We Work With

Health Plans

Working with Health Plans

NFP Health has a long history of strong partnerships with Health Plans. In 1969, NFP Health (formerly known as the Massachusetts Business Association) partnered with the health plans in Massachusetts to offer health insurance to employers with fewer than five employees. Prior to this, group insurance for this size employer was not available. Through the new alliance between the health plans and NFP Health, these small businesses could now shop among health plans and select health insurance that met the needs and price range of this business segment. NFP Health has since expanded beyond the borders of Massachusetts, and now works with small businesses in Rhode Island and New Hampshire, as well as every health plan in each of these states.

By virtue of its unique business model, commitment to service, and experienced professionals, NFP Health brings efficiency to the process for small groups and individuals by providing the administration and service typically reserved for large employers. NFP Health acts as an extension of the plans, providing the high quality customer service and support to these small groups that is at least at par with the services provided larger groups.

NFP Health’s operation mirrors that of the plans. Health plans refer small business and individual clients directly to NFP Health, typically by way of their website and also through NFP Health’s exclusive health plan-dedicated toll free phone lines. Utilizing rating workbooks from each health plan; rates are programmed to generate new business quotes and account renewals. NFP Health was a pioneer in the industry in developing electronic data feeds to health plans to provide real-time processing.

NFP Health also works closely with smaller, traditional Medicaid-only plans to help them enter the commercial marketplace.

Most recently, NFP Health worked with Network Health in Massachusetts to provide them with the tools to operate as a Qualified Health Plan (QHP) under the Affordable Care Act, to both retain and grow its membership and revenue.

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Online and Live Support for Clients:

  • Needs Assessment: we’ll walk clients through the complexities to determine their needs
  • Quoting: either online or with the assistance of our representatives
  • Sales: Our licensed representatives will assist the client throughout the sales process
  • Online Bill Pay
  • Customer Service: ongoing Best in Class Customer Service
  • Annual Renewal Process: Providing all alternative options including an
    easy way to save premiums by changing the design of their current plan.

Additional Operational Functionality:

  • Eligibility: On-staff eligibility team ensures quality control based on strict health plan standards
  • Enrollment: On-Staff Enrollment Team submits data to complete enrollment process
  • Billing: Ensuring account reconciliation
  • Electronic transmission of records: Providing timely processing of ID cards

Through ongoing training, the NFP Health staff is expert on plan design, market changes, service networks, physician networks and eligibility requirements.

Our health plan partners perform routine auditing to ensure that all guidelines and standards are met as per strict health plan parameters. NFP Health has successfully developed a highly respected status; having met or exceeded every health plan’s high standards and received industry accolades for exceptional service.

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Choose a partner who is secure, experienced, expandable, flexible, proven

and can successfully solve your premium billing needs

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