Letter from the President 
When the economy is throwing us lemons,
it's time to make lemonade.

By Debi Hardwick, Coastal TPA, Inc.

I don't mean to come off like Pollyanna, but I believe that the time is ripe for our TPAs to increase their business. Everyone is trying to cut costs these days, and that means Brokers and Human Resource Managers are looking at all options in their attempt to provide health care benefits at an affordable cost, and the Presidents, CEOs and Board of Directors of businesses are mandating the research of alternatives to the fully insured products that they have typically provided to their employees. It may have been true in past years that HR departments did not want to be bothered with what they thought was the administrative burden of self insured benefit administration through an independent TPA. They and their bosses are ready now, if we can show them that self insured benefit administration is their best choice. This is opportunity time for TPAs. Let's go for it.

Unfortunately, it is easy to get distracted because we are also required to deal with all the legislative mandates that have come our way during the past several months. Between the Premium Assistance for COBRA Benefits provision in the American Recovery and Reinvestment Act, the Mandatory Insurer Reporting Law and the Mental Health Parity and Addiction Equity Act, we are busier than ever; however, this is also a time when we can demonstrate, to our clients, the value of working with a smaller, customer service savvy health plan administrator. Our employer sponsored plans are extremely happy that we are taking the lead and guiding them through this maze of legislation.

HCAA's Public Relations Committee plans to promote the self-funded industry through press releases and pitch letters. If you have a "success story" about how your TPA is making lemons out of lemonade, please send it to Jaime Nolan at jnolan@hcaa.org and she'll take it from there.

HCAA's latest success story is that we hit another milestone with the attendance at our 2009 Executive Forum, "The Next Generation TPA: Preparing for Strategic Growth." Almost 250 people attended the conference at the Wynn, Las Vegas, which is a new attendance record for us. But, we haven't stopped to rest as we prepare for our 7th Annual TPA University, which is being held from July 15th through July 17th at the Disneyland Grand Californian Hotel in Anaheim. This year's theme "High Performing Companies: A Syllabus for Success" is based on our Certified Self Funding Specialist (CSFS) designation which will be unveiled during the program. Mark your calendar now; you will not want to miss this exciting conference.

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 Executive Forum Wrap-Up

Close to 250 people attended the 2009 Executive Forum at the Wynn Las Vegas. The theme for the three-day event, which took place from Tuesday, February 3 through Thursday, February 5 was, "The Next Generation TPA: Preparing for Strategic Growth." Attendees heard presentations from 11 speakers on nine topics. Bob Prosen of the Prosen Center for Business Advancement gave the keynote presentation for the event, "Leadership - The Key to Execution." Other presentation topics included a panel on the Next Generation TPA, Compliance Strategies for Mental Health Parity and Creating a Sales Culture for Your Organization.

A special thank you to our sponsors: A&G Healthcare Services; American Health Holding, Inc., VentureNet Healthcare, Bases Loaded, Inc., Beacon Spy Glass, Benefit Informatics, Inc., Carewise Health a SHPS company, Coalition America, Inc., CVS Caremark, Devon Health Services, Inc., Ebix Health, MPHASIS Eldorado, Express Scripts, Evolution Benefits, Inc., Emdeon, First Dental Health, Focused Health Solutions, Inc., Health-e-Web, Healthplace America, HealthX, Hines & Associates, Inc., INETICO, Inc., Interface EAP, Lighthouse 1, LLC, Maxor National Pharmacy Services Corp., MedImpact Healthcare Systems, Inc., National Care Network, Preferred Medical Claims Solutions, RedCard Systems, RESTAT, LLC., SOCRATES, Inc., The Lungen Group, The Phia Group, LLC, TPA Benefits, Inc., United Claims Solutions, Universal Health Network and WellDyneRx.

To view photos from this year's event, click here.

Planning for the 2010 Executive Forum has already begun! HCAA will be one of the first groups to stay at the new Fontainebleau Las Vegas, scheduled to open in November 2009. Mark your calendars now to attend February 2-4, 2010

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TPA University Update

The 2009 TPA University is right around the corner! Join us at the "Happiest Place on Earth", the Disneyland Resort in Anaheim, CA from July 15-17.

This years theme is High Performing Companies: A Syllabus for Success.

Hotel rooms for the three-day conference, held at the Grand Californian Hotel, are available now. Take advantage of the group rate, $235 a night + tax (single or double occupancy) and book your room.

Click here or call (714) 520-5005. Refer to HCAA TPA University 2009 when making your reservations.

Watch your e-mail for more information regarding the event and registration as the date nears! Executive Forum was a great success; let's make TPA University even better!

