Health plan administration

Your business is unique — so are AmeriHealth Administrators solutions. We offer customized self-funded health plan solutions by giving you the ability to customize benefits and networks, as well as integrate with vendors. On an ongoing basis, we provide access to claims data to help you make informed decisions with confidence.

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Claims administration

Our modern, sophisticated claims administration system is built with innovative technology, enhanced medical management tools, and powerful analytics and reporting. It offers cross-platform interoperability and continuously supports new regulatory requirements.

Claims cost management

By optimizing and individualizing care, our team of medical directors, nurses, clinical pharmacists and integrated specialty solutions help reduce and eliminate avoidable costs. Through proactive outreach and wellness incentives, they promote greater understanding, healthier choices, and long-term savings.

Eligibility management

Using our online enrollment application, your employees or HR department can easily submit member updates or additions. Once we receive the member details, we'll promptly update the information within the business day.

Compliance and other common services

  • 1099 Reporting
  • Tax Forms 1095 and MA-1099-HC
  • Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC)
  • Recovery services
  • Fiduciary services
  • Medicare Secondary Payer (MSP)

Stop loss support

If you self-insure your members, especially if you're a smaller organization, an unexpected, large, unpaid claim can upend your annual budget and future plans. AmeriHealth Administrators offers comprehensive and expert stop loss administration designed to mitigate your risk and bring peace of mind.

Learn more about our other services and solutions

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Business process outsourcing

Leverage our expertise and technology to enhance your capabilities and expand or grow.

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Dedicated account management

Learn how our account support team's expertise and understanding can help you manage your plan and financial goals.

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Customized solutions

Maintain or grow membership with solutions and programs designed for your needs.

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Ready to learn how we can help you?

Reach out for a proposal.

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