintain official fund records (i.e., plan documents and amendments, SPDs/SMMs/Benefit Overviews, CBA/Participation Agreements, meeting minutes, trust agreements, and rate/fee adjustments) general administration, coordination and communication with fund professionals (i.e., attorney, actuary, accountant and other fund consultants)
  • Attendance at, and preparation for trustees meetings including coordination of meeting materials
  • Attend membership meetings, collective bargaining coordination and new employer/orientation/implementation
  • Coordination of fiduciary liability insurance, and fidelity and crime bond insurance

Benefits Administration Customized to Your Needs

At Amalgamated Employee Benefits Administrators, we realize that each organization has its own systems, processes and needs. That’s why we customize our solutions and pricing to assure a best in class experience for your organization and your members. Our knowledgeable transition team provides an efficient, seamless onboarding experience. Each client is served by a designated Service Executive and Account Management Team responsible for overseeing all services ranging from appeals, trustee meeting participation, regulatory reporting, open enrollment and educational meetings, to implementation of plan benefit changes, review of SPDs and SMMs and troubleshooting.

ADDITIONAL CUSTOMIZED SOLUTIONS AVAILABLE IN PARTNERSHIP WITH AMALGAMATED MEDICAL CARE MANAGEMENT

Once onboarding is completed, expect to receive effective administrative services in all areas of your employee benefits, including:

  • Utilization Management
  • Case Management
  • Disease Management, Wellness and Health Coaching
  • Hospital Readmission Management
  • Maternity Management
  • 24-Hour Nurse HelpLine and Health Information Library
  • Health Risk Assessments
  • Independent Review Organization
  • Claims Cost Management Services

Exceptional Customer Service

Amalgamated Employee Benefits Administrators takes great pride in its high quality customer service. We have all the resources and proven processes in place to consistently provide responsive, efficient service. Our customer service features:

  • Highly skilled staff of 30 customer service professionals serving from our award-winning call center (Benchmark Portal “Top 100 Call Centers”) in White Plains, New York with capacity to easily increase within the day, as needed
  • 65% of our customer service representatives and 100% of our management are bilingual and our language line interpreter service facilitates calls in over 240 languages
  • Easy access, Monday-Thursday 8 AM- 8 PM, Friday 8 AM-6 PM, Saturday 9 AM- 2 PM Eastern Time
  • Plan-specific toll-free number or redirected existing current number

Our customer service representatives efficiently handle over 25,000 calls monthly through 75+ client toll free and direct numbers. Real-time analytics, voice and screen captures, and audio recordings of all telephone interactions, coupled with our rigorous new hire training program, assures that our high service quality standards are met. Based on our automated customer service surveys in which we have 20,000 participants annually, we are exceeding or meeting the expectations of 98% of survey respondents, with 81% reporting we are exceeding their expectations.

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A Member of the Amalgamated Family of Companies

Amalgamated Employee Benefits Administrators is one of the nation’s leading third party administrators (TPA) of employee benefit plans for unions, businesses, associations and self-insured plans. A member of the Amalgamated Family of Companies, we are a full-service TPA offering services across all benefit plans. The Amalgamated Family of Companies is a group of affiliated businesses which have grown from the flagship company, Amalgamated Life Insurance Company, a leading provider of comprehensive insurance solu-tions. Founded in 1943, Amalgamated Life operates in all 50 states and the District of Columbia. It has consistently earned the “A” (Excellent) Rating from A.M. Best Company since 1975 attesting to its strong fiscal position. In addition to Amalgamated Life, the Amalgamated Family of Companies includes: a third party administrator, Amalgamated Employee Benefits Administrators; Amalgamated Medical Care Management, a medical care management firm; Amalgamated Agency, a property and casualty broker; and AliGraphics, a printing firm.