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Help Members Maximize Their Benefits

Help members maximize their benefits with instant access to claims records and coverage details across every health plan

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Why do you need data on benefits utilization?

Track Spending in Real-Time

Real-time accumulator tracking provides precise monitoring of deductibles, out-of-pocket maximums, and other cost-sharing elements. This ensures both employees and employers understand their current financial positions, enabling better forecasting of employer liability and timing of when plan members will hit coverage thresholds.

Design Better Plans with Real Data

Detailed claims pattern analysis helps identify most-utilized providers and services, supporting data-driven decisions about network design and benefit structure. This intelligence can inform mid-year adjustments and future plan year strategy.

Monitor Healthcare Spending Live

Real-time visibility into claims data enables organizations to track healthcare expenditures as they occur, rather than waiting for quarterly reports. This allows for proactive cost management and early identification of emerging utilization trends that could impact annual budgets.

How do you currently get benefits utilization info?

Source	Data available	Limitations
TPAs/Insurance Carriers	Claims reports provide detailed healthcare service utilization and cost data for employee medical claims.	Data arrives with significant delays of 60-90 days, making timely analysis impossible. Reports come in inconsistent formats across different carriers, requiring extensive manual work to aggregate and standardize the information.
Benefits Administrators	FSA and HSA usage data shows employee spending patterns for qualifying medical expenses through their flexible spending and health savings accounts.	Data is restricted to specific spending account transactions only, missing crucial information about broader healthcare claims and provider interactions. The limited scope prevents comprehensive analysis of total healthcare spending and utilization patterns.
Benefits Consultants	Utilization reports offer analyzed summaries of benefits usage and spending trends across the organization.	Reports are only available quarterly or annually, making them purely retrospective tools. The delayed nature of these reports makes it difficult to implement timely program adjustments or address emerging issues proactively.
HR Departments	Employee surveys collect direct feedback about benefits usage, preferences, and satisfaction levels from the workforce.	Survey data relies on employee self-reporting, which is often incomplete or inaccurate. Response rates tend to be low, and the information does not capture actual claims data or precise utilization patterns.

Flexpa can plug these gaps in information

Flexpa provides instant access to claims records with 93% of data retrievals completed in under a minute. Get immediate access to complete Explanation of Benefits (EOBs) and adjudicated claims data, enabling real-time expense validation and automated reimbursement processing.