Thank you to HCAA's TPA University sponsors:

(current as of 4/16/09)

Annual Corporate Sponsors

A&G Healthcare Services
American Health Holding, Inc.
Benefit Informatics, Inc.
Express Scripts, Inc.
INETICO, Inc.
The Lungen Group
Phia Group, LLC
Preferred Medical Claims Solutions, LLC
Red Card Systems
WellDyne Rx

Platinum Sponsors

D2Hawkeye, Inc.
Ebix Health
GlobalCare, Inc.
Imagenet, LLC
MPHASIS Eldorado
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Navitus Health Solutions LLC
TPA Benefits, Inc.
ValueOptions, Inc.
World Doc
Young Consulting, Inc.

Gold Sponsors
PPC Partner-Plus Consulting, Inc.

General Session Sponsor
CVS Caremark

Breakfast Sponsors
First Dental Health
Hines and Associates, Inc.

Wednesday Night Welcome Reception Sponsor
Consumer Health Technologies

Conference Bags Sponsor
Imagenet, LLC

Program Binder Sponsor
Coalition America

Thursday Night Reception Sponsor
Phia Group, LLC

Lunch Sponsor
HealthX, Inc.

Name Badge Sponsor
RESTAT, LLCkeye, Inc.

For more information on this event or how to become a sponsor visit our
Web site, www.hcaa.org.

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Benchmarking Survey - Due April 30

The Benchmarking Committee worked with Industry Insights to develop and revise the 2009 Benchmarking Survey. The survey, to be completed by TPAs only, was released March 13 and the completion deadline is April 30. Your responses help HCAA determine patterns and trends among TPAs; and, in turn, allows HCAA to develop new methods to better serve its members. If you need more information or did not receive the survey, please contact rachel@hcaa.org.

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Certified Self Funding Specialist - Coming Soon!

The Education Committee announced at the Forum the proposed launch date for the HCAA designation CSFS (Certified Self Funding Specialist) which will be in conjunction with HCAA's TPA University. The committee has written the tests and is going through the final editing preparations to bring the course work live on the web. WebCE will host the course. More information is coming soon.  
 
The committee will teach a course on the designation at the TPA University July 15-17 in Anaheim to raise awareness of the content and its value to the membership and the industry. In conjunction with the TPA University class, HCAA will release a PR announcement to the industry through the media and industry newsletters, magazines and blogs announcing the availability of the courses and the designation. 
 
Interested parties, members and non-members can contact HCAA or committee members to be put on an "Interest List." Parties on that list will be notified of developments on the courses and their launch as the date approaches.

The committee has requested that WebCE file for Continuing Education credits for each course for us in the following states: Alaska, Idaho, Oregon, Arizona, Montana, Utah, California, Nevada, Washington, Colorado and Oklahoma. Other states will be filed as the need arises and membership/interest indicates penetration or requests the credits.

As credit is approved, the WebCE site will be updated and the shopping cart for the course will be annotated with information that the course is eligible for CE in that state. By launch date,

· Courses 1 - 4 will have been submitted to the identified states and some state CE's will most likely be available by this time. We can not guarantee which states will finalize CE or for what hours.

· Courses 5 - 7 will be available for purchase without insurance CE - courses will have been submitted to the states for CE and 30-90 days from launch we should know what they are approved for.

 

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News from GRA

The GRA Committee has laid out a series of webinars to help keep the HCAA membership informed and up to date on new regulations and legislations that affect them. Webinars will be held about every other month for the remainder of 2009. The first two webinars, December 3, "The Mandatory Medicare Reporting Rules: What Every TPA Must Do to Comply," and March 5, "COBRA and HIPAA Dramatically Change under Stimulus Bill" were great successes.

Additional webinars will take place in May, focused on "Michelle's Law," and August, focused on "Service Provider Fee Disclosure." 

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Online Membership Directory - Coming Soon!

The Membership Committee is working on a Searchable Buyers guide for the Web site. Once this database is completed, anyone visiting the Web site can search the buyers guide to find the company or services they desire. At the Executive Forum, members were able to sign in and change their demographic information as well as choose the words they will be searched by. This opportunity will be made available to all members during the month of April.

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Share Your Success Stories!

The Public Relations Committee plans to pitch one or two press releases and pitch letters to media outlets each month. The committee hopes to promote the self-funded industry through these releases and pitch letters. The committee is working on creating an outline of story ideas; if you have an idea, please contact Rachel England. The committee has also agreed to sign-up for a press release distribution service. This service will take the press releases and pitch letters and determine the appropriate media outlet to receive the pieces. With this, HCAA stands to earn more media hits and exposure as well as identify the association as the leading source for information on the self-funded industry. If you have a story idea you would like to share please contact Rachel England at rachel@hcaa.org.

