Products and Services
SOMI has been developing and delivering innovative products and solutions to help our customers manage benefits more effectively for over 25 years. We offer a comprehensive set of benefit management options that can be designed to meet your specific needs efficiently and cost effectively. Whether its managing one specific service or providing total support, SOMI fits seamlessly into your benefits administration. Large or small, local or national, fully insured or self-funded, SOMI has the expertise and flexibility to meet the benefit needs of your company. And as you change, SOMI is right there to change with you. Our services include:
Medical plans administration: Claims management and processing of fully or partially self-funded health plans. SOMI offers unlimited creative design solutions from traditional CMM and PPO plans to a multitude of consumer-driven (CDHP) models including HRA105 plans.
Medical management services: In coordination with our preferred vendor, SOMI provides pre-certification and utilization review, maternity management, large case management, disease management, transplant coordination, direct discount negotiations and health and wellness programs.
Prescription drug plans: As the fastest growing expense category for medical plans, SOMI has negotiated extremely aggressive pharmacy benefit management (PBM) contracts with its preferred PBM partners. With real time access to their systems for eligibility, customer service and reporting purposes, we are able to actively manage this expense.
Dental plans administration: Claims management and processing of self-funded dental plans – traditional and PPO.
Preferred Provider Organizations (PPO): PPO arrangements offer medical and dental plans a network of preferred providers in which discounts and provider practice criteria bring substantial savings. Plan designs are written to give incentives to members seeking care from PPO providers. SOMI’s philosophy is to find the best PPO for each location in which a company operates as opposed to requiring the use of a single national network.
Life insurance plans: Administration of group life insurance plans such as basic employee group term life and various elective employee, spouse and child(ren) options.
Short-term disability insurance plans: Management and administration of short-term disability insurance plans for self-funded and fully insured programs. Full claims processing and advice to pay options.
Long-term disability insurance plans: Management and marketing of long-term disability insurance plans including management of existing plans, new plan development, enrollment activities, plan documents, claims and accounting services.
Flexible benefit plans: SOMI offers comprehensive Flex Benefit Administration as an integrated or stand alone option. Services include underwriting, design, implementation, legal documents, testing, 5500s, enrollment, communication, Section 125/129/132 direct deposit, auto pay, web access and debit card processing.
Defined contribution plans (CDHP): Consumer-driven plans, such as HRA 105 plans, have been growing rapidly in popularity and can be an important part of a company’s overall Flex Benefit plan.
COBRA administration: SOMI offers comprehensive COBRA administration as an integrated or stand alone option. SOMI’s administrative process offers secure on-line application as well as paper transmission. Payments from participants can be made monthly, quarterly and/or annually using coupon books.
Dependent Eligibility Audit Program: This program reviews the eligibility of all the participants covered to ensure that they are all eligible for coverage.
· National averages show that 12.9% of dependents are ineligible for the benefit plans they are enrolled in
· By Identifying and removing ineligible dependents from the plan you reduce your plans costs at the most fundamental level.
· The audit can be purchased financially risk free based upon ineligible dependents identified.
Consult-A-Doc™: provides members with on-demand, 24/7 phone and e-mail access to U.S. based, licensed physicians. Employees and their family members can connect instantly with Consult-A-Doc’s network of physicians for information, advice, and treatment including prescription medication, when appropriate.
Consult-A-Doctor’s services are available to employees at home, work, or wherever they may be.
EAP, employee benefit surveys and Population Health Management programs: Employers are increasingly recognizing the importance of additional benefit and support programs to retaining employees and keeping them healthy and productive. SOMI can help design, manage, administer and market employee assistance and wellness programs. We can also work with you to design and administer employee surveys to evaluate the effectiveness and satisfaction with current program offerings.
Common remitter and consolidate benefits billing: SOMI offers clients the ability to make one payment each month for all non-claim related expenses such as life and disability premiums, administration expenses, stop loss coverage, etc.
Communication and enrollment services: Since inception, SOMI has given its customers services that complement any Human Resource benefits function. From our customized consolidated enrollment booklet to our consolidated enrollment form, SOMI is able to communicate and enroll a company’s total benefit plan offering. This service includes any benefit plan a company offers even if SOMI is not the administrator of that benefit.
Retirement Plan Compliance and Administration: SOMI’s sister company, The GreatGASB Group, provides customers with a consistent administrative model for support in all aspects of IRS compliance for 403(b), 457(b) and 401(a) plans as well as GASB 43/45. We can help an organization achieve GASB compliance through a seamless process that integrates all of the required services into one solution.
Population Health Management: Through our vendor partners, we are able to provide integrated employee and member wellness products, services and programs that are designed to empower people with the information, tools and support they need to take charge of their health. The population health management resources and tools help people address a wide spectrum of health needs.
Dependent Eligibility Audit: This program reviews the eligibility of all the participants covered to ensure that they are all eligible for coverage.
Fully Insured Transplant Coverage: This product offers a risk management solution with its Comprehensive Transplant Insurance. This product integrates risk transfer with expert transplant medical management. The insurance is designed to carve out transplant exposures from 1st dollar up to a $1 million lifetime maximum. The program covers 100% of all in-network transplant-related organ procurement, hospital, physician and drug charges from the point an employee or dependent is diagnosed, through 365 days post transplant procedure, including access to world-class transplant centers across the country, experienced case management from registered catastrophic case nurses, and medical assessment and determination from their Medical Director (who has reviewed over 3000 transplant cases).
The range of our resources spread the spectrum from broad-based health awareness and education tools to highly targeted and personalized programs for those who have health risks, are managing chronic conditions, or are facing crucial health decisions.