Letter from the President

By Todd Archer

Dear HCAA Member:

Our association has been in conversations with the Self Insurance Institute of America (SIIA) and the Society of Professional Benefit Administrators (SPBA) to better coordinate our industry's voice in Washington during this time of health care debate. SIIA has traditionally focused on "legislative" issues, SPBA has traditionally focused on "regulatory" issues and HCAA has emerged with an "educational" focus for the industry. The HCAA Board of Directors felt our membership would be served by bringing together these entities to unify our voice on reform.

The group (representatives from HCAA, SIIA and SPBA) felt that the two most feasible options for impacting the outcome of the debate was either a public relations program (something along the lines of the Harry and Louise campaign used during the "Clinton Care" discussion), or a grassroots initiative to educate swing votes in both the House and Senate. Since we have neither the time nor the money to fund a large scale public relations campaign (Harry and Louise cost about $20 million in the early 1990s), we felt like the grass roots approach was the most viable alternative. One big reason for this is that SIIA had already developed a Grassroots Toolkit to be used for this purpose.

As a result, we are asking each HCAA member to do the following:

1. Please go to www.siia.org and click on the Grassroots Toolkit link on the left side of their home page. The last paragraph of that page contains a link to all of the resource documents in the Toolkit. Please review these documents and familiarize yourself with them.
2. Click here for a list of key Senate and House members who will likely play a crucial role in whatever comes out of this debate. If you reside in one of these States or Districts (or have offices there) it is especially important that you reach out to them. It is imperative that we make sure our voice is heard loud and clear.
3. Send a letter and make a phone call to each of your state's congressional delegates. The purpose is not to solicit a response, but to have the preponderance of the feedback their staff receives to be against anything that weakens or diminishes the employer based system. Congressmen pay attention to this feedback (in the aggregate) and will factor it into their vote on issues. Your employees can participate in this as well.
   

We understand that all of you are busy running your businesses and caring for your clients. If each of us takes just a couple of hours to do these three simple things we can go a long way to preserving our livelihood. Please schedule this activity now on your calendar; you owe it to yourself, your employees and your clients.

Respectfully,

Todd Archer
President

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2009 TPA University
Earns a Passing Grade

Over 200 people attended the 2009 TPA University July 15 - 17. The conference was held at Disney's Grand Californian Resort at Disneyland in Anaheim, CA. "High Performing Companies: A Syllabus for Success" provided TPA attendees with best practices for current and future leaders within TPA organizations. Attendees heard from 11 speakers over the 3-day conference, all of whom provided information that was especially valuable to TPAs.

A special "Thank You" goes out to all our sponsors::

Annual Corporate Sponsors: A&G Healthcare Services; American Health Holdings, Inc; Benefit Informatics, Inc; Express Scripts, Inc; INETICO, Inc.; The Lungen Group; The Phia Group, LLC; Preferred Medical Claims Solutions, LLC; Red Card Systems; and WellDyneRx

Platinum Sponsors: Ebix Health; GlobalCare, Inc.; Imagenet, LLC; Eldorado; Navitus Health Solutions LLC; One Call Medical, Inc.;
Partners Rx Management LLC; The TriZetto Group, Inc; TPA Benefits, Inc; ValueOptions, Inc.; Verisk Health; WorldDoc, Inc.; and
Young Consulting, Inc.

Gold Sponsor: PPC Partner-Plus Consulting, Inc.; Interlink Health Services, Inc.; Maxor National Pharmacy Services Corp.

General Session Sponsor: CVS Caremark

Breakfast Sponsors: First Dental Health and Hines and Associates, Inc.

Wednesday Night Welcome Reception Sponsor: Consumer Health Technologies

Thursday Night Reception Sponsor: The Phia Group, LLC

Lunch Sponsor: Healthx, Inc.

Conference Bags Sponsor: Imagenet, LLC

Program Binder Sponsor: Coalition America, Inc.