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NewsBytes

Global Claim Resources, Inc., (GCR) a leading medical discount company, is pleased to announce the launch of their new website at www.gcrinc.com.

This new platform can be used by providers and payers alike to disseminate relevant information on medical claims, as well as automatically re-price an unlimited amount of medical claims.

"The new section on our website, created exclusively for providers, will allow convenient access to our skilled team of provider relations representatives," explains President Christopher Jackson. "Reflective of our commitment to customer care, the website serves as an additional communication tool, providing members with a bevy of helpful information and cost management services."

Other features include The Global Claim Resource Center, a comprehensive source for industry and company news via blog, news feeds and press releases.

Clients will enjoy the same automatic re-pricing, simple data entry, and customized reports in a new, cleaner look complete with easier navigation.

Capitol Administrators, a leading third party administrator (TPA) of self-funded health plans, announced the recent addition of Linda Ludwick as Chief Operating Officer.

In her new position, Ludwick will coordinate and oversee operations and staff for Capitol Administrators' California, Georgia and Texas operations which include administering health benefits for employers and health plans across the US. Ludwick brings nearly 25 years of leadership experience in the healthcare industry to her new role.

"We are very excited to welcome Linda to Capitol Administrators," said Dave Reynolds, President and CEO. "She is a respected leader and expert within our industry and brings a wealth of knowledge and experience in managing TPA operations. Her leadership will enhance our customer service, client relations and administration and add value to all of our relationships."

Prior to joining Capitol Administrators, Ludwick served as Executive Director for Tucson-based TPA Mountain States Administrative Services. Her previous experience includes Regional Operations Manager for 10 states for Aetna Life & Casualty, as well as management positions with Blue Cross and Blue Shield.

She served as President and is currently a member of the board of the HCAA. She also serves on the board of the American Association of Preferred Provider Organizations (AAPPO).

CoreSource, a leading national provider of administrative and care management services for self-funded employee benefit plans, announced today that its plan members across the country have access to a new integrated online consumer health portal - the HealthCenter, powered by WorldDoc "Our new online HealthCenter will create opportunities for CoreSource to communicate with our plan members through a comprehensive, integrated health management solution," said Paul Lotharius, President of CoreSource. "The HealthCenter will provide members with tools they need to get and stay healthy, leading to decreased costs for them and their employers."

For more than 30 years, CoreSource has been delivering customized employee benefit administration services to self-funded employers across the U.S. In 2007, CoreSource introduced a suite of total population management products designed to promote prevention and management of chronic conditions. Those programs will be integrated into the WorldDoc portal as an added platform for communicating personal wellness information to each member. Among the tools included in the CoreSource HealthCenter are a health risk assessment, personal health record, online wellness coaching, hospital and treatment cost comparison tools, and optional 24-hour online nurse chat.

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 Standard Stop-Loss
 Employer Disclosure Form

As reported in previous issues of HCAA Reports, the Self Insurance Institute of America (SIIA) and the Society of Professional Benefit Administrators (SPBA) met to develop a system to "standardize" the disclosure reporting process, with the objective that all insurers would come to accept the reporting system/form as an industry standard. As a result, they have endorsed a standardized stop-loss disclosure form, which also includes ICD-9 codes. The documents are intended to help facilitate the sharing of health data information between self-insured entities/TPAs and stop-loss insurers/MGUs for the purpose of medical stop-loss underwriting.

HCAA Reports will continue running a recurring notice in each issue of the Stop Loss Carriers and MGUs that have adopted the Standardized Form. If your company has adopted the form, please contact Jaime Nolan at jnolan@hcaa.org

AIG Medical Excess

Azeros Healthcare (MGU) on behalf of London Life Reinsurance Company

BEST Re on behalf of US FIRE & BEST LIFE 

BP Inc. (MGU) on behalf of Combined Insurance - Supplemental Insurance

Cairnstone Re

The Hartford

HCC Life

HMA MGU, LLC (MGU)

Independence Holding Company (Standard Security Life Insurance Company of New York, Madison National Life and Independence American Insurance Company)

Intermediary Insurance Services, Inc. (IISI), MGU on behalf of QBE Insurance Company and American National Life Insurance Company of Texas

Medical Risk Managers (MGU)

Mid Atlantic Underwriters, Inc., (MGU) on behalf of ACE American Insurance Company

National Benefit Resources (MGU) on behalf of UnitedHealth Group insurance companies

J. Allan Hall & Associates, Inc. (MGU) on behalf of their underwriting facility, Lloyd's of London

R. E. Moulton, Inc. / American United Life Insurance Company (OneAmerica Companies)

Spectrum Underwriters (MGU)

RMTS, LLC (MGU) on behalf of their carriers Nationwide Life Insurance Company, Gerber Life Insurance Company, and Trustmark Insurance Company (as filed)

Stop Loss Concepts, Inc., (MGU) on behalf of their carriers, Gerber Life Insurance Company and QBE Insurance Company

Swiss Re Commercial Insurance

Zurich North America

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 Welcome New Members!

