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Employee & Member Services

from PLC Insurance

Claims Issues

We work directly with employees and their families whenever there is a question about a claim. Whether it’s a denial or just a high price, we can ensure claims are processed appropriately and negotiate costs downward at every opportunity.

Claim Audits

Ever seen the pile of incomprehensible bills after the exciting delivery of a newborn baby? Or after a major surgery? There are enough headaches without trying to figure out if everything was processed appropriately. We do this to ensure employees can focus on their health (or their child’s) while we comb through the details for accuracy.

Special Appeals

We pride ourselves in helping our members access care that was not originally approved by the insurance carrier. Imagine your doctor says you need a cutting-edge surgery that isn’t approved by the insurance company. Then, imagine we are able to get them to change their minds with a well-crafted letter and research showing it’s the best treatment for your condition. It’s these miracles that make us excited about our work.

Network Research

Did you just find out that your doctor is no longer in your network?  Do you need a new dentist? Doctor saying you need to see a specialist? We can make sure the providers you’re choosing from will be in-network and that you’ll receive the highest benefit level available to you. Just let us know what kind of provider you need to see and where.

Healthcare Cost Research

The cost of care is almost always expensive and seems to keep getting more expensive. We have the ability to help determine how much a course of treatment will cost with a given provider and insurance company. This can make seeking care more approachable and less scary for employees. It also helps them make smarter, better-informed decisions on how to direct their care. It’s rare for this decision to happen between doctors and patients even today, so we bridge the gap.

Prescription Drug Research

With the cost of drugs increasing in America, employees are needing to find alternatives to expensive prescriptions.  Many are unaware of the many ways to save themselves a lot of money on prescription medication. While we certainly don’t prescribe medications, we can give employees information on less expensive alternative drugs to explore with their doctor or even just information on how to acquire their prescriptions through mail order to capture cost savings without even changing their medication. It’s all about information.

Advocacy

We really did design our benefits division to offer the same level of service to your employees that we do for the “C Suite”.  We want to help your employees through the health care finance maze. We want to be their point person for dealing with all of their benefits and any questions that may come up. From simple questions to complex analysis and problem resolution, we’re here for them.

Human Resource Support

Not everything needs to be reviewed by an attorney. We are happy to review DOL notices and supply our clients with model notices that they can customize. Our consultants are also members of the Society of Human Resource Managers and have access to thousands of HR Professionals for questions we can’t answer ourselves.

Employee Benefits Handbook

The first step to ensuring your employees appreciate their benefits package is clear communication. PLC develops custom educational materials and curricula for employees to drive greater satisfaction and better utilization of the benefits you provide.

Employee and Dependent Educational Meetings

Employee benefits are for creating goodwill with employees. Being confused by insurance plans, no matter how good they are, will never create goodwill. We create custom employee benefit education programs to help your employees better understand how to get the most out of their employee benefits and set the expectations of what their participation may look like.

Escalated Claims Resolution

We hope you never need this. But, if you do, you’ll be glad to have a competent, well-versed advocate with experience and relationships to help.

Want to find out more about your Employee Benefits options?

Jan Fernandez
Employee Benefits Practice Leader
425-712-3755

Brandon Rucker
Employee Benefits Consultant
425-712-8045

Lynnwood Employee Benefits insurance

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PLC Insurance, LLC - Serving the Greater Seattle Area and all of the Pacific Northwest

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888-455-7554

425-712-3664

Mon-Fri 8AM-5PM

Our location

Lynnwood office

19401 40th Avenue W, Suite 440
Lynnwood, Washington 98036

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PLC Insurance services all of the US, with a focus on the Puget Sound, Lynnwood, and Seattle, Washington