If you have decided to consider a self-insured level funded health plan for your business, you’ve made a smart decision. However, an important part of having a self-insured level funded plan is choosing the right Third Party Administrator (TPA).
Choosing a TPA Over a Carrier
Traditionally, TPAs are known for white glove service. They are in the business of customizing service and plan designs to meet the needs of each client. Insurance carriers administer self-insured level funded plans and fully insured level funded plans the same way. To them, the only difference is the financial aspect. This is why employers favor TPAs for their self-insured level funded plans.
There are a myriad of other reasons to choose a TPA:
- Group Size: Most insurance carriers will not provide self-insurance administration for groups under 500 people. This has led to a misconception that self-insurance is for larger groups. A good TPA, like Insurance Administrator of America, has created self-insured plans for as low as 35 lives.
- Savings: Be wary of the carrier or TPA that credits your account with a percentage of your savings. The employer should always keep 100% of the savings.
- Select a TPA that provides 24/7 access to your claims data. The broker and employer should have access to data and standard reporting at all times.
- Shell game: Some carriers present level funding as a new, exciting product, when it is nothing more than a funding method. The employer always has the option of paying for claims as they are incurred or paying a fixed amount (level funding).
- TPAs are the self-insurance level funding experts because that’s all they do. TPAs think outside the box, the type of creative thinking that leads to savings.
Of course the best benefit of all with a TPA is more money in the employer’s pocket.
How to Choose a TPA
When choosing a TPA there are many factors to consider:
- Years of existence/experience
- Funding options: Traditional and level funding
- Savings: Make sure your savings don’t turn into a TPA surcharge
- Education of staff
- Claims risk: Your TPA should be able to clearly estimate the maximum claim liability of your plan and provide multiple stop loss insurance policy limits and health plan design options to help lower the overall claims risk for the health plan.
- E&O insurance and bonding
- Claims system flexibility
- Internet capabilities
- Claims turnaround
- PPO re-pricing and UM
- Stop loss administration
- Termination: Even if and when you terminate with a TPA, claims that were incurred during the health plan year, but received after the termination date of the contract, should be managed by the TPA. Your TPA should be able to help manage payments for terminal liability costs easily, as well as provide accurate estimates of what terminal liability costs will be.
How IAA can Help
IAA has been a TPA for over 20 years. Our knowledgeable and dependable staff has been in the insurance business for over 20 years as well. IAA prides itself on being able to offer employers and brokers a personalized experience that comes with great advantages. As your TPA, IAA can offer:
- Access to multiple stop loss carriers so IAA can provide the one that works best for your business
- Employee web portals so they can keep track of their claims information
- Experienced, expert plan administration
- Reports that will help you keep track of your savings goals
- And so much more!
If you are interested in learning how IAA can become your TPA please reach out! You can reach IAA by phone at 856-470-1200. Remember, with IAA one call does it all.
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The Affordable Care Act (ACA) has created a multitude of questions and increased carrier rates. Employers want to know how their health plan is being managed and utilized, and what changes they should make (and be aware of) in the coming years.
Self-Insured Level Funding and the ACA
Self-insurance offers employers traditional and level funding options. Regardless of which funding option an employer chooses the results are the same, savings! Level Funding is not a product it is simply a funding option. Insurance Administrator of America has been offering traditional and level funding options for 20 years. Our clients decide on the funding option that works best for them. Some prefer to pay as they go and some want to make the same payment each month, either way they experience 100% of the savings.
- Monthly Administrative Fee: This is your fixed cost and paid monthly based on the employee count.
- Traditional Claim Funding: Pay for claims as they are incurred, this allows the employer to keep his money in the bank until it is needed.
- Level Claim Funding: Pay a monthly fixed amount for claims. This option feels more like a fully insured plan, which is comfortable for some employers.
With access to the IAA web portal, brokers and employers will be armed with information and knowledge that allows you to design the right health plan for now and in the future. With IAA, you can be sure that your health plan is ACA compliant.
IAA’s Affordable Care Solution
IAA is offering employers a solution designed to meet the ACA requirements. Our “Affordable Care Solution” (ACS) plans can save an employer up to 60% in healthcare costs and fulfill the employer ACA obligations.
- Platinum (IAA ACS National Network Plan): This plan option meets the ACA minimum value requirement; this plan design is for the employee looking for a buy-up option.
- Gold (IAA ACS National EPO Network Plan): This program option also meets the ACA minimum value requirement; this plan design has in-network benefits only and is for the employee looking for a buy-up option.