Gene Bitonti, Vice President
P&M Corporate Finance, LLC
26300 Northwestern Hwy, Suite 120
Southfield, MI 48076
PH: 248.603.5088
FX: 248.233.9184
gene.bitonti@pmcf.com
www.pmcf.com
Type: Investment Banking

Mark Ciamarra, VP Opportunity Management
informedRx, Inc., and SXC Company
2441 Warrenville Road, Suite 610
Lisle, IL 60532-3642
PH: 630.577.4701
FX: 630.288.9827
mark.ciamarra@sxc.com
www.sxc.com
Type: PBM

Christian Clark, Exec. Director, Business Development
Integrated Health Plan, Inc.
4020 Park Street, Suite 103
St. Petersburg, FL 33709
PH: 7273458614
FX: 727.345.5886
cclark@ihplan.com
www.ihplan.com
Type: PPO

Tom Day, CIO
CBIA - Connecticut Business & Industry Assoc.
350 Church Street
Hartford, CT 06103
PH: 860324431993
FX:
tom.day@cbia.com
www.cbia.com
Type: Insurance Intermediary

Jim Delaney, Chief Operating Officer
Advanced Medical Pricing Solutions
7433 Spout Springs Road, Suite 101-88
Flowery Branch, GA 30542
PH: 678.528.3041
jdelaney@advancedpricing.com
www.advancedpricing.com
Type: Medical Management

Joe Edwards, CEP
HealthSCOPE Benefits, Inc.
27 corporate Hill Drive
Little Rock, AR 72223
PH: 501.218.7813
FX: 501.225.9197
joe.edwards@healthscopebenefits.com
www.healthscopebenefits.com
Type: TPA, not carrier owned

Andrew Gasho, VP Group Health Sales
KeyClaims, Inc.
22286 Lorraine Drive
Strongsville, OH 44149
PH: 216.389.0386
FX: 440.848.8618
agasho@keyclaims.net
www.keyclaims.net
Type: Medical Management

Roy Glazier, Chief Sales & Marketing Officer
EcomPPO Advisors, LLC
8350 North Central Expressway, Suite 600
Dallas, TX 75206
PH: 214.561.6300
FX: 214.561.6301
roy.glazier@ecomppo.com
www.ecomppo.com
Type: Consultant

Kara Hamilton, Director of Marketing
Trover Solutions
9390 Bunsen Parkway
Louisville, KY 40220
PH: 502.214.1074
FX: 502.214.1350
karahamilton@troversolutions.com
www.troversolutions.com
Type: Consultant

Robert Hendrick, Co-founder & CEO
change:healthcare
237 Gillette Drive
Franklin, TN 37069
PH: 615.969.3333
rhendrick@changehealthcare.com
www.changehealthcare.com
Type: Web Based Service

Bob Janicek, President
Health-e-Web, Inc.
PO Box 1540
Helena, MT 59624
PH: 406.422.1516
FX: 406.449.0190
bjanicek@hewedi.com
www.hewedi.com
Type: Electronic Health Care Clearinghouse

Robert K. Kerr III, EVP & CMO
Group Resources
3080 Premiere Parkway, Suite 100
Duluth, GA 30097
770.623.8383
robby@groupresources.com
www.groupresources.com
Type: TPA, not carrier owned

Christine Knapik, Marketing Coordinator
Healthation, Inc.
7955 South Cass Ave
Darien, IL 60561
PH: 630.324.8840
FX: 630.324.8842
cknapik@healthation.com
www.healthation.com
Type: Software

Lisa Olexy, COO
ValueOptions, Inc.
1199 South Beltline Road, Suite 100
Coppell, TX 75019
PH: 941.708.0380
FX: 972.906.2780
sales@valueoptions.com
www.valueoptions.com
Type: Other

Daniel Opinante, President
The Seneca Group
68 South Service Road, Suite 100
Melville, NY 11747
PH: 631.577.4092
FX: 631.360.8288
dan@thesenecagroup.com
www.thesenecagroup.com
Type: TPA, not carrier owned