Name Badge Sponsor: RESTAT, LLC

Attendee Flash Drive Sponsor: Carewise Health, a SHPS company

Notepad / Pen Sponsor: Healthation, Inc.

Wi-Fi Hot-Spot Sponsor: Lighthouse 1, LLC

Click here to view photos from the conference.

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Executive Forum 2010 Update

Planning for the 2010 Executive Forum is underway! Join us February 9 - 11, 2010 at Encore at Wynn Las Vegas. Book your hotel room now and take advantage of the group rate. Rooms are available for $179 a night plus tax (single or double occupancy). Call 1-888-320-7125 to make your reservation. Refer to 2010 HCAA Executive Forum when making your reservations to get the group rate.

Hotel reservation deadline is January 9, 2010.

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2009 - 2010 Board of Directors

The 2009 - 2010 Board of Directors became effective on July 1, 2009. HCAA is proud to welcome the following members to their new positions:

President - Todd Archer, Mutual Assurance Administrators Inc.
Vice President - Carolyn Jarschke, QVI Risk Solutions, Inc.
Treasurer - Kevin Larson, Employee Benefit Management Services, Inc.
Secretary - Rayne Niehaus, CDS Group Health
Director - Matt Cooper, Brokerage Concepts, Inc.

Continuing their service on the Board are:
Carol Berry, Consultant
Dolores Green, Foundation Administrative Services, Inc.
Debi Hardwick, Coastal TPA, Inc.
Linda Ludwick, Capitol Administrators
Thomas Partlow, Delta Health Systems
David Reynolds, Capitol Administrators
Jean Sukovez, United Administrative Services
Nancy Young, Zurich North America

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Don't Drink and Drive
(or Expect Your Claims to Be Paid If You Do)
By Adam Russo, The Phia Group, LLC

If I earned a dollar for every call and email that I have received from claims administrators in the past ten years questioning whether claims should be paid in situations where drunk drivers hit a tree in the middle of the night, I could buy a nice American made Corvette, with a briefcase full of cash in the trunk.

The typical situation involves a client asking whether claims are payable. I always utter the same initial response - "What does your plan document say?" Too many administrators believe that they can process every claim the same way across the board, administering various plans, no matter what the provisions actually say (assuming there is a provision that addresses the matter). Nothing could be further from the truth! The wording (or lack thereof) in a plan document will specifically dictate the process of handling tough claim decisions.

I found some recent, interesting cases involving injuries linked to intoxication and the related claims. As you will read, every case boils down to the same two issues - the facts of the case and the terms of the plan document.

In Arnold v. Hartford Life Insurance Co. ( 542 F. Supp. 2d 471 (W.D. Va. 2008), Hartford denied a beneficiary's claim for accidental death benefits, concluding that the insured's death was not due to an "accidental" injury as defined in the policy. The insured died at the scene of a motorcycle crash. The immediate cause of death was a closed-head injury with cervical spine fracture.

At the time of the crash, the insured was legally intoxicated. Hartford denied the claim because the insured's death was reasonably foreseeable and the assumption of a known risk by the insured did not constitute an "accident" under the terms of the policy. The plaintiff argued the policy included an alcohol / intoxication exclusion with regard to seat belt coverage, but not with regard to AD&D coverage. The plaintiff contended the specific exclusion for intoxicants under the seat belt coverage would not be necessary if the term "accident" was understood not to include a situation where the insured was legally intoxicated.

The court disagreed, noting that for the alcohol/intoxication exclusion under the seat belt coverage to apply, a person would simply have to be under the influence of alcohol, not necessarily intoxicated. The court held the insured's death was reasonably foreseeable because his alcohol consumption placed him well above the legal limit at the time of the crash that ultimately led to his death. In the absence of any other reasonable explanation for the crash, the court found that it was reasonable for Hartford to determine the insured's death was not an "accident" as that term was used in the policy.

