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
information - Co-marketing, co-branding or private labeling
- Limitations of debit cards and the impact on product designs
Scott Polansky
Director of Product Management
HARVARD PILGRIM HEALTH CARE
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
