Letter from the President

By Todd Archer

Dear HCAA Members:

With the passage of health care reform, the future of our industry (in spite of some question marks) looks to be as bright as ever. A recent Industry Insights publication by Duff & Phelps on the Third Party Administrator market summarized it this way: "2009 and Health Care Reform - It Could Have Been Much Worse for TPAs". Admittedly this report was released just prior to the actual passage of the reform legislation, but the pertinent parts of the reform effort were largely unchanged from what was known during the drafting of their comments. The report expounds further:

The Good

• We were never targeted as a portion of the market that needed reform
• The mandated coverage provision should benefit TPAs
• Reform should enhance our competitive position in the marketplace

The Bad

• Depressed employment numbers are expected to continue through 2010
• US economic growth is lagging except for health care, education and government

The report concludes that consolidation in the market will likely increase as scale creates a significant competitive advantage. Other factors fueling this are:

1. The economy has stabilized, albeit at a depressed level, and valuation is easier in a stable environment
2. Transaction financing is returning, slowly and moderately
3. The uncertainty of health reform has largely lifted
4. Potential changes in the treatment of capital gains

The purpose of these comments is not to promote the buying or selling of TPAs but to provide insight into how the investment market is viewing our industry. This report indicates that the market is largely bullish on us, and that optimism should instill confidence in our future.

Join us at the TPA University in Denver on July 21 - 23 as we start Gearing Up for a Challenging Future. While the future looks bright, there will certainly be challenges as we go about the work brought on by our ever evolving marketplace. "The Value of Connection" can help you make the most of these opportunities. Respectfully, Todd E. Archer President

Respectfully,

Todd E. Archer
President

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HCAA CELEBRATES 30 YEARS OF CONNECTIONS

2010 marks the Health Care Administrators Association's 30th anniversary.

HCAA was formed in 1980 as the Independent Administrators Association, a California-based not-for-profit that acted as a legislative and regulatory advisory group for third-party administrators and related service providers. Following the passage of ERISA and similar laws, third-party administrators needed a voice in Washington as well as educational opportunities with leading experts in the industry.

For over 30 years, HCAA has supported third party administrators through education opportunities from leading industry experts. With the 2010 passing of health care reform legislation, HCAA has also committed to take a leading role in legislative advocacy, working to increase its influence with policymakers and the media in order to transform the TPA industry and its role in health care.

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TPA University Update

2010 TPA University "Gearing Up for a Challenging Future" is just around the corner. Be sure to join us July 21 - 23 at the Westin Tabor Center in Denver, CO.

This year's TPA University is full of valuable sessions that will help you find out what gears your organization needs to meet the challenges that are coming. Wednesday, July 21 will kick-off with keynote presentation, "How to Build a Better You and Gear Up for a Challenging Future" presented by Bryan Dodge, Dodge Development. Thursday's keynote presentation is from Michael McMillan titled, "The Power of Teamwork." Other session topics include: "The Politics and Policies of the Newly Enacted Health Care Reform Law," "Gearing up for ICD-10-CM/PC S Implementation," "Shifting Gears, Excelling at PPO Business," "Evolution of PBM Strategies to Control Pharmacy Spend," "Complying with the New Benefit Laws: Practical Examples and Guidance" and "High Performance Living - Tools to Supercharge Your Life." For a full list of sessions and speakers, click here.

Early bird registration rates are now available. These rates end on June 25, click here to register and take advantage of the discounted rate. For hotel information, click here.

Thank you to our many sponsors who make our conferences possible: (current as of 6/09/2010)

Corporate Sponsors
A&G Healthcare Services
American Health Holding, Inc.
Benefit Informatics, Inc.
INETICO, Inc.
Preferred Medical Claim Solutions, LLC
RedCard Systems
Strategic Recovery Partnership, Inc.
TC3 Health, Inc.
The Phia Group, LLC
WellDyneRx

Platinum Sponsors
A&S Financial Services Inc.
American Specialty Health
Eldorado Computing, Inc.
Envision Pharmaceutical Services
GlobalCare Inc.
Global Excel Management Inc.
Healthation, Inc.
Medical Cost Management
Navitus Health Solutions
Partners RX Management, LLC
ProPeer Resources, Inc.
The TriZetto Group, Inc.