Similar to Arnold, in Grose v. Sun Life Assurance Co. of Canada (568F. Supp. 2d 652 (W.D. Va. 2008) the insurer denied a claim for accidental death benefits because the insured was intoxicated when he crashed his motorcycle because his injuries were reasonably foreseeable. The beneficiaries argued there was no evidence of intoxication at the time of the crash and the death was a result of an accident. The court first concluded the insured was intoxicated; the insured's blood-alcohol content was twice the legal limit when his body was found, which was five hours after his death and twelve hours after his crash. The court next rejected the beneficiaries' interest argument that, even if the insured was intoxicated, his death was still accidental because there was no evidence his intoxication was voluntary. The court noted that the beneficiaries failed to provide any evidence "in support of these fantastical, though not impossible, scenarios," and "it would be unreasonable to conclude anything other than voluntary intoxication."

As many of you know, I love to preach about the importance of asserting discretionary authority within the plan document. In another interesting case, the court found that a plan administrator's interpretation of an alcohol exclusion, as written in an ERISA accidental death insurance plan coming within the purview of ERISA, was "legally correct" and granted the defendant's motion for summary judgment in Pando v. Prudential Insurance Co. of America (524 F. Supp. 2d 848, 853-56 (W.D. Tex. 2007).

The exclusion provided that a loss involving a person's illegal use of alcohol is not covered if it results while operating a motor vehicle. The plan defined neither "use" nor "illegal use". Plaintiff contended that the decedent's actual consumption of alcohol was legal since he was of legal age and there was no evidence he consumed alcohol while driving. Prudential argued that by driving while intoxicated under state law, the decedent illegally "used" alcohol.

The court found the exclusionary provision ambiguous, analyzed legal authority within and outside the Fifth Circuit, and stated that the law is clear that an administrator's reasonable interpretation of an ambiguous provision is entitled to deference. The court held that Prudential's interpretation was reasonable and consistent with a fair reading of the plan. The court further held Prudential's factual determination that the decedent's use of alcohol was illegal at the time of his death and his intoxication significantly contributed to his death was supported by sufficient evidence, such as autopsy and police reports attesting to the decedent's blood-alcohol concentration and driving behavior.

The insured in Smith v. Liberty Life Insurance Co. (535 F.3d 308 (5th Cir. 2008) was a lifelong drug addict with seven arrests under his belt for driving under the influence. He was killed when the truck he was driving struck two trees. Toxicology reports established that he had potentially lethal doses of drugs in his system along with ethanol. Meanwhile, his policy excluded from coverage any death resulting directly or indirectly from an injury occurring while under the influence of alcohol or drugs.

The Fifth Circuit concurred with the lower court's determination that, under Louisiana law, the policy exclusion could be interpreted less favorably for insureds than a similar Louisiana statute mandating that an "insurer shall not be liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of narcotics unless administered on the advice of a physician."

Interpreting Louisiana law, the court found Liberty proved the insured was "under the influence" of drugs sufficient to "lose normal control" of his faculties and proof of a complete loss of control was not necessary. The court held Liberty was only required to prove intoxication was a contributing cause, which it did when it presented uncontroverted testimony that the insured's level of intoxication impaired his faculties and contributed to his death.

Other than the obvious lesson of "don't drink and drive", I hope that there are other important lessons learned here. Review your standard plan document templates' alcohol, illegal act, and/or intoxication provisions (or whatever else they are called) with your attorney to ensure that the provision lives up to your expectations. Chances are it doesn't say exactly what you or your clients want it to say.

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LynAnn Henderson named
HCAA's 2009 Volunteer of the Year

At the 2009 TPA Univesity and Annual Business meeting, HCAA named LynAnn Henderson, EBMS, the first ever HCAA Volunteer of the Year.

"LynAnn exemplifies the term, "Rock Star," which is why she received our very first Volunteer of the Year Award," said Debi Hardwick, immediate past president of HCAA.

