Self Funded Guide. 326 East Coronado Road Phoenix, Arizona

Transcription

1 Arizona Foundation for Medical Care (AFMC) was founded in 1969 as a not-for-profit organization by a group of 800 physicians from the Maricopa County Medical Society that believed there was a better way to create and manage a healthcare network in Arizona. Today, AFMC has grown into Arizona s largest, statewide independent healthcare network. AFMC realizes no two companies are the same; each employer needs a solution customized to their specific needs. This flexibility enables AFMC to offer the most cost-effective, highly accessible, quality healthcare and network options to individuals, families or businesses. AFMC also offers a comprehensive package of Medical Management services that include Population Health Management (Utilization, Case and Disease Management, 24-hour Nurse Care Line and Maternity Management) and a Lifestyle and Wellness Program. AFMC s network includes more than 13,000 professional providers in 30,000 locations throughout Arizona and border states, as well as a comprehensive contracted network of hospitals, laboratories, outpatient surgical facilities, urgent care facilities, radiology centers, and other ancillary facilities. Self Funded Guide The strength and integrity of the Arizona Foundation for Medical Care (AFMC) is proven by 40 years of experience. AFMC offers complete, fully integrated network solutions where Access to Healthcare Services, Cost Competitiveness, and Quality Healthcare come together to create superior value in the Arizona marketplace. AFMC s unique difference is that we do not offer benefits nor act as a benefit administrator. instead, AFMC works directly with brokers, consultants, general agents, third party administrators, and insurance companies to provide Arizonans the freedom of choice by endorsing a variety of healthcare solutions some of which are listed in this Guide. This flexibility enables AFMC to offer the most cost-effective network options to fit the needs of individuals, families and businesses. How to use this Guide: If you are an Employer seeking information and/or quotes on AFMC Self-Funded Endorsed Plans, please contact the companies listed in the column for assistance. Or, you may contact AFMC s Marketing and Network Management Department at ; by to marketing@azfmc.com; or via the Web site AFMC will arrange to have an insurance representative contact you. If you are an Insurance Professional seeking information and/or quotes on AFMC endorsed Self-Funded Group Plans, please contact the companies listed in this Guide for assistance. Please note: This is not an inclusive list. If you are interested in placing your company in this guide, or would like further information, please contact AFMC s Marketing & Network Management Department at or by marketing@azfmc.com. To find out more how AFMC s networks can impact you or your client s business, and for a no-obligation cost savings analysis, call AFMC Senior Sales Consultants: Judi Hayer direct: or jhayer@azfmc.com Larry Dennis, RHU direct: or ldennis@azfmc.com 326 East Coronado Road Phoenix, Arizona marketing@azfmc.com

2 For Information or Quotations, Please Contact the Companies Listed Below Advanced Benefit Solutions (ABS) Michele Terzich Phone: (623) Fax: (623) ABS provides full third party claims administration services for single employer, self-funded, and self-insured employee benefit plans. ABS assists with plan design and works with Reinsurance Carriers to secure the most favorable rates. Allied Rob Valerious Phone: (800) Allied is a national health solutions company providing a wide range of medical, dental, FSA, COBRA and government compliance services to health and welfare plans throughout the United States. AmeriBen/IEC Group Jon Aubrey Phone: (801) ext jaubrey@ameriben.com AmeriBen administers medical, dental, vision and STD plans for self-funded employers, medical administration for fully insured student plans, COBRA and HIPAA administration along with FSA, HRA and HSA administration. America s TPA Jean LaFavor Phone: (952) Fax: (952) jean.lafavor@americastpa.com America s TPA has more than 25 years experience in the healthcare industry. They are leaders in administering consumer-driven and wellness-centric plans for self-funded employers, which has resulted in minimal cost increases. They provide a consolidated statement and medical payment service to members through HealthEZ. Arizona Benefit Plans, Inc. Mike Hoffman Phone: (800) or (602) Fax: (602) azben@azben.com Delta Health Systems Richard Roge VP, Sales & Marketing Phone: (714) Fax: (209) rich.roge@delapro.com Employee Benefit Management Services, Inc. (EBMS) Sandra Hartman, RHU, Regional Sales Manager Phone: (406) ext Fax: (406) shartman@ebms.com Self-Insurance; Reliable Claims Technology; Individual Policy Purchasing, EDI - Electronic Claims Payment; Quality Services; Delta TeamCare - Risk Identification, Disease Management, Case Management, and Utilization Management; Delta Direct - Administration of consumer directed products; Delta DataMart - Online reporting tool. EBMS offers medical, dental, vision, flexible spending, HSA, HRA, disease management, wellness, COBRA, HIPAA, proprietary PPO and LTD (for single employers), Multiple Employer Welfare Arrangement (M.E.W.A.), association plans, government sponsored, fully-insured, and proprietary stop-loss products. 1

