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Slide 1Self-Funded Dental and Vision PlansConfigurable plan designs that provide dental and vision benefits
## What are Self-Funded Dental and Vision Plans?
With our Self-Funded Dental and Vision plans, employers completely fund all dental and vision claims for their employees.  However, they have the freedom to design and tailor the benefit plan to what fits their company’s needs the best. Most employers design their plan to include a share of costs arrangement with their employees.
**Share of Costs** – A share of costs is a concept that allows employers to make employees financially responsible for a portion of their benefit plan.  For example, if the benefit amount per employee is $100, your client could design a share of cost plan of 50/50, where they would pay 50% of the $100 and their employee would pay 50% of the $100. That means they would both owe $50.  Employers can also require the employees to pay a monthly “premium” towards the costs as well.
Self-funded dental and vision plans allow an employer to only pay for claims that are actually incurred. Under traditional fully insured dental and vision plans, an employer must pay premiums for a participating employee even if they do not use the plan. These plans can implement claims being paid based on Usual, Customary and Reasonable (UCR) fees. Under this scenario, the benefits paid will be restricted to a certain UCR percentile chosen by you. This protects you from paying claims to providers whose fees are higher than UCR.
## Dental and Vision Networks
### Dental Networks
With our dental plans, we offer several different networks to choose from to give your employees a bigger discount when seeing a contracted dental provider. Below are the networks you can choose from:
### Vision Network
With our vision plans, we do not offer a network. The participants will receive an benefit ID card and they can go to any provider to receive vision services. Some vision providers choose to require payment up front for services, which means your employees will have to pay out-of-pocket upfront and then submit an itemized statement to us for reimbursement.
## Navia Solutions
### Configurable plan designs
**Plan designs customized to fit your needs.** Navia’s Self-Funded Dental and Vision plans are configured to allow employers full control of their plan design. Our plans are the most comprehensive in the marketplace, providing you and your employees with quality benefits.
### Minimize cost
**Don’t miss out on cost savings.** Unlike fully-insured traditional plans, Self-Funded Dental and Vision plans allow employers to manage their benefit costs economically. Our plans have affordable administration fees and lower out-of-pocket costs for members.
### Dedicated service team
**Do away with customer service concerns.** Unlike most administrators, Navia trains dedicated customer service representatives that exclusively serve dental and vision plan clients and participants. Employees, clients, and brokers talk receive exceptional support from plan experts.
### Versatile, easy claims tools
**Eliminate claims management headaches.** Our online portal and mobile app are convenient and user friendly. Plan participants can log in easily to submit claims, enroll eligible dependents, view claims, and access other acocunt information on the go.
## Participant Features
* Lower out-of-pocket dental and vision expenses
* Quick, easy, versatile online and mobile account access
* Simple claim submission
* Pay to provider directly or option for member reimbursement
* Access to large range of providers with multiple network options
* Comprehensive benefit education
* Dedicated plan service representatives
## Employer Features
* Configurable support and flexible plan designs
* Significant savings compared to traditional health plans
* Full plan design capability
* Comprehensive enrollment assistance
* Annual reporting and claims utilization data
* Employer portal for plan administration and reporting
## Open Enrollment Support
Navia’s clients who participate in our OE webinars see an average 6% increase in enrollment, and clients who participate in our email campaign see an average 15% increase!
Check out our  for our robust open enrollment program to help increase your enrollment year over year!
## Interested in learning more?
Contact our sales team at 425.452.3498 or sales@naviabenefits.com
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Slide 1
For Individuals
Self-Funded Dental and Vision PlansReduce your out-of-pocket dental and vision expenses
Self-Funded Dental and Vision plans are an employer provided dental or vision benefit plan.  A Self-Funded Dental and Vision plan is set up and funded by your employer to reimburse you or your provider for qualified healthcare expenses.
## Who and What is Covered?
Dental and Vision plans typically covers eligible out-of-pocket dental and vision expenses incurred by you and/or your covered dependents. However, since these plans are customizable by your employer, the design for each plan is endless. Eligible expenses are determined by your employer.
***In order to determine who and what services are eligible for coverage/payment, please refer to your plan’s Schedule of Benefits*.**
## How Does it Work?
* **Enroll in your Dental and Vision plan.** During your open enrollment select the dental and/or vision plan provided by your employer.
* **Learn about your specific plan.** Since each plan is different, you will need to make sure you know your plan details. You will receive a Summary of Benefits. This will be your guide to all of your plan specifics.