- Silver (IAA ACS Regulated Payment Plan): This option meets the ACA minimum value and affordability (9.5% of the employees W-2 salary for single coverage) requirements. It provides the employer with a very affordable plan for employees on a limited budget. This program mitigates the employer’s risk and cost by limiting provider payments.
- Bronze (IAA ACS Minimum Essential Coverage Plan):This preventative only coverage plan does not meet the ACA minimum value requirement. It can be offered with one of the above options as it meets the minimum essential coverage requirement of the ACA.
If you are interested in learning more about IAA, call 856-470-1200 and ask to speak with one of our ACA self-insurance experts.
Insurance Administrator of America has been working with businesses to create Level Funded Self Insured health plans for over twenty years. Learn how IAA can help the life of your business.
What is Level Funding?
You may be surprised to learn that level funding is not a new self-insurance concept, only the term “level funded” as a label is new.
All self-insured plans have an expected and maximum cost which is provided during the quoting process. Level funding in its simplest terms is nothing more than funding the maximum plan cost each month.
Level funding offers employers:
- Preset monthly payments based on your maximum plan cost.
- Payments that do not fluctuate based upon claims experience
- Savings: At the end of the plan year the employer keeps 100% of the savings.
How Level Funding can Help Your Business
Not sure what your healthcare dollars are being spent on or where the money is going? With a self-insured level funded plan, you’ll always know exactly how your healthcare dollars are being spent. IAA provides access to detailed reporting:
Monthly Aggregate Report will allow you to take an active role in plan administration
- The IAA web portal allows 24-7 access to utilization reports detailing trends in spending (such as overuse of emergency services or out-of-network services), which allows you to identify education opportunities for maximum savings
- 100% of employers’ unused funds are returned to the employer. Many carriers’ level funded plans keep up to 50% of unused funds.
Self-funding allows you to make sure your plan design fits and grows with your employee base by:
- Creating a plan that fits your business and employees’ needs
- Having the ability to change your plan based on the utilization
The best part is that employers can:
- Maintain the level funded payments they have with fully insured plans
- Benefit from the savings by putting money back into their pockets
IAA’s Self Insured Level Funded Benefits
Self-funded benefits that are already included with level funding are:
- Avoiding state-mandated benefits: Self-funded plans are governed only by the Federal Employee Retirement Income and Security Act (ERISA), not by the individual states. You decide which benefits to include in your plan. This greater flexibility can help save you money.
- Maximize healthcare dollars: Self-funding allows you to have more control over your benefits; budget and your savings can be used however you choose.
- Provider network options: One size rarely fits all! IAA has access to many different provider networks throughout the country. Our level funding programs get the best provider coverage and the best network discounts for the employer.
- Providing a uniform benefits program in multiple states: Self-funding allows you to offer the same benefits program to employees in all states.
- Reducing premium taxes: Self -insured plans are not subject to taxes.
- Stop-loss coverage: IAA offers employers access to multiple A+ stop-loss carriers to ensure their business is protected from catastrophic claims. Many level funding carrier options only offer one stop-loss option.
Working with IAA comes with many other benefits as well:
- Dedicated customer service line: Each customer service representative is assigned to a client, allowing them to know the ins and outs of you company’s plan.
- Health and wellness education support: IAA will assist you in designing a Wellness Program to fit the needs of your workforce.
- Interactive online resources: IAA’s online portal allows members to access their information at anytime. Members can now access their information on the Member Mobile App as well, which is available through Google Play, the Apple App Store and the Windows Store.
If you are interested in learning more about level funding or self-funding, please reach out. You can give IAA a call at 800-220-8503. Remember, with IAA one call does it all.
Summer is nearly over, which means it’s almost time for kids to go back to school. Going back to school can also mean it is time for your child to get vaccinated.
Your Child’s Vaccinations
The best way to protect your children from vaccine preventable diseases is to vaccinate them. It sounds simple enough, but there are many questions that arise with vaccines, among them: Which vaccines does your child need? When does your child need to be vaccinated? Which diseases do vaccines protect against?
So what vaccinations do your children need before they head off to the school playground?
From the ages of four to six, your child may need a dose of the:
- DTaP vaccine
- Hepatitis A: This would be the first dose that your child would receive.
- Measles, mumps, rubella (MMR) vaccine
- Polio vaccine
- Varicella (chicken pox) vaccine
While the above can be given between the ages of four and six, the majority of them should be given earlier, starting around a year old.
From the ages of 11 to 12 years old, the following vaccinations are recommended:
- Hepatitis B vaccine: This three shot vaccine course is recommended for adolescents who did not receive it as part of their childhood vaccinations.