Henderson co-chaired committees responsible for planning HCAA's 2008 and 2009 TPA Universities as well as the 2009 Executive Forum. These conferences play an important roll in the TPA industry, providing those who work in the industry the most current information regarding compliance and trends.

"Through my involvement with HCAA, I've developed a strong network of industry contacts who have served as mentors and helped share ideas to help me grow in my position and also strengthen my organization," said Henderson of her commitment to HCAA. "While I am honored to have received this recognition, I humbly accept it on behalf of the dozens of individuals who serve on the Board and other committees who give countless hours of time outside their professional responsibilities. Thank you for providing this opportunity to serve."

Hardwick praised Henderson for her "knowledge of the TPA industry, organizational skills and 'can do' attitude," calling these attributes, instrumental in elevating conference content and awareness of HCAA as the go-to association for TPAs."

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In this Section:

• Results of 2009 Benchmarking Survey Shared at TPA University
• Certified Self Funding Specialist™ Designation Launched
• Movement in Washington Keeps GRA Committee Busy
• Now You Can Update Your Information in the HCAA Database

Results of 2009 Benchmarking Survey
Shared at TPA University
The results of the annual HCAA Benchmarking Survey were presented at the 6th Annual TPA University held July 15-17 in Anaheim, CA. As announced at the conference, a new vendor was used for the processing and custom versions, for each TPA completing the survey. The comparison results to the norms are currently underway and should be delivered shortly. Also, as part of the TPA University, there was a breakout session to discuss the benchmarking process. HCAA received excellent feedback and new categories that the benchmarking committee will discuss.

If you have additional categories you would like considered for the next Benchmarking Survey, please contact Tom Partlow or Dave Reynolds. It is important for each TPA member organization to complete future Benchmarking Survey's so HCAA can increase the number of respondents and therefore the pool of data. This is viewed as a significant benefit by participating TPAs and HCAA strives to make it representative of the industry as a whole.

The committee is also looking at ways to integrate TPA industry data from other potential sources.

Thank you to the member TPAs that did participate. We look forward to new and improved processing as we move forward."

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Certified Self Funding Specialist™
Designation Launched
HCAA launched the new Certified Self Funding Specialist™ (CSFS™) designation July 15, 2009 at the 6th Annual TPA University in Anaheim, California. The CSFS™ program is designed to educate and enhance your understanding of self funding while explaining the history, reporting requirements and legal ramifications faced by third party administrators.

The courses and certification for this program focus on the self funded benefit model and its associated ERISA framework. The certification consists of seven training courses, each qualifying for continuing education credits in the following states: Washington, Utah, Oregon, Nevada, Montana, Idaho, Colorado, California, Arizona and Alaska. We are still waiting for confirmation on the total number of credits awarded by Montana and Oklahoma.

The seven courses, in order, are:

1. Introduction to Self Funding, Risk Management,
   and the TPA Environment
2. Stop Loss and Marketing in Self Funding
3. Cost Containment and Vendor Selections
4. Accounting, Funding and Tax Consequences
5. Actuarial, Legal, Reporting and Disclosure
6. State Regulations and Federally Mandated Benefits
7. MEWA and VEBA

All seven courses must be completed to become a Certified Self Funding Specialist™. However, many students may only desire information in one or more classes, so students may take as many classes as interest them, with the only caveat being that the Introduction course must be taken by all and as the first course.

The cost for each course is $100. Upon registering for the first course, students are required to pay a $50 registration fee. This registration fee is not required for any subsequent courses taken. Continuing education credit, for those states offered, can be requested for an additional fee and must be specified at the beginning of the course. All classes are offered without continuing education credits.

This certification is for anyone who works with, or plans to work with, a self funded health care plan. The courses cover every aspect that plan sponsors, brokers, employee benefit professionals and other health care professionals need to consider when establishing or maintaining a self funded health care plan.