3 For Information or Quotations, Please Contact the Companies Listed Below Gilsbar, Inc. Mark Thurston Phone: (480) Toll Free: (800) Fax: (480) Third Party Administration; Medical, Dental, Vision, COBRA, Utilization Review, Medical Management, Disease Management, and Wellness Programs. HealthNow Administrative Services (HNAS) Matthew J. Cooper Phone: (623) Fax: (623) HealthNow Administrative Services (HNAS) is one of the nation s leading administrative services organizations offering innovative strategies to meet any plan sponsor s group benefit objectives. As an affiliate of HealthNow New York, Inc., parent company of BlueCross and BlueShield of Western New York and BlueShield of Northeastern New York, HNAS has unparalleled access to resources with the capacity to provide superior administrative and outsourcing services that deliver integrated and creative benefit solutions. HNAS offices are located in Arizona, Kentucky, Massachusetts, Pennsylvania and Texas. IHC Administrative Services, Inc. Brad Waldrop Phone: (602) Fax: (602) waldropb@iacusa.com Insurer s Administrative Corp. offers Medical; Dental; Life; Limited Benefits; Short Term Medical; Self Funding; and Hour Bank administration. The Loomis Company Bill Bixler Phone: (610) x2439 Fax: (801) bbixler@loomisco.com Full array of TPA services; Custom Proprietary Enrollment System; Custom Reports; Low Admin Fees. Mayo Clinic Health Solutions (MMSI) Scott Scherkenback Phone: (480) Fax: (480) scherkenback.scott@mayo.edu Mayo Clinic Health Solutions works with more than 600 employers, health plans, and member organizations to provide Web, telephonic and print population health management resources to employees and members. PreferredOne Administrative Services, Inc. Phone: (763) Fax: (763) PreferredOne offers a full range of products, services, and networks to brokers, employers and members. These include self funded and fully insured products. Professional Benefit Services, Inc. Mabel LaChappell Phone: (602) Fax: (602) mlachappell@pbsfbs.com 2 Third Party Administrator (TPA) for self funded health plans, pension, annuity, HRAs, FSA, Vacation, Dental, Vision, Cobra, STD, LTD for single or multi-employers/or health plans.

4 For Information or Quotations, Please Contact the Companies Listed Below Tall Tree Administrators, LLC Michael Ward or Mark Wade (602) Fax: (602) Tall Tree Administrators is a Utah based, privately held third party administrator that offers medical and dental claims administration, stop-loss placement, cafeteria, FSA, HRA, HSA, COBRA and HIPAA administration. Our state-of-the-art, web-based systems are dynamic and adaptable to allow for unlimited plan designs and tailored reporting packages with online tools for enrollment and H.R. and member ease of use. Trustmark Companies: Small Group Starmark Phone: (800) ext Fax: (847) Arizona Benefit Plans, Inc. Phone: (800) or (602) Fax: (602) azben@azben.com Insurance Network America, Inc. Phone: (800) or (208) Fax: (208) Starmark is a distinguished leader in small group healthcare benefits. By offering flexible health plans, unparalleled personal service, innovative, paperless employee enrollment, comprehensive health and wellness management tools, nationwide network access, and seamless HRA administration, Starmark is the choice to meet the diverse needs of small businesses today. Trustmark Life Insurance Company, Lake Forest, Illinois, insurers Fully Insured Plans and provides Stop-loss Insurance for the self-funded market in the Starmark portfolio. Plan availability and/or coverage may vary by state. Western Region Sales Office Trustmark Life Insurance Company Phone: (888) or (208) Fax: (208) Trustmark Companies: Associations Trustmark has more than 50 years experience serving the healthcare benefit needs of associations. Contact George Michelic for more information. Phone: (847) george.michelic@trustmarkins.com Trustmark Companies: Large Groups Trustmark Group Benefits, a division of Trustmark Life Insurance Company Arizona Benefit Plans, Inc. Phone: (800) or (602) Fax: (602) azben@azben.com Trustmark Group Benefits, an operating division of Trustmark Life Insurance Company, delivers health, prescription drug, dental, life and disability coverage to companies with 100 or more covered lives. Health plans are underwritten by Trustmark Life Insurance Company or Trustmark Insurance Company, Lake Forest, Illinois. Plan availability coverage by vary by state. 3

