Member Advocacy

A benefit-benefit for you and your team.

Do your employees struggle with the complex healthcare system? Do they not understand their benefits? Do they come to you in need of help with sensitive and very personal health care issues?

To help your employees and their dependents deal with the complexities of the healthcare system, we offer a proprietary, high-touch and personalized Member Advocacy Center.

With our Center, your employees get direct and unlimited access to a team of advocates – specialists committed to resolving healthcare difficulties. These Member Advocates help your employees with all their benefit needs from determining benefit eligibility to explaining claims processing to helping appeal a coverage rejection.

As a result, your employees make more informed decisions and maximize their benefits, while cutting down on time HR spends answers benefits-related questions. Call it a benefit-benefit.

Member Advocacy Center Features

  • New plan member engagement and on-boarding
  • Year-round personalized and compassionate support
  • Open enrollment assistance
  • Faster resolution of issues/concerns
  • Expert claims assistance
  • Clarification on what is covered under the plan
  • Assistance in finding medical providers
  • Explanation of full scope of available benefits
  • Access to BeneRN, a clinical nurse navigator platform for complex cases

Highlighted Member Advocacy Experience

CASE STUDIES / MEMBER ADVOCACY

For one Member Advocacy restaurant client with 500 employees, our Member Advocates logged over 32,000 minutes of activity from 450 calls over a 12-month period. At an average of 71 minutes per call, this translates to approximately 10 hours per week of member advocacy for this one client. That’s 10 hours per week the client’s HR department was free to focus on their regular responsibilities.


Diane Peterson
Partner, Senior Consultant, Health Insurance Funds Business Leader