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Determine eligibility
Eligible or not? For each person, the answer is, ultimately, a simple “yes” or “no.” Arriving at that answer is anything but simple. Eligibility is governed by complex contracts and government regulations couched in the opaque, often ambiguous, legal provisions. TotalBenefits maintains records of employer contributions and credited service, while taking an expert system approach to eligibility determinations—basing decisions on a logical, complete, and accurate set of rules readily updated to reflect changes in plan provisions so that your plan can meet the notice provisions of PPA 2006.
Process and pay pensions
How large a pension? Again, there’s no simple answer. A vested right to a pension is just the beginning. Pension amounts are based on many variables, including employer contributions, credited service, retirement age, and payment options. TotalBenefits can calculate benefits for the full range of ages and options, and produce customized reports showing plan participants how different decisions translate into dollars. Once an option is selected, the system can generate monthly payments and manage deductions, including adjustments to reflect changed circumstances—for example, converting pensions to alternatives either elected or especially for survivors.
Process and pay health and other benefits
The rules that govern health plans are at least as complicated as those that govern pension plans. TotalBenefits can handle them. The system comes equipped to coordinate with Medicare and can be custom-tailored to the coverage specified by your plan, for active participants and pensioners as well as eligible dependents. Functions run the gamut from processing claims to calculating benefits to making payments—all the activities associated with administering health, lump sum, and other benefit plans while complying with the provisions of HIPAA.
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