General Session Sponsor
CVS Caremark

Gold Sponsor
Sentinel Air Medical Alliance

Hotel Key Card Sponsor
Maxor National Pharmacy Services

Lunch Sponsor
HealthX, Inc.

Name Badge Sponsor
RESTAT

Conference Bag Sponsor
INTERLINK Health Services, Inc.

Notepad/Pen Sponsor
Lighthouse1, LLC

Program Binder Sponsor
Coalition America, Inc.

Water Bottle Sponsor
Star Line Group

Welcome Snack Sponsor
WellDyneRx

Sponsorship opportunities are still available, click here for more information on becoming a sponsor for the 2010 TPA University.

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CSFS® IS PLEASED TO ANNOUNCE ADDITIONAL STATE CERTIFICATIONS

We are pleased to announce several additional states approved CE credits for CSFS® courses. As we told you in previous articles, due to state cutbacks, education credit awards are being delayed and the process is much slower in receiving the awards than in the past.

However, we have received good news and wanted to share with you the awards we have received. The following is our update:

• Delaware- All Seven Courses Approved - 35 credits total
• District of Columbia - All Seven Courses Approved - 84 credits total
• Minnesota - All Seven Courses Approved - 71 credits total
• New Jersey -One Course Approved - Course 5 Actuarial - 24 credits
• North Dakota - All Seven Courses Approved - 61 credits total
• Oklahoma - Six Courses Approved - Courses1-5and Course 7 - 62 credits
• Rhode Island - All Seven Course Approved - 84 credits total

There are now 17 states and the District of Columbia that have approved all seven courses; partial credit is available in two states. We will advise you as soon as we receive word on the rest. We know many of you would like to combine your studies with the credits.

We have awarded 14 designations of CSFS® since July 1, 2009 and look forward to awarding more. Thank you all for your interest and your support.

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HCAA INTERACTIVE MAP

HCAA's Interactive Map is a tool developed to provide valuable information to you, your producers and your staff. This map provides the opportunity to seek services from HCAA members as well as provide information on the HCAA designation program, the Certified Self Funding Specialist® (CSFS®).

We currently offer two search categories in each state: "Member Services Offered" and "CSFS®".

Find a Service
The "Member Services Offered" category provides an opportunity to discover the myriad of services offered by our member companies. Select the state where you are seeking services, then select the search criterion which allows you to choose up to five types of services offered at a time. The map will return basic information on all members meeting your criteria operating in that state. The list will show you the firm's name, Web site, as well as a contact person, including their e-mail address and phone number.

See CSFS® Designees & Students
The "CSFS®" category offers three searches: CSFS® Designees, CSFS® Students and CE Credits Offered. CSFS® Designees are listed in their home state with full demographic information. CSFS® Students are listed by name only. CE Credits, if awarded in that state, will be listed by Course. If credits are not awarded in the state selected, a message will appear on the screen stating credits are not available yet. CE Credits have been applied for in all 50 States and the District of Columbia.

Build Your Connection
Do you have an RFP you are preparing and need a service out of your area? Are you seeking a new PPO, PBM or Stop Loss Carrier? Or, maybe you are ready to do business with the CSFS® Designees in your region? You can also encourage your producers to get started on their CSFS® training by suggesting they check out the CE available in their state by course. We are offering many ways for both HCAA members and non-members to reach out to our members for TPA administration and related services.

Get Listed on the Map
The first step to making sure your firm is shown in a search is to update your member information by logging in to www.hcaa.org and clicking on the members only log-in located on the right hand side of every page. Make sure to update your personal contact information as well as update your companies information, including the states where you do business. Your user name is your e-mail address where you receive HCAA communications, your password is hcaa2009. For log-in assistance or questions, please contact rachel@hcaa.org.

If you are ready to experience the HCAA Interactive Map, visit the HCAA Web site today and select the Interactive Map link on the home page navigation to be taken to the Interactive Map. Simply select the state and your area of interest and learn more!