* **See provider for services.** Give your provider both your provided benefit ID card. Once you’ve received dental or vision services from a provider, they will bill your insurance. In some cases, you may have to pay out-of-pocket for expenses and then submit a claim for reimbursement.
* **Submit claims online!** Claims can be submitted online on the participant portal or through the mobile app. You will need a copy of your Explanation of Benefits (EOB) or receipt when sending your claim to Navia.
## Accessing Your Benefits
### Participant Portal
Get 24/7 access to your benefits with the our . Submit claims, view account balances and history, get alerts and notifications, and much more!
### Mobile App
Whether you’re at the doctor’s office or on vacation, the mobile app allows you to manage and access your benefits right from your smartphone! Available for iPhone and Android devices, the mobile app is a free-to-download and free-to-use tool for any Scheduled HRA participant.
### Vision Benefit Card
With our vision plans, we do not offer a network. You will receive an ASi/Navia Benefit ID Card and can go to any provider to receive vision services. Some vision providers choose to require payment up front for services, which means you will have to pay out-of-pocket upfront and then submit an itemized statement to ASi/Navia for reimbursement.
## Questions?
Call us at 866-777-1320 and ask to speak to a SPS representative.
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# Slide 1 For Employers / Brokers COBRAComplete health options for people who need it the most 
## How does it work?
Our full-service COBRA administration allows you to concentrate on your active employees without worrying about managing the open enrollment, premium billing, or carrier eligibility for your COBRA population. By providing our industry expertise and timely administration and pairing it with industry leading software, we’ve created an ideal solution for COBRA administration.
If your employee loses benefit eligibility either by employment termination, retirement, reduction in hours, or any other COBRA qualifying event, that employee becomes entitled to a continuation of benefits through COBRA. Within 45 days after the employee’s loss of coverage, the employee will receive a notice outlining their rights to COBRA continuation and their COBRA election notice allowing them to select the coverage(s) that they’d like to continue. The COBRA election notice will include all of the dates, deadlines, and rules for making an election. Using that information, the employee is able to make an election online or submit their election using the paper form included.
## Who is eligible to continue coverage through COBRA?
Employees, covered spouses or covered children all have rights to continue coverage under the COBRA continuation coverage rules. Each individual in the employee’s family is considered a qualified beneficiary. A qualified beneficiary is any individual who has experienced a loss in coverage and has an independent right to elect COBRA continuation coverage. This means that they can pick and choose between the available COBRA plans or decline COBRA continuation coverage in its entirety.
## Features
We offer a full-service solution that can handle every aspect of COBRA administration. Using the COBRAPoint™ system by Benaissance, the industry-leader in COBRA administration software, we deliver our clients a complete outsourcing solution that includes the following services:
* *Carrier notifications for reinstatement / loss of coverage*
* *All COBRA letters (General notice, QE notice, rate change letter, etc.)*
* *Premium remittance to client or carrier with premium payment reports*
* *Premium collection and tracking with partial premium payment rules*
* *Open enrollment services including carrier forms, rate tables, etc.*
## What types of reports are accessible?
The COBRAPoint™ System allows the employer to runs numerous reports, including, but not limited to:
* *Qualified Beneficiary Plan Member Summaries*
* *Paid Through Reports*
* *Remittance Reports*
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For Qualified Beneficiaries
COBRAContinue your terminated group insurance coverage
If you lose benefit eligibility either by employment termination, retirement, reduction in hours, or any other COBRA qualifying event, you become entitled to a continuation of your benefit through COBRA. Within 45 days after your loss of coverage, you’ll receive a notice outlining your rights to COBRA continuation and your COBRA election notice allowing you to select the coverage(s) that you’d like to continue. Your COBRA election notice will include all of the dates, deadlines, and rules for making an election. Using that information, you’re able to make an election online or submit your election using the paper form included.
Employees, covered spouses or covered children all have rights to continue coverage under the COBRA continuation coverage rules. Each individual in your family is considered a qualified beneficiary. A qualified beneficiary is any individual who has experienced a loss in coverage and has an independent right to elect COBRA continuation coverage. This means that they can pick and choose between the available COBRA plans or decline COBRA continuation coverage in its entirety.
## How long can my coverage last?
If you elect for COBRA continuation, the maximum amount of time that you can remain covered varies depending on the Qualifying Event. The standard length of coverage for most individuals is 18 months. Some states have longer lengths of coverage and each employer’s plan may provide longer periods of coverage beyond this range. Your specific coverage time-frame will be outlined in your specific rights notice.