5 For Information or Quotations, Please Contact the Companies Listed Below Trident Plan Administrators Peter Ranke or Pauline Doherty (602) Fax: (602) Trident Plan Administrators is a full service third party administrator for employer self-funded employee health benefit plans. They process, adjudicate and handle all aspects of medical, dental and vision claims, and can arrange for and coordinate network placement, utilization review, case management, disease management, stop loss/reinsurance placement and claims filing. Trident can also assist with plan design and SPD preparation. Trident also offers COBRA/ HIPAA and Section 125/FSA services. 4 Last updated 3/4/11

6 Arizona Foundation for Medical Care (AFMC) was founded in 1969 as a not-for-profit organization by a group of 800 physicians from the Maricopa County Medical Society that believed there was a better way to create and manage a healthcare network in Arizona. Today, AFMC has grown into Arizona s largest, statewide independent healthcare network. AFMC realizes no two companies are the same; each employer needs a solution customized to their specific needs. This flexibility enables AFMC to offer the most cost-effective, highly accessible, quality healthcare and network options to individuals, families or businesses. AFMC also offers a comprehensive package of Medical Management services that include Population Health Management (Utilization, Case and Disease Management, 24-hour Nurse Care Line and Maternity Management) and a Lifestyle and Wellness Program. Reinsurance Carriers Working with Arizona Foundation for Medical Care More Information and Quotes To find out more how AFMC s networks can impact you or your client s business, and for a no-obligation cost savings analysis, contact AFMC Senior Sales Consultants: Judi Hayer direct: or jhayer@azfmc.com Larry Dennis, RHU direct: or ldennis@azfmc.com Please note: This is not an inclusive list. If you are interested in placing your company in this guide, or would like further information, please contact AFMC s Marketing & Network Management Department at or by marketing@azfmc.com. AFMC s network includes more than 13,000 professional providers in 33,000 locations throughout Arizona and border states, as well as a comprehensive contracted network of hospitals, laboratories, outpatient surgical facilities, urgent care facilities, radiology centers, and other ancillary facilities. 326 East Coronado Road Phoenix, Arizona marketing@azfmc.com

7 Reinsurance Carriers Working With AFMC Please Contact the Companies Listed Below for More Information Benefit Dynamics, LLC Richard Anderson Phone: (719) Fax: (719) Stop Loss Intermediary HCC Life Insurance Company Holgate Dean Phone: (714) Fax: (972) HCC Life Insurance Company has been an industry leader in the medical stop loss market for over three decades. They have outstanding ratings such as A+ by A.M. Best Company; assets of over 8 billion; and are traded on the NYSE, symbol HCC. HM Insurance Group Steve C. Atkinson, CEBS, Regional Sales Director Phone: (602) Fax: (602) steve.atkinson@hminsurancegroup.com As a leader in Stop Loss for nearly three decades, HM Insurance Group puts a high value on protecting companies from catastrophe. Utilizing our strength and experience in employee benefits, we have created a connected portfolio of products to deliver Health Risk Solutions. Current product portfolio includes: Stop Loss; Worksite Critical Illness, Accident, and Disability income; and Limited Benefit Medical. ING Employee Benefits Adam Bessette Phone: (602) Fax: (602) adam.bessette@us.ing.com ING offers both Specific and Aggregate Stop Loss Insurance to groups of 250 employees or more, with a minimum spec level of $75k. International Specialty Underwriters/ Companion Life Tom Thompson Phone: (480) Fax: (904) tthompson@isu-inc.net ISU provides self funded proposals through Companion Life, an A+ carrier. ISU partners with their clients by offering competitive pricing and services such as large claims consulting on dialysis, transplants, and premature deliveries. Intermediary Insurance Services, Inc. (IISI) Jim Henry Phone: (415) Fax: (415) jim_henry@iisinet.com IISI is a full service Managing General Underwriter (MGU) of employer stop loss for groups of 50+, representing QBE Insurance Company and American National Life Insurance Company of Texas. Headquartered in San Francisco, IISI has been providing quality MGU services since