HCAA worked with WebCE, a nationwide leader in continuing education, to host the CSFS™ classes and designation online. This allows participants to view the materials online, print them from home and study at their own pace. The final exam for each course is completed online when the participant feels they are ready. To access CSFS™ directly with your web browser visit, www.hcaa.webce.com

For more information visit www.hcaa.org or call 952.564.3048 or toll-free at 1.888.637.1605.

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Movement in Washington
Keeps GRA Committee Busy
The Government and Regulatory Affairs (GRA) Committee didn't take much of a break during the summer months. In June, committee member, John Barlament, Michael Best & Friedrich LLP, presented the webinar, "Complying with the New Changes Taking Effect Yet in 2009." Sixty-seven individuals, all HCAA members, participated in the webinar that covered: Michelle's Law, Genetic Information Nondiscrimination Act, Wellness Plans, how the American Recovery and Reinvestment Act of 2009 modifies HIPAA rules, Applying Security and Privacy Rules to business associates and new breach notification rules.

On September 2, the committee again called on Barlament to present a webinar on New HIPPA Breach Notifications that require immediate attentions from TPAs. Michael Best & Friedrich LLP released information on the new notification requirements, and excerpt from that release is below:

On August 19, 2009, the U.S. Department of Health and Human Service ("HHS") posted an "advance copy" of its final HIPAA breach notification regulations on the HHS website. These regulations are expected to be published in the Federal Register on August 24, 2009. Once published, covered entities and business associates will, as a practical matter, only have 30 days to comply with the new rules - a very short time and one which will force them to work very diligently to comply with the new rules.
To read more, click here.

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Now You Can Update Your Information
in the HCAA Database
As part of your membership with our organization, you now have the ability to log-in to the database and update your contact information. By doing so, you will ensure that HCAA has all the correct information and can keep you well informed of everything from legislative updates, to webinars and upcoming events.

You will have the ability to update your name, title, billing, work and home addresses, e-mail and telephone. You will not have the ability to change any company information where you are employed. If you are the primary contact for your company, you will have the ability to select which fields your company can be searched under by members and non-members visiting the HCAA Web site.

To edit your information, simply log on to the HCAA Web site and click on the Member Log-in link located on the right-hand side of the screen. You will then be transferred to the membership portal and be asked to enter your primary e-mail address and password. Your current password is: hcaa2009. You will immediately be asked to change your password. Once you are logged-in, you will be able to update your information, search for other HCAA members as well as register for upcoming events.

Once you are logged-in, select "My Information" from the menu on the left-hand side of the page. You will then be transferred to your page containing all your contact information. To edit this information, select "Edit Information" located at the top of the page. To view your company's information, simply click on your company's name and you will be transferred to their information page. If you are the primary contact for the company, at the bottom of the page you will see a drop-down box where you will be able to select your company's demographics.

If you have any questions, please contact Sharon Noble or Rachel England.

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Healthplace America announced the appointment of Robert A. Yungk to Chief Executive Officer. He will be responsible for the company's strategic direction and all day-to-day business operations to ensure the success of the company's overall business objectives and growth.

"Healthplace America is an innovative, market driven and solution-based surgery management company," said newly appointed CEO, Yungk. "I look forward to helping the organization continue its growth and revolutionizing this country's approach to managing the cost and quality of surgery care. I am committed to its success and to making certain we have the resources and operations to fuel innovation and leadership in our marketplace.

Prior to joining Healthplace America, Yungk served with Mercer where he was Global President of Health and Benefits. While at Mercer he led the development of healthcare solutions for Fortune 500, multinationals and mid-size corporations in 42 countries around the globe.

Data Dimensions, a leading business process optimization (BPO) organization, announced ddTracker, it's proprietary production tracking system, and successfully completed implementation. The web-based user interface provides clients of all industries access to real-time work in progress information, allowing for greater transparency and control.

As work is received, ddTracker follows it every step of the way. The controls built into ddTracker allow management to view each resource at each workflow stage involved in processing, as well as progression of work throughout the entire workflow. The web portal allows clients to review where their work is at any point in time throughout their workflow, providing for better management of resources.