The development team included the Membership and Education Committee Chairpersons. We welcome your feedback as you begin using this new tool so that we can continue to evolve this tool.

As part of our core mission, HCAA continues to focus on providing tools to keep your connected.

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Follow the HCAA Blog, "Connections"

HCAA is not only active when it comes to health care reform; we are vocal about concerns. Since January, HCAA has offered a place for not only members, but non-members alike to engage in conversation surround the ever changing environment of health care. Each month, a member of HCAA's Public Relations Committee posts on the HCAA Blog, "Connections" to voice his or her opinion, concerns, or general thoughts on a subject of their choosing. Click here to visit the blog.

Below is a posting by Adam Russo, The Phia Group, from May 18, 2010.

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After spending much of the past 4 months on the road speaking at various conferences, one thing is clear - people are freaking about health care reform. Not the fact that it is happening but that so many issues are unresolved and answers are unclear. Many of the details are just not known yet and it is frustrating to everyone. I am still waiting to hear the true meaning of "grandfathering"!!!! What is it?

The main factor that hasn't been addressed with reform is the rising costs of health care and that is where the self insured industry can make the difference. We need to begin innovating and collaborating now. Let's face the fact that health care reform is here and take the lead in promoting cost savings that this industry desperately needs.

Recently, America's Health Insurance Plans (AHIP) stated that it fears that employer-sponsored self-funded plans will siphon off healthier, cheaper beneficiaries to create isolated, lower-risk pools, which an AHIP official said could force insurers to raise premiums as health reform moves the country toward more universal coverage. Really? Well, what is the true underlying cause of AHIP's statements? This same official stated that self-funded plans threaten to deprive the insurance industry of healthy lives that support large risk pools.

Insurers are concerned about "adverse selection and ability of smaller and smaller firms to pull themselves out of the exchange and go into the business of self-funding - which would be very, very bad for the structure of the exchanges," said Scott Keefer, VP for policy development at AHIP. He was speaking on April 30 at a hearing sponsored by the Alliance for Health Reform in Washington, D.C.

Self-funded plans may also pull themselves out of the pool because that way they can avoid state taxes on health insurance premiums, Keefer said. He also said the following:

1. Smaller and smaller firms might choose self-funding, because incentives to self-fund are stronger under reform
2. Whereas previously, the threshold for self-funding may have been groups of 500 or more, after reform that threshold may decrease to 300 or less for young, healthy groups.
3. Self-funding employers are able to get the job done cheaper than insured plans because they can tailor plan design, have lower administrative costs, do not operate for a profit and have access to claims data, which insurers often refuse to share.

We need to take advantage of all of this. The rivalry of insured versus self-insured has been around for years but the danger is that reform will persuade all kinds of companies to move away from employer-based coverage.

HHS will be doing an annual study on impact of exchanges on market dynamics, adverse selection and self funding. By April 1, 2011, HHS will report on whether self-insurance is more affordable than insured coverage. In addition, HHS will review the likelihood of self-insured plans not being able to pay obligations or becoming financially insolvent; and the extent to which rating rules are likely to cause adverse selection in the large group market or to encourage small and mid-size employers to self-insure.

I think it's pretty curious that AHIP was responsible for this inclusion in the rules!!!! What do all of you think? Do you agree with my conspiracy theories?
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Join the conversation by following HCAA's blog. Your comments and feedback are a critical part of the conversation. We can't wait to hear from you.

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ABCT, Inc.
http://www.abct.com

Deborah Karlewicz

Bardon Insurance Group
http://www.bardon.net

Community Health Plan
http://www.communityhealthplan.org

Fox/Everett, Inc.
http://foxeverett.com

GTESS Corporation
http://www.gtess.com

MCM - Medical Cost Management Corp., Solutions for Better Health
http://www.medicalcost.com

PacificSource Administrators, Inc.
http://www.tpa.pacificsource.com

Resolution Concepts LLC
http://resolutionconcepts.com/

The Language Banc, Inc.
http://www.thelanguagebanc.com

TPA Systems Inc.
http://www.tpasystems.net

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