Wednesday, January 26, 2011

#Health3 StrategicPartnerships with Third Party Administrators for HRA/HSA

 Conference in Orlando Florida.
Here is the session outline: 

Explore Challenges and Opportunities with StrategicPartnerships with Third Party Administrators for HRA/HSA
This session will explore the challenges and opportunities for sending eligibility and/or claims files to TPAs. Health Plans are seeing a significant increase in requests from independent TPAs as well as broker-owner TPAs for claims and eligibility data files to provide a competitive edge. The session will address both strategic as well as technological challenges and limitations. The following issues will be explored during the session:

  • Pros and cons of Exclusive versus Preferred strategic relationships
  • Challenges with file exchanges in terms of provider and member level
  • Co-marketing, co-branding or private labeling
  • Limitations of debit cards and the impact on product designs

Scott Polansky 
Director of Product Management

Harvard - 1.1M members in MA, NH, ME & RI. Ranked #1 customer satisfaction and Clinical Quality from NCQA.

National - 2010 - $7.7B in 5.7m HSA/HRA accounts. Average balance = $1,355 down from $1,420 in 2009.

Average percentage of Premium paid by covered workers has jumped significantly in 2010 ( 27% to 30%  for Family coverage)

Brokers are purchasing their own software to administer HRAs or demand that data is sent to their preferred TPA.

Lessons learned: 
- Can't please everyone. 
- Each vendor relationship comes with overhead
- Consider charging a setup fee to TPAs and brokers
- Understand and communicate how each vendors processes and service models work (communicate internally and externally)
- Accounts are complex especially when handling HRA and FSA
- Need dedicated support staff

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