Data Dimensions was selected for the 2009 Best of Janseville Award in the Data Processing & Preparation category by the U.S. Commerce Association (USCA).

The USCA "Best of Local Business" Award Program recognizes outstanding local businesses throughout the country. Each year, the USCA identifies companies that they believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and community.

Various sources of information were gathered and analyzed to choose the winners in each category. The 2009 USCA Award Program focused on quality, not quantity. Winners are determined based on the information gathered both internally by the USCA and data provided by third parties.

The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, recently launched the industry's first accreditation program for TPAs. This past February, Allied Benefit Systems, Inc. became the first TPA firm to secure such accreditation through the Healthcare Network Accreditation Program for TPAs (HNAP-TPA).

HNAP-TPA generates a crucial level of trust in a company's operational control and procedural standards. Through a program of self-assessment and on-site evaluation, EHNAC reviews organizations' accommodation of industry-established standards and compliance with all relevant HIPAA regulations. The process ensures that companies meet or exceed criteria spanning privacy and confidentiality; technical performance; business practices; physical, human and administrative resources; and security. For organizations like Allied Benefit Systems, this means absolute confidence when exchanging critical data with its customers.

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News from LinkedIn

HCAA offers a members-only discussion forum through its online discussion community on LinkedIn. In each issue of the newsletter, we share with you the latest discussions taking place. For more information or to join HCAA's LinkedIn group, contact jnolan@hcaa.org.

Question: Out of Network Facility Claims, how are you paying them? Are you applying UCR to the claim or just relying on negotiations?
- Linda Ludwick, Chief Operations Officer, Capitol Administrators, Inc.

Response: You need to check the Plan Document wording but we are definitely seeing some of our TPA partners cutting to UCR. Many are trying to negotiate first and using a vendor who will apply UCR and then try to negotiate on top of it. We are seeing new plan wording which is incorporating tighter UCR language which will allow cuts both in and out of network moving forward.
- Anne Trupiano, Principal, TRU Services, LLC

Question: I'm looking to gather/share information with other small TPAs on a few topics noted below.

We are Portland-based with 70 employees - always wanting to share best practices.

1. How is your organization structured?
2. Do you have an Advisory Board?
3. How is your IT department structured? Is it outsourced? If you administer pension plans and issue pension checks, is it in-house or do you use a vendor?
4. Do you have a dedicated compliance staff member or utilize external resources?

- Julie Zola, Director of Marketing & Business Development, A&I Benefit Plan Administrators, Inc.

Response: I think one of the biggest challenges in competing with the large carriers is the way they present themselves. Meaning when they approach a prospect they imply additional savings that a "small TPA" cannot generate. In reality, they are simply including benefits...medical necessity...that kind of stuff. As a PPO we only show savings off of a claim and don't include any logic and a lot of times that is how the RFP is forwarded to the prospect.
- Joy Beth Fissette, Sr. Account Executive, Integrated Health Plan, Inc.7.

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Welcome New Members!

Sriram Iyer, Managing Director
Advisory Board Company
2445 M Street NW
Washington, DC 20037
PH: 202.266.5662
sacchetb@advisory.com
Type: Consultant

Cheryl Williams-Khoury, President
Affordable Benefit Administrators, Inc.
444 Irving Drive, Suite 201
Burbank, CA 91504
cwkhoury@benefitsaba.com
Type: TPA

Jan Fernandez-Hunter, Sales Executive
BenefitMD
708 Broadway
Tacoma, WA 98402
PH: 253.682.4803
FX: 253.591.9009
jhunter@benefitmd.org
Type: TPA

Allison Johnson, Partner
Benefit Dynamics Co.
618 North Tejon Street
Colorado Springs, CO 80903
PH: 719.575.0411
FX: 719.575.0456
ajohnson@benedyn.com
www.benedyn.com
Type: Broker/Agent