Jim Phifer, Vice President
One Call Medical
2183 Hillsboro Road, Suite 204
Franklin, TN 37069
PH: 615.791.4243
Jim_phifer@onecallmedical.com
www.onecallmedical.com
Type: PPO

Laurie Schroeder, VP National Sales
Antares Management Solutions
17800 Royalton Road
Strongsville, OH 44136
PH: 440.878.4135
FX: 440.878.4136
Laurie.schroeder@antaressolutions.com
www.antaressolutions.com
Type: TPA

Todd Squilanti, SVP Corporate Development
Meritain Health
300 Corporate Parkway
Amherst, NY 14226
PH: 716.319.5103
Jennifer.martz@meritain.com
www.meritain.com
Type: TPA, no carrier owned

Mike Taylor, VP Sales & Marketing
LDI Pharmacy Services
9175 south Yale, Suite 200
Tulsa, OK 74137
PH: 314.652.2006
mtaylor@ldirx.com
www.ldirx.com
Type: PPM

Barry Thompson, VP Sales
LifeTrac, Inc.
11100 Wayzata Blvd, Suite 350
Minneapolis, MN 55305
PH: 763.647.5087
FX: 763.647.5012
bthompson@lifetracnetwork.com
www.lifetracnetwork.com
Type: Organ Transplant Network

Mary Jane Weber, President
Morgan & Franz Administration
10606 Trademark Parkway, Suite 201
Rancho Cucamonga, CA 91730
PH: 909.980.1194
FX: 909.980.1984
maryjaneweber@morganandfranz.com
www.morganandfranz.com
Type: TPA, not carrier owned

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 Join a Committee

Looking for ways to get more involved in the association? Join a committee! HCAA's success depends on the hard working volunteers who keep us moving forward and bring new ideas to the table. The following information highlights the committees that are currently accepting new members. If you are interested, email jnolan@hcaa.org

BENCHMARKING COMMITTEE
This committee is responsible for the implementation of the annual benchmarking survey. Duties include securing and working with selected vendor, reviewing and revising survey content, providing feedback for continuous improvement, and presenting results at TPA University.

EDUCATION COMMITTEE
This committee is responsible for the following:
i. Development and management of the Certified Self-Funding Specialist Certification (CSFS) program.
ii. Development of an Employer Education program to include HR, CE, CLE, CPA credits
iii. Application of Continuing Education credits for HCAA conferences
iv. Development of additional education opportunities for members (e.g. webinars, etc.)

EXECUTIVE FORUM COMMITTEE
This committee is responsible for creating the theme of the conference, identifying topics and speakers, and approving presentation content before publishing. The committee will support HCAA staff as needed in planning of logistics.

GOVERNMENT & REGULATORY AFFAIRS COMMITTEE
This committee is responsible for serving as a legislative watchdog for HCAA members, communicating legislative updates as needed to the membership. This committee shall also identify and recommend to the Board opportunities to support organizations that have legislative efforts which support our industry.

MEMBERSHIP COMMITTEE
This committee is responsible to assist with the recruitment and retention of HCAA members. Duties include evaluating member benefits, making recommendations for change and/or new benefits as opportunities arise, and establishing and implementing a membership campaign.

PUBLIC RELATIONS COMMITTEE
This committee is responsible for overseeing and making recommendations for change to the HCAA website and the newsletter. The committee is also responsible for the development and implementation of a plan to market HCAA and the TPA industry.

SPONSORSHIP COMMITTEE
This committee is responsible for evaluating the annual sponsorship campaign and making recommendations for benefits to the Board, as needed. This committee will also assist in finding and securing sponsors for annual corporate sponsorships and the individual conference sponsorships.

TPA UNIVERSITY COMMITTEE
This committee is responsible for creating the theme of the conference, identifying topics and speakers, and approving presentation content before publishing. The committee will support HCAA staff as needed in planning of logistics.

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 SAVE THESE DATES!

2009 TPA University
July 15-17, 2009
Disney's Grand Californian Hotel, Anaheim, CA

2010 Executive Forum
February 2-4, 2010
Fontainebleau Las Vegas, Las Vegas, NV

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In This Issue

Letter from the President

Executive Forum Wrap-Up

TPA University Update

Benchmarking Survey

Certified Self Funding Specialist

News from GRA

Online Membership Directory

Share Your Success Stories!

NewsBytes

Standard Stop-Loss Employer Disclosure Form

Welcome New Members!

Join a Committee

SAVE THESE DATES!