Employers

A Partnership for Better Health Benefits.
 
get started

Why Be Self-Funded?

Self-funding your employer health plan offers a greater level of control and savings than fully-insured coverage. Self-funded employers have greater control about their plan’s benefits and ancillary services, medical and pharmacy networks, and member contributions. Best of all, you pay only for actual member claims received, rather than pooling premiums with employers who may have less healthy populations.

Savings.

You keep any money that doesn’t go toward paying claims… and MedBen helps you keep as much of that money as possible.

Z

Flexibility.

You choose the health care plan options that work best for your employees.
i

Regulatory.

Self-funding offers a greater degree of freedom from state and federal regulations.

If you’re fully insured, MedBen can assist you in making the switch to self-funding. And if you already have a self-funded plan in place, you’ll find that we offer outstanding service and benefit management tools.

Dedicated to helping your plan succeed.

If you’re a current MedBen client, we are pleased to serve your business and help you succeed… and if you’re not, we’d welcome the opportunity to work with you.

Here you’ll find links to useful plan administration resources. Should you need further assistance, please contact your dedicated Account Representative team.

And thanks again for choosing MedBen!

ONLINE SERVICES AND RESOURCES

Use this secure 24/7 service portal to access claims and benefits information. If you need assistance logging in or using the site, please contact your team of dedicated Account Representatives.

Track your plan performance using our interactive executive dashboard. To set up your account, please contact Marketing Analyst Morgan Hardy at 800-423-3151, Ext. 424 or mhardy@medben.com.

PLEASE NOTE: The reporting platform will not work in the Internet Explorer browser. Please use Firefox or Google Chrome for best results.

Documents containing protected health information (PHI) are posted electronically on this safeguarded site. When a document is available, you will automatically receive an e-mail notification with download instructions.
A detailed list of qualified medical expenses under Section 213 of the Internal Revenue Code.

When the opening screen appears, simply type in the MedBen password mbc26 (case sensitive) and press the “Enter” button on your keyboard.

If you have any questions regarding qualified medical expenses under your MedBen plan, please contact your team of dedicated Account Representatives.

FORMS AND APPLICATIONS
Medical
Dental
Dental Employee Application – Apply or make coverage changes.
Dental AND Vision Employee Application  Apply for dental and/or vision coverage or make coverage changes.
Vision
Vision Employee Application – Apply or make coverage changes.
Vision AND Dental Employee Application  Apply for dental and/or vision coverage or make coverage changes.
FSA
Employee’s Guide to Flexible Spending Accounts – Overview/FAQ of MedBen FSAs for plan participants
FSA Mileage Reimbursement Form – For claiming under your Health FSA the mileage used to obtain qualified medical services from a physician, hospital or facility to prevent or alleviate a physical disease, defect or illness.
Debit Card Substantiation Form – Substantiate purchases made with your MedBen Debit Card.
Orthodontia Services Reimbursement Request Form – An orthodontist (or authorized bookkeeper) can use this form to request reimbursement for services.
Request for Debit Card – Request a debit card for your dependent or replace a lost or stolen card.
Sample Letter of Medical Necessity  If a Letter of Medical Necessity is required from your provider to receive reimbursement from your FSA, this sample letter can be used for that purpose. Simply print out/save and give to your doctor.
FSA Reimbursement Request Form – Used when requesting reimbursement from a Health FSA plan, Limited Purpose FSA plan and/or Dependent Care reimbursement plan.
HRA
HRA Reimbursement Request Form – Request reimbursement from your HRA account. NOTE: This form is generic and may not be specifically based on your HRA plan design.
COBRA
COBRA Qualifying Event Form – Notifies MedBen of a COBRA qualifying event.
HIPAA
Access to Personal Information Request Form – Request access to copy or inspect personal health information held by MedBen.
Request to Restrict Uses and Disclosures of Protected Health Information – Request restrictions of the use or disclosure of personal health information held by MedBen.
Accounting of Protected Health Information Request Form – Request an accounting of disclosures made by MedBen of your health and medical information.
Confidential Communication Request Form – Request alternate means of communication with MedBen.
PHI Amendment Request Form – Request MedBen to make corrections or amendments to your protected health information.
Privacy Complaint Form – Register a complaint if you believe anyone at MedBen has inappropriately used or disclosed protected health information.
Other
Disability Claim Form – Plan members can submit a claim for long-term or short-term disability benefits.
Transportation Reimbursement Form – Plan members can request reimbursement from their transportation compensation account.
Notice of Appeal/Designation of Authorization Form – Plan members wishing to file a formal appeal of a disputed claim should use this form. They can also designate another entity to file an appeal on their behalf.
Death Claim Form (Life Insurance Claim) – Please contact MedBen Customer Service (800-686-8425 or medben@medben.com) to obtain a death claim form. Employers must complete and return this form (accompanied by a certified copy of the death certificate) in order for designated beneficiary to receive life insurance benefits.
RX FORMULARIES

blue and white pills spilling from bottleMedBen clients who use Ventegra or Pharmacy Data Management, Inc. (PDMI) as their Rx network for their pharmacy plan can request the most recent formulary from their Account Representative.

MedBen clients who use pharmacy networks other than Ventegra or PDMI can typically access formulary information through that network’s website. Visit the Networks page for pharmacy network links.

NETWORKS
Visit the Networks page for links to medical, pharmacy, vision and dental networks.
Tell Your Broker!

Like what MedBen has to offer and want to let your broker know? We’ll help you take the first step.

Just click on the link below… it’ll create an e-mail for your broker, complete with message. Just replace the “TO” email address with your broker’s, plug in your names, and you’re good to go!