Tribal Health
888-419-6139

Services

As a full-service, third-party administrator in partnership with the Sycuan Band of the Kumeyaay Nation, Tribal Health Partners is dedicated to providing top-quality administrative services tailored to the unique needs of tribal entities.

Whether you are looking to cover Tribal Members, employees or Tribal government representatives, Tribal Health Partners has a solution for you! See how our cost-effective solutions and personal attention can help you get the most from your benefit plan.

Tribal Life Insurance Coverage

Tribal Health Partners has setup a program to protect the heritage of Tribal Members by making Group Life Insurance policies available for Tribal Members. This special Group Life Insurance policy does NOT require the insured Tribal Member to be employed by the Tribe. In fact, it's specifically designed for those Tribal Members not employed by the Tribe. All Tribal Members are eligible for coverage.

This program includes several value-added benefits:


Group Life Insurance Benefits

Life insurance coverage limits and guaranteed amounts to suit the needs of the Tribe.


Tribal Member Assistance Program

Similar to a traditional employee assistance program, but just for Tribal Members.


Beneficiary Companion Program

Assistance with managing notifications and protecting the deceased's identity from fraudulent use.


Identity Theft Resolution

Support for members in the event their identity is stolen.

Other Products & Services
Benefit plan consulting including analysis of existing program, design, management, and level of risk
Value-based plan designs: HSA/HRA/HDHP
Extensive network evaluation to ensure adequacy of access to entire population
COBRA/FLEX/HIPAA administration
Dental/Vision ASO
Medicare D notices and equivalency services
Assistance in preparation of applicable 1099's and DOL 5500 reporting forms at year end
Engagement in plan implementation
ID card customization and generation
Online enrollment
Dependent eligibility audits
Consolidated billing and distribution
Premium and claim payment audits
Claim adjudication: prompt turnaround, audit of large dollar claims, COB, and 98% accuracy rate
Proactive out-of-network negotiations
Appeal assistance for claim denials
Client specific reporting based on needs
Comprehensive data analytics to aid in making educated decisions
Utilization analysis and recommendation for plan design modification
Detailed evaluation to aid in maximizing cost savings while maintaining employee satisfaction
Creation of long-term strategies to perpetually stay on par with objectives
Committed liaison between broker, client, providers, and vendors

Strategic Alliances
To provide the best service to our clients, Tribal Health Partners maintains strategic alliances with a variety of industry-leading organizations including:

  • Stop Loss/Reinsurance relationships that leverage competitive rates
  • Case/Disease Management
  • Utilization Review
  • Pharmacy (PBM)
  • Subrogation recovery solutions
  • Nationwide networks
  • Nurseline
  • Wellness/Health Management
  • Telemedicine
  • Employee handbook review and production
  • Plan Doc/SPD creation
  • Perpetual compliance and regulatory adherence
  • Ancillary Care Specialty Network
  • EAP