Personalized solutions from CCStpa. Making your job easier

Transcription

1 Personalized solutions from CCStpa Making your job easier

2 Personalized solutions delivering results In today s health care marketplace, finding health plan solutions that are personalized for your clients needs can be a challenge. As one of the largest third party administrators (TPA) in the Midwest, CCStpa understands unique self-insured employers and has the solutions to deliver what your clients need. Since 1982, our TPA has helped businesses improve the health of their population and manage costs through personalized solutions. Solutions designed for each client With CCStpa, your clients have the flexibility to select the benefits they want and the administration they need. Customizable health and wellness options to support your clients health goals Collaboration with a TPA who will support and integrate with you and your clients preferred and other best in class vendors Flexible tools and services you and your clients need 30 YEARS EXPERIENCE IN SELF-INSURED THIRD-PARTY ADMINISTRATION MEDICAL ADMINISTRATION FOR MORE THAN 300,000 LIVES PROCESSING AND INTEGRATION EXPERTISE FULL SERVICE TO SHARED ADMINISTRATION

3 CCStpa is client-centric Our service team gets to know you and your client. We work to understand your clients health plan, business and culture while making the members health care needs a priority. You and your clients will receive highly personalized, quality service from onboarding to account management. CCStpa RECEIVED A NET PROMOTER SCORE (NPS) OF 50, WHICH IS NEARLY 30 POINTS HIGHER THAN THE COMPETITIVE AVERAGE. Our implementation team will work closely with you and your clients to create innovative solutions around plan design, administration and preferred vendor integration. We also take into consideration the unique health care markets in which they operate to help optimize claims performance. Throughout the on-boarding process, our Implementation Specialist works closely with you and your clients Account Management team to ensure a smooth transition when set-up is complete. Nine Oars, Customer Satisfaction & Employer Client and Broker/Consultant Thought Leader Survey, 2014 INFORMATION TECHNOLOGY OPERATIONS CLINICAL TEAM ELIGIBILITY VENDORS REPORTING AND ANALYTICS Account Manager CLIENT Account Specialist Client Advocate NETWORK LEGAL HEALTH CARE SPENDING ACCOUNTS HEALTH AND WELLNESS VENDORS PHARMACY BENEFIT MANAGERS CCStpa s flexible approach to health care administration combined with our strategic account management positions you and your client for success. 1

4 CCStpa offers varying levels of medical plan administration CCStpa has created an innovative suite of efficiently designed, third-party-administered plans to meet the needs of value-conscious clients. Solid benefits. No unnecessary extras. Personalized for each client. All backed by a trusted TPA partner CCStpa. With a personalized approach, clients can choose the level of benefit personalization and value added services that meet their needs. TYPICAL HEALTH PLAN TYPICAL TPA CCStpa Integrated solutions 4 4 Choice of solutions 4 4 Personalized solutions 4 Cost management tool options: Benefit education, cost and quality tools easy to use and mobile enabled for 24/7 access Stop-loss coverage available to balance coverage and financial risk Medical management and data integration pinpoint major claims cost drivers Online reporting and benefits modeling tools identify health care cost drivers Online Client Center provides administrative control 24 hours a day, seven days a week Claims processing system integration Pharmacy benefit management 2