8 Reinsurance Carriers Working With AFMC Please Contact the Companies Listed Below for More Information Medical Excess Michael Hopkins Phone: (415) Fax: (415) Medical Excess provides catastrophic health care risk solutions to organizations that are at risk for the health care of their members. We distribute our Employer Stop Loss and first-dollar Organ Transplant products through a select number of qualified Claims Administrators and Brokers. Montgomery Management Corporation Carrie Staab Phone: (800) Fax: (215) cstaab@montmgmt.com Montgomery Management Corporation (MMC) is a managing general underwriter of employer stop-loss coverage. MMC has been in this business since They provide a full range of services including underwriting, policy binding, contract issuance, premium collection and claims payment. In additin to stop-loss, they offer Life, AD&D, STD and LTD coverage. They are a wholly-owned subsidiary of COmpanion Life Insurance Company. Montgomery Management s staff is known for its excellent customer service and responsiveness. Our goal is to be flexible in accommodating the needs of their partners. MMC ensures the entire process of underwriting, premium remittance, contract issuance and claims payment is done in an efficient and timely manner. NorthWind, LLC Douglas Thomas Phone: (610) ext Fax: (610) dthomas@northwindllc.com NorthWind, LLC is a full service Managing General Underwriter of various specialty insurance products. Since its 1997 inception, NorthWind has written over $200 million of premium with insurance companies rated Excellent by AM BEst across 40 states. In addition to its underwriting services, the company provides specialty brokerage services in both employee benefit and property/casualty spaces. Outsource Marketing Strategies, Inc. Cindy Lee Rottmann Phone: (480) Fax: (480) cindyr@oms.inc.net Outsource Marketing Strategies, Inc. provides self-funded services to Consultants and TPAs nationwide since They are a behind the scenes marketing and services company representing a variety of stop loss companies and managed care vendors. They provide additional market access, stop loss enrollment, technical support and renewal management. This leaves the Broker/Consultant to oversee the entire process for your client and know someone else is sweating the details on the stop loss piece. They are your Easy Button. Consider Outsource Marketing Strategies for your self-funded renewals and prospects over 30 employees. R.E. Moulton Inc., Staci O Toole Phone: (650) Fax: (650) staci_otoole@remoultoninc.com Products and Services: R.E. Moulton Inc. offers affordable premium rates, alternative funding arrangements and competitive producer compensation. R.E. Moulton s medical stopp loss insurance products are issued by AUL, a OneAmerica company and exclusively marketed and administered by R.E. Moulton. 7

9 Reinsurance Carriers Working With AFMC Please Contact the Companies Listed Below for More Information Risk Assessment Strategies Pat Vignone lll Phone: (860) Fax: (860) Risk Assessment Strategies is a full service Managing General Underwriter providing Medical Stop Loss to employer groups who self-fund their medical benefits. Swiss Reinsurance Company Matt Leming Phone: (913) Fax: (913) matt_leming@swissre.com Direct writer of Employer Stop Loss coverages - Specific and Aggregate Stop Loss. Since 1975, Swiss Re s Medical Expense Group has protected self-funded employers against catastrophic and unpredictable losses with a variety of innovative and creative Employer Stop Loss Programs. Symetra Life Insurance Company Arizona Benefit Plans, Inc. General Agent Steve Hoffman Phone: (602) Fax: (602) Symetra Financial offers life, disability, limited medical coverages, and stop-loss insurance. The Symetra contract and claims paying ability are the cornerstone of their commitment to the stop-loss business. Zurich North America Customer Inquiry Center Zurich North America 1400 American Lane Schaumburg, IL info.source@zurichna.com Phone: Offering operational and financial discipline, coupled with a strong capitol base. Zurich retains 100 percent of the risk, so all claims decisions are made in-house and paid quickly. Their contract is easy to read and does not include actively at work, pre-existing condition limitations, or self inflicted injury limits to provide continuity with typical plan language. They offer a No Laser and Limited Rate Increase Renewal Option, which allows customers to accurately forecast a maximum renewal increase, and offer a step down deductible when their Interlink transplant network is accessed. Also offering a fully insured organ transplant carve out product. 8 Last updated 3/4/11