TPA Transition Update PPMS | October 8, 2009 Brian Riehs, Service Representative VEBA Service Group, LLC

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Presentation transcript:

TPA Transition Update PPMS | October 8, 2009 Brian Riehs, Service Representative VEBA Service Group, LLC

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

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

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

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)

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

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

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.

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

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

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

Employer Portal. Dashboard

Contribution remittance Electronic (recommended) ◦ Upload contribution data report via online employer portal ◦ Remit contributions via ACH or wire transfer Paper ◦ Mail or contribution data report to Meritain ◦ Mail paper checks to lockbox

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): ◦ Forms (Meritain Health): or

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)

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)

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

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

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

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

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

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

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