## How do I make payments?
If you are choosing to elect COBRA coverage, you will receive payment coupons to submit with a check to pay for your COBRA premiums each month. Payments can also be made online for an additional fee. You can also make payments through ACH direct debit.
## When can I make changes to my coverage?
You can only make changes to your COBRA coverage during your insurance plans open enrollment period or with a qualifying event. However, if you would like to cancel your COBRA coverage, you can do so at any time. Once you’ve cancelled your COBRA coverage, you cannot reinstate that coverage.
## What are COBRA qualifying events?
Qualifying events are events that cause an individual to lose their benefit coverage. The type of qualifying event will determine who the qualified beneficiaries are and the amount of time that a plan must offer the health coverage to them under COBRA. A plan, at its discretion, may provide longer periods of continuation coverage.
Qualifying Events for Employees include:
* Voluntary or involuntary termination of employment for reasons other than gross misconduct
* Reduction in hours of employment
Qualifying Events for Spouses and Dependent Children include:
* Voluntary or involuntary termination of the covered employee’s employment for any reason other than gross misconduct
* Reduction in hours worked by the covered employee
* Covered employees becoming entitled to Medicare
* Divorce or legal separation from the covered employee
* Death of the covered employee
* Loss of dependent child status under the plan rules (Dependent Children Only)
## Still have questions?
Contact our  at 1-877-920-9675 or cobra@naviabenefits.com
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# Slide 1Benefits AdministrationWe deliver large provider technology with unparalleled customer service 
## What is Navia's Benefit Administration Solution?
Navia’s Benefits Administration Solution uses a cutting-edge technology platform to enroll your employees and engage them throughout their benefits journey. We deliver a fast, simple, and easy user experience. Most importantly, we work hard to remove administrative burdens for our clients. Many Ben Admin platforms have self-service modules, but we build upon the platform’s outputs to adapt to our client’s needs. We provide in-house administration for a full suite of benefit services and deliver a streamlined solution with one website, one dedicated service team, one call center, and one integrated user experience for employers and participants.
### We listen to you
**Avoid cookie-cutter solutions that don’t meet your needs.** Our nimble teams are willing to adapt to each client’s unique needs and provide exceptional support. We provide solutions to obstacles, share our best practices, and collaborate with your team to achieve your organizational objectives.
### White glove administration
**Eliminate administration burdens.** Our team handles many functions other vendors can’t or won’t. We reach out to your plan participants for Dependent SSN information, resolve ACA errors in real-time to avoid a year-end scramble, resolve complex situations like dual enrollments, track and resolve all carrier file issues, and much more!
### High-touch support
**Don’t wait in a long queue to get support.** When you need the Navia Team, you don’t submit a work ticket or get stuck in a work queue. Our team adeptly manages acquisitions and divestitures with tremendous flexibility and eleventh-hour changes.
### Data-driven for better decisions
**Stop guessing how to make your product better.** Analytics and trend data provide valuable insight into how employees are using their benefits and plans to help refine your benefit offerings and make strategic business decisions that align with your organizational goals.
* Mobile app with full enrollment capabilities
* Decision support tools with recommendation engine, side-by-side plan comparison, deduction calculator, and a multitude of different calculators covering investments, taxes, savings, and insurance topics
* Comprehensive communications–customized and targeted messaging
* AI Chatbot who acts as a personal benefits assistant. Chat is available 24/7 with conversational enrollment and many languages available
* Customized look and feel with company branding
* Enrollment (custom/configured platform for New Hires, OE, and Life Event/Status Changes)
* Eligibility data management
* COBRA management
* Full ACA suite – tracking, timely notifications, and reporting
* Call center support with Sofia AI Chatbot
* Consolidated monthly carrier/vendor billing
* File import/export dashboard & payroll compare
* Total Compensation Statements
* Payroll deduction/closed loop payroll
* Dependent Life Verification – EOI
* Document storage and delivery
## User Experience
### Smart technology for a better benefit experience.
We know well-designed technology can make administering your benefits easier and improve employee satisfaction.
* Enroll or change your benefits on the mobile app, easily keep track of action items and deadlines, upload documents, and even add your ID Cards for quick use!
* Our recommendation engine and decision support tools engage your employees and guide them to better outcomes with a personalized user experience
* A personal benefits assistant is available 24/7 in many languages
### Unparalleled service, no matter where you are.
Navia serves 7,000+ employers across all 50 states. We have 30 years of experience serving the benefits industry and we are committed to providing unparalleled service to our brokers, employers, and participants.