5 Expertise in best custom-fit solutions We understand the changing health care landscape and the different parts that make up a fully integrated, comprehensive experience for clients and their members. We have the ability to integrate with vendors that clients choose and in-house solutions on pharmacy and stop-loss. We provide assurance that you re collaborating with a TPA who will support and integrate with preferred, best in class vendors, such as: SelectAccount Medical spending accounts help members save and pay for health care expenses when they choose an eligible highdeductible health plan. These plans are fully integrated with CCStpa to make it seamless and easy for members to use. SelectAccount offers health savings accounts (HSA), health reimbursement arrangements (HRA) and medical flexible spending accounts (Medical FSA). Stop-loss Through stop-loss offered by MII Life, Inc., we can protect employees or their dependents when they incur unusually high medical expenses due to illness, an accident or other unanticipated circumstances. We understand the complexities of stop-loss and ensure employers are positioned to manage the financial risks of their health plan. Pharmacy benefits When medical and pharmacy benefits are integrated, better health outcomes are achieved. Our business partner, Prime Therapeutics, delivers fully integrated pharmacy benefits to over 22 million people, including our CCStpa members. Neither Prime nor CCStpa is owned or aligned with any drug manufacturer, wholesaler or a distributor, so we act independently and in your clients best interests. Additional administrative services that are available include: Wellness services such as biometric screenings, health assessments, coaching and incentives COBRA administration Subrogation Each health care provider is an independent contractor and is not our agent. MII Life, Inc., d.b.a. SelectAccount, is an independent company providing account administration services. Prime Therapeutics LLC is an independent company providing pharmacy benefit management services. United Concordia Dental Research has shown the strong connection between oral health and overall health. That s why CCStpa offers a dental plan in partnership with United Concordia, an organization with more than 40 years of dental insurance expertise, to bring affordable, integrated dental programs to clients and their employees. United Concordia has built some of the largest dental networks in the country, ensuring members can easily find a nearby network dentist, no matter where they live. Network design Since seeking care within a specific provider network is the most cost effective, choosing the right network is an important decision. We ll work with you and your clients to create a network strategy based on the goals of your client. We offer high-performance networks delivering even greater savings while providing members access to providers who deliver quality and efficient health care. Through our relationships with regional and national PPO networks, we deliver provider access and savings for members and employer groups nationwide. Network access in all 50 states We offer best-fit solutions for access and discounts based on your clients needs. PHCS 4,500 hospitals and over 670,000 health care professionals Multiplan Network 734 hospitals and 53,000 health care professionals Health EOS PPO network More than 135 hospitals and 26,000 professionals Doctor On Demand Real-time, online access to boardcertified physicians in 49 states United Concordia Companies, Inc. is an independent company providing dental benefit management services and access to the Advantage Plus 2.0 network. Doctor on Demand is an independent company providing telehealth services and is not available in every state. Check DoctorOnDemand.com/ccstpa to ensure you are located in a state that is eligible to participate. 3

6 Member engagement We are committed to working collaboratively to help members achieve their best health which, ultimately, helps control health care costs. We ve identified top health habits that commonly affect people s health today: managing stress, eating right, staying active, managing weight, quitting tobacco and maintaining a healthier pregnancy, to name a few. Through year-long engagement, members will be informed and encouraged to take advantage of their health benefit resources to help encourage healthy habits in these areas. From pre-enrollment education to onboarding, to increasing the use of their health and wellbeing resources, members will receive the information they need to get the most from their benefits. Our industry-leading approach: EDUCATION To ensure high satisfaction, we conduct an integrated marketing campaign ( , text, direct mail, in-office signage, events) designed to provide information about health plan benefits, value-added services and decision management tools. ONBOARDING During open enrollment, we provide members with the resources they need to feel clear and confident with their health plan. Some of the tools include: Printed material Trifolds, brochures and other printed materials that provide information on plan benefits, administration, networks, care management programs and frequently asked questions. Telephone resources Member services specialists are available to answer member and non-member questions on specific benefits, network or transition of care issues prior to the effective date. Internet resources Members have access 24 hours a day, seven days a week to valuable health tools (for example, Find A Doctor), even before coverage is effective. Member service specialists are happy to assist with questions about these web-based tools. ENGAGEMENT We recognize that one of the best ways to produce healthy outcomes is by engaging members regularly. We offer a comprehensive health and wellbeing outreach campaign utilizing marketing, in-office signage and events to help you ensure members are regularly thinking about their health. 4 Through this collaborative effort, members will feel connected throughout the enrollment process and have every incentive to use the benefits, value-added services, decision support tools and health and wellness solutions available to them.

7 Resources ccstpa.com Our mobile-enabled web portals are easy to use for everyone members, employers, providers and agents. Available anytime, day or night, allowing access to the information you need, when you need it through our secure web portal. It s just one more way we strive to make it easy to do business with us. Members have immediate access to their detailed information and tools: Enrollment status Current coverage Claims status and Explanation of Health Care Benefits (EOBs) Deductible and out-of-pocket balances Answers to frequently asked questions Order member ID cards Find a doctor Send secure inquiries to the customer service team and view responses Client have access to a portal with features that include: Enrollment Maintain enrollment View enrollment Claims Claim detail view line item detail Claim summary view payment information 5

8 CCStpa makes your job easier At CCStpa, we combine exceptional service and responsiveness with unsurpassed expertise, programs and technology. With access to the highest value networks of providers, our personalized approach to benefit administration will help you make benefit and plan decisions with confidence. Visit ccstpa.com Visit ccstpa.com for information about all of our products and programs. Here you will find connections to our online resources, such as myccstpa member center, CCStpa Client Center enrollment and maintenance area, find a provider tool and much more. Susan Foor, Sales Executive Comprehensive Care Services, Inc. P.O. Box St. Paul, MN We provide personalized solutions through real understanding. Toll-free: , ext ccstpa.com Comprehensive Care Services, Inc. M00403 (8/17)