The Challenge
A client received a demand letter from the Centers for Medicare & Medicaid Services (CMS), holding them liable for over $100,000. At issue: a coverage dispute over whether Medicare or the employer group plan should have been the primary payer, dating back to years when Pancoast wasn’t even their broker of record.
How Pancoast Helped
With limited historical documentation and no support from their prior broker, the client turned to us in a moment of urgency. By aggregating payroll data with historical reports and cross-referencing employee counts, we were able to recreate the data CMS needed, accurately and comprehensively.
Results
- CMS accepted the documentation
- The $100,000+ liability was cleared
- The employer was no longer held responsible
Unexpected Wins
We were able to reconstruct employee headcount data from a time when we weren’t even managing their benefits, giving the client the clarity and documentation they lacked internally.
Why It Matters
The owner was deeply appreciative, not only for the outcome but for the willingness of the Pancoast team to step in and solve a problem that predated our involvement. It turned a potentially devastating liability into a non-event.
Our Impact
Even when we’re brought in after the fact, Pancoast shows up with diligence, expertise, and a commitment to advocacy. We’re here to solve problems — past, present, and future.
Need Help Untangling a Compliance Issue?
We don’t just manage benefits, we solve problems — even ones we didn’t create.