- Human Papillomavirus (HPV) vaccine
- Meningococcal vaccine (MCV 4): The Centers for Disease Control recommends that adolescents receive this vaccine during their 11 to 12 year old check up or when they enter high school or college.
- Tetanus-diphtheria-pertussis (Tdap) vaccine: Adolescents ages 11 to 18 should receive one dose of this vaccine.
School-age children, from preschool to college, need to be vaccinated. Making sure that children of all ages receive their vaccinations on time is one of the most important things you can do as a parent. Vaccinations can help ensure your children’s long-term health, as well as the health of friends, classmates and others in your community.
If you’re unsure of your state’s school immunization requirements, now is the time to check with your child’s doctor, your child’s school or your health department. That way, you can get your child any vaccinations he or she needs before the back-to-school rush.
The Need for Vaccinations
It’s true that some vaccine preventable diseases have become very rare. However, outbreaks still happen. In fact, since certain diseases crop up so rarely, parents sometimes ask if vaccinations are even necessary anymore. This is just a common misconception about vaccinations. The truth is most diseases that can be prevented by vaccines still exist in the world, even in the United States.
Without vaccines, your child’s body will not be prepared to fight the illness. Vaccines work by preparing a child’s body to fight illnesses. Each immunization contains either a dead or weakened germ (or parts of it) that causes a particular disease. The body practices fighting the disease by making antibodies that recognize specific parts of that germ. This permanent or longstanding response means that if someone is ever exposed to the actual disease, the antibodies are already in place and the body knows how to combat it, and the person does not get sick. This is called immunity.
Parents who choose not to vaccinate their children increase the risk of disease not only for their children, but also for other children and adults throughout the entire community.
What IAA has to Say
Immunizations have protected millions of kids from potentially deadly diseases and have saved thousands of lives. Insurance Administrator of America wants to make sure your kids are ready to go back to school. Getting your children vaccinated against diseases is important not only for them, but for the community as well. Check with your child’s doctor to make sure that they are up-to-date on their vaccinations. Just think of IAA as your self-funded back-to-school helper.
Spending quality time with a dog, cat or other animal can have a positive impact on your health.
More to Pets Than Meets the Eye
A pet is certainly a good friend. In fact, nearly 25 years of research has shown that living with a pet provides certain health benefits. Pets can help provide their human friends with:
- A healthier heart: Your dog could help you avoid heart disease. This is because dog owners walk more and have lower blood pressure than people who don’t have dogs. Pets can also be good for you if you already have heart problems. Heart attack survivors and people with serious abnormal heart rhythms who own dogs live longer than people with the same heart problems who don’t have pets.
- Stress soothers: Petting your dog or cat not only feels good, it’s good for you. It can lower your blood pressure, help your body release a relaxation hormone and cut down on levels of a stress hormone.
- Social magnets: Pets, especially dogs, can help you connect with other people.
- Better mood, more meaning: People with pets are generally happier, more trusting and less lonely than those who don’t have pets. They also visit the doctor less for minor problems.
- Social support for autistic children: Kids tend to relate better to their classmates who have autism when pets are in the classroom.
Pet ownership has physiological, psychological and social advantages.
Children and Pets
Exposure to animals early in life helps “train” the immune system. There is reason to believe that germs, such as those associated with dogs, may be good for children’s health.
In fact, babies raised in families that have pets may be less likely to have allergies and asthma. Babies with dogs or cats at home have fewer colds and ear infections during their first year than babies living in pet free homes.
Man’s Best Friend
Besides being cute and cuddly, dogs can provide owners with better health. Dogs can help their human counterparts with their:
- Anxiety: A study found that hospitalized patients with mental health issues, who underwent therapy with animals, reduced their anxiety levels more than conventional recreational therapy sessions.
- Cardiovascular health: A study published in the American Journal of Cardiology found that male dog owners were less likely to die within one year of having a heart attack than those who did not own a dog.
- Loneliness: Dogs function as important companions and family members, but certain groups may benefit more than others. The elderly, particularly those in residential care facilities, often become socially isolated once separated from immediate family. Dogs seem to improve the well being of residents by promoting their capacity to build relationships.
Like any enjoyable activity, playing with a dog can elevate levels of serotonin and dopamine—nerve transmitters that are known to have pleasurable and calming properties. There are so many ways that Fido can help your health!
What IAA has to Say
Insurance Administrator of America wants you to thank your pet for helping you in the health department. Give them a treat or an extra belly rub as a way to say thank you for all they do for your mental and physical health. Don’t have a pet, but want to improve your health? Look into IAA’s wellness program. Remember, with IAA one call does it all.