Benistar – Nationwide Leader In Retiree Benefit Plans

Benistar Health

Benistar is a specialist firm that focuses specifically on providing retirees with a host of medical and prescription medication solutions. The company has been operating for over 35 years, having been established in 1978. During this time, the company has earned a well-deserved reputation as the nationwide authority on the design, installation and administration of retiree medical benefits for the post-65 age group.

In its quest to provide retirees with the highest quality products and services possible, Benistar maintains an extensive network of brokers and consultants. These providers supply a variety of medical and prescription drug solutions geared specifically for the needs of our select clientele. Among the companies and organizations serviced by this network are:

  • Public firms and privately-held companies
  • Labor unions
  • City and county government organizations
  • Educational institutions
  • Religious organizations

All over the United States, more than 400 plan sponsors benefit from the health and retirement plans and administration services provided by Benistar. The company currently administers premiums in excess of $100 million a year.

Benistar’s range of services covers three major categories: consulting and administration, group retiree medical benefits, and prescription drug solutions. These services are provided by the company’s own in-house team of specialists, and each is delivered with thorough professionalism and competency. With years of extensive experience handling various plans and programs under these categories, the Benistar team of professionals is equipped to deliver these services at the highest level of quality possible.


Consulting and Administration

Among our most sought-after services is our range of consulting and administration services that meet the most rigorous national and global standards. We are especially proud of our ability to deliver a comprehensive range of benefit solutions that address the needs of retirees in creative and cost-effective ways. Our benefit solutions have also been designed to meet the expectations of our plan sponsors.

Our consulting professionals work tirelessly to develop specialized medical and prescription drug plans that will address the specific needs of the over-65 age group. Unlike other firms that adopt a “one-size-fits-all” approach to retiree benefit plans assistance, we strive to develop unique solutions that address unique concerns that our beneficiaries may have. We work closely with each and every client, analyzing their present retiree programs, and coming up with ways by which these programs may be improved. This is in line with our goal to ensure that beneficiaries receive the most comprehensive services possible.

Our administrative team assumes responsibility for every aspect of the program implementation and ongoing administration in order to make the program as simple as possible for both our plan sponsors and broker partners. We also work closely with our clients in order to ensure the effective flow of communications between retirees and sponsors. Depending on our client’s preferences, we may bill the group, bill the retiree directly, or divide the bill in equal parts between group and retiree.

We employ a staff of customer service representatives that have received training in Medicare-related concerns, all of whom have worked extensively with retirees. Like the rest of the company’s personnel, this team exerts extra effort in ensuring that all our member clients are familiar with the most important aspects of the programs that they have signed up for, and that they are thoroughly comfortable with the arrangement. We even go to the extent of staying online with clients as we look up specific concerns with their carrier or CMS.

Group Retiree Medical Benefits

Another service we provide involves the management and administration of group retiree medical plans. This range of services has been developed in order to address certain medical costs that are recognized under Medicare, but that are not typically covered according to Parts A and B of the plan. Some of the most important features of this service are:

No network restriction – Signatories to our plans have access to all Medicare providers all over the country, with the privilege of choosing their own doctors. In contrast with most other plans, our beneficiaries are not restricted to networks in their immediate area.

No referrals necessary – We do not require our beneficiaries to obtain referrals from us before they can see a specialist. With the plans that we provide, retirees may see specialists of their own choosing whenever they want.

Guaranteed plan issuance – All our beneficiaries are guaranteed a suitable plan. We do not impose any restrictions with regard to pre-existing conditions.

Spousal coverage – Beneficiaries automatically get spousal coverage if their spouse is over the age of 65 and enrolled in Medicare Parts A and B.

Portability – Beneficiaries may continue to enjoy full coverage even if they opt to move elsewhere in the country, or if they maintain more than one residence.

Affordability – We offer the most competitively-priced plans available, with our rates backed by full insurance in order to mitigate financial risk to our beneficiaries.

Electronic claims – All beneficiary claims are electronically coursed through Medicare’s crossover process. There are virtually no physical claim forms to fill out.


Prescription Drug Solutions

Our prescription drug plans have been developed in accordance with Employer Group Waiver Plans (EGWP) guidelines, and are intended for those who belong to the category of Medicare Part D. Our partners firms are under contract with the Centers for Medicaid and Medicare Services (CMS) in order to serve as sponsors under the guidelines of that particular Medicare section. Our plans are developed specifically in order to manage compliance with Medicare Part D as they pertain to CMS regulations. Among the most significant features of this service are:

Donut hole filling – Our plans are intended to fill the coverage gap in Medicare Plan D, also known as the “donut hole”. Plans may cover branded and generic drugs that fall into the coverage gap, or generic drugs as determined by the plan design of the specific group.

Coverage for all Part D drugs – Under the Medicare National Preferred Formulary, beneficiaries are covered for all drugs under Medicare Part D.

Extensive network of pharmacies – Beneficiaries have access to more than 56,000 pharmacies all over the country, with the closest 10 locations listed in the provided ID card.

Government subsidies – Our premium rate plans include subsidies for Medicare Part D, with no additional subsidy filing necessary.

Mail order medications – Retirees have access to 90-day supplies of most medications, at lower than retail prices.

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