Jim Considine, MD, President
Considine & Associates
25401 Cabot Road, Suite 200
Laguna Hills, CA 92653
jim.considine@healthclaim.org
Type: Medical Management

Jennifer White, Administrative Assistant to the President
Data Dimensions
PO Box 1465 / 400 Midland Court
Janesville, WI 53547
PH: 608.373.6228
FX: 608.373.3228
jwhite@datadimensions.com
Type: Other
Business Process Optimization

Rick Klingler, Program Director
Dialysis Cost Containment, Inc.
975 Baldy Mountain road
Sandpoint, ID 83864
PH: 866.265.1719 X111
FX: 208.263.0824
rklingler@dccinc-us.com
Type: Consultant

Jason Elliott, VP Sales & Marketing
Eagle Innovations
2502 Spindletop Trail
Frisco, TX 75034
PH: 214.202.1080
jayandkel_elliott@sbcglobal.net
www.eagleinnovations.com
Type: Software

Linda Wikler, Director-Regional Sales
Emdeon
143 Lost Ball Court
Henderson, NV 89074
PH: 702.243.4242
FX: 702.269.4683
lwikler@emdeon.com
Type: Software

Don Hockmuth, COO
Excess Loss Insurance Services (EXL)
1575 Delucchi Lane, #103
Reno, NV 89502
PH: 775.826.5505 X240
FX: 775.826.7665
donh@exl1.com
www.exl1.com
Type: Broker/Agent

Mike Petruzzello, VP of Operations
HealthCare Strategies
9841 Broken Land Parkway
Columbia, MD 21046
PH: 800.582.1535
FX: 410.423.9430
Mike.petruzzello@hcare.net
Type: Medical Management

Jean LaFavor
HealthEZ
7201 West 78th Street, Suite 100
Bloomington, MN 55439
PH: 952.896.1205
FX: 952.896.4888
amy.waara@healthez.com
www.americasppo.com
Type: PPO

Kathy Major, President/General Manager
Innovante
8300 East Maplewood Ave, Suite 100
Greenwood Village, CO 80111
PH: 720.482.3712
FX: 303.323.1026
kmajor@innovante.net
Type: TPA - Carrier Owned

Brent Boyd, COO
Managed Care Systems, LP
4550 California Ave, Suite 500
Bakersfield, CA 93309
PH: 661.716.7120
FX: 661.716.9120
bboyd@managedcaresystems.com
Type: TPA, not carrier owned

Anne Marie McCarthy, President
Montgomery Management
Two Valley Square, 512 Township Line Road, Suite 110
Blue Bell, PA 19422
PH: 215.793.0313
FX: 215.793.0535
amccarthy@montmgmt.com
www.montmgmt.com
Type: MGU

Jessica Yarbrough, Marketing & Communications Manager
Satori World Medical
591 Camino de la Reina, Suite 407
San Diego, CA 92108
PH: 619.704.2005
FX: 619.704.2049
j.yarbrough@satoriworldmedical.com
Type: Other
Global Healthcare Network & Service Company

Josh Ayers, Manager
Stone Carlie & Company, LLC
101 South Hanley Road, Suite 800
St. Louis, MO 63105
PH: 314.889.1100
FX: 314.889.1101
jayers@stonecarlie.com
Type: Consultant

Carolyn Carder, Vice President
United Claim Solutions
10835 North 25th Ave, Suite 105
Phoenix, AZ 85029
PH: 602.393.4553 X106
FX: 602.863.1681
ccarder@unitedclaim.com
Type: Medical Management (Cost Containment)

Karen Janousek, COO-TPA Services
Valence Health
600 West Jackson Blvd.
Chicago, IL 60661
PH: 312.277.6341
kjanousek@valencehealth.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!

2010 Executive Forum
February 9 - 11, 2010
Wynn Las Vegas, Las Vegas, NV

2010 TPA University
July 21 - 23, 2010
Westin Tabor Center
Denver, CO.

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