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TPA Transition Update

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33 diapositives · 514 Views · Aug 22, 2014

TPA Transition Update. PPMS | October 8, 2009. Brian Riehs, Service Representative VEBA Service Group, LLC brian@veba.org. Introduction. Why the change? REHN & ASSOCIATES made a business decision to resign and focus on other business VSG’s role has not changed Technical support

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  1. TPA Transition Update PPMS | October 8, 2009 Brian Riehs, Service Representative VEBA Service Group, LLC brian@veba.org

  2. Introduction • Why the change? • REHN & ASSOCIATES made a business decision to resign and focus on other business • VSG’s role has not changed • Technical support • Onsite service • Meritain TPA responsibilities • Customer service • Claims processing • Recordkeeping

  3. Today’s topics • TPA services • Enhancements • Transition-related challenges • Service stats • What’s new? • Redesigned veba.org • Online employer portal • Contribution remittance • Plan literature and forms • Help reduce costs • Conclusion

  4. Service enhancements • Online employer portal • Employer reports, electronic handbook, upload contribution data • 150+ employers registered • myVEBA Plan online • Additional, more user-friendly online services • 2,500+ participants registered

  5. Service enhancements • Daily participant account valuations • Permits investment allocation change at anytime during the month • Industry standard • Extended customer service hours • 5 a.m. to 5 p.m. (Pacific)

  6. Service challenges • Your feedback is important • VSG working closely with Meritain • Additional training, experience, and personnel should result in • Improved accuracy of responses to inquires • More timely response and follow up • Shorter call hold times

  7. Blackout period • June 26 through July 19 • Data transferred, tested, downloaded • Certain services temporarily unavailable • Claims processing • Enrollments • Contribution posting • Investment allocation changes

  8. Backlog • Slower-than-expected processing was result of • Volume • New coding within Meritain’s system • Processed items “triple checked” to ensure accuracy • Backlog prioritization • Contributions • Enrollments • Claims • Investment changes, etc.

  9. Service stats • Call center • 100+ calls received per day • Average call time about 5 minutes • Call metrics analyzed daily/weekly • Claims • 15,000+ line item claims received in August • Most processed within one to three days of receipt • Random audits reveal 100% statistical and financial accuracy

  10. Redesigned veba.org • Quick links • Most common items just one click from homepage • Improved education/information resources • How is VEBA helping you? • About VEBA Trust • Frequently asked questions (FAQ) • Logins • Online employer portal • myVEBA Plan online

  11. Online employer portal • VEBA Plan Employer Handbook • Upload contribution data • Employer reports • Employer Contribution Posting Report • Participant Asset Allocation Snapshot • Disbursement Report • Employer News and Participant News archives

  12. Employer Portal . Dashboard

  13. Contribution remittance • Electronic (recommended) • Upload contribution data report via online employer portal • Remit contributions via ACH or wire transfer • Paper • Mail or e-mail contribution data report to Meritain • Mail paper checks to lockbox

  14. New plan literature and forms • VSG conducted critical review • Improve efficiency • Better communicate and gather important information • Recycle/discard all outdated materials • Order up to a six-month supply • Plan literature (VSG): formsrequest@veba.ws • Forms (Meritain Health): employersupport@meritain.com or 1-888-828-4953

  15. Education and enrollment • Introductory Overview (for education) • Enrollment Kit (for new enrollments) • Basic Plan Information & Enrollment Form • Investment Fund Information brochure • Investment Fund Overview (inserted by employer)

  16. Claim Form • Improvements • All necessary information contained on front side • Instructions and supporting information on reverse • Use single form for multiple covered individuals • Don’t have to itemize each expense (receipts still required)

  17. Participant Status Change Form • Replaces Notice to Third-party Administrator of COBRA Qualifying Event • Gathers information needed to comply with • COBRA • Medicare secondary payer reporting requirements

  18. Systematic Premium Reimbursement Form • Automatic reimbursement of ongoing insurance premiums • Direct deposit or paper check reimbursement to participant • Current direct payments to HCA or other providers will continue until cancelled or account runs out • HRAs are a reimbursement tool, not intended to make direct payments

  19. Help reduce costs • Encourage your participants to use these recommended services • e-Communication • Direct deposit • Online forms

  20. e-Communication • Skip the paper; go electronic • Statements (quarterly) • Explanation of benefits (EOB) • Consent required • New enrollment form • myVEBA Plan onlineregistration • Account preferences • 9,500+ participants signed up

  21. Direct deposit • Get your money back faster • More secure than paper checks • Sign-up required • New enrollment form • New systematic premium reimbursement form • myVEBA Plan online

  22. Online forms • Download and print forms at veba.org • Electronic “fillable” format • Forms tab contains lists and descriptions of all participant and employer forms

  23. Conclusion • Your service providers are committed to providing you and your participants with excellent service