Current Press Releases
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OutsourceOne announces formulation of a dedicated reinsurance facility
OutsourceOne, a national provider of web benefit enrollment, benefit administration, and reinsurance, has built on its twenty-five year relationship with Lloyds of London to create a private stop loss facility. The facility will be dedicated to OutsourceOne clients, expanding the one source model to include reinsurance.
To manage the facility, OutsourceOne has retained John Abbot as underwriter. John has forty years of experience in the reinsurance field, most recently with Manning Williams Limited as a board director and head of its reinsurance division.
With Lloyds of London, John was class underwriter for several Lloyds syndicates with total medical expense portfolio responsibility. Recognised market leader for the class, writing up to $20m capacity per year for the syndicate, which equated to approximately £300m in overall capacity to the London market.
As a part of the stop loss facility roll out, OutsourceOne is offering an incentive program to customers that will allow them to obtain on-line enrollment and COBRA administration at reduced costs when reinsurance is purchased through the facility.
Bill Mehus, CEO of OutsourceOne, says of the rollout, "We are excited about the potential for this product. John's extensive experience and reputation in the field make him the perfect choice to head up this initiative. This will be a highly valuable addition to OutsourceOne's offerings, particularly in connection with the other benefit services offered by OutsourceOne and our ability to reduce costs on high interest services like web enrollment by bundling it with stop loss coverage."
For more information, call 612-436-2721 or email info@outsourceone.com.
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OutsourceOne Manages College Associations On-line Open Enrollment.
OutsourceOne joins with the Independent Colleges and Universities Benefits Association (ICUBA) to provide a state of the art, integrated on-line benefits administration solution to eight leading Florida colleges.
ICUBA, building one of the premier college benefits associations, has chosen OutsourceOne to provide on-line employee and college administrator access to benefit information. In addition, OutsourceOne will provide on-line enrollment, COBRA, Flexible Spending Account and Health Reimbursement Arrangement (HRA) administration, and electronic benefit vendor eligibility management.
OutsourceOne's WebOne eligibility management tool will be the technology behind this innovative benefits administration plan. In addition to offering a plan with an HRA component and on-line access to account information, WebOne will allow ICUBA plan participants to do cost and benefit plan modeling on-line before making their medical plan elections. ICUBA's intent is to provide participants with the tools they need to become active partners in their benefit elections process and cost modeling.
ICUBA's use of HRA benefit design combined with the technology of OutsourceOne's WebOne administration system will provide member colleges with a cost effective and forward looking benefit program.
Bill Mehus, OutsourceOne CEO, describes the opportunity as "An excellent chance to prove WebOne's self-service capabilities and the value of predictive modeling in assisting employees to make informed benefit decisions."
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QuickMedx, OutsourceOne, Create New Health Care
Delivery and Payment System for Companies, Employees
MINNEAPOLIS, April 1, 2003 -- A delivery system
that may prove to be an important solution to the
major business and employee problem of rising health
care costs, long medical reception room delays and
payment system hassles, is being tested in partnership
with a major Minnesota manufacturing company.
QuickMedx, a company that provides high quality,
quick and affordable basic family health care in
convenient retail and corporate headquarters, has
teamed up with OutsourceOne, a company that provides
outsourcing of benefits administration and human
resources services, to create a debit card for employees
that allows them instant access to more than eight
satellite clinics throughout the Twin Cities. Under
the new system, employees simply use a plastic debit
card that is “swiped” at these satellite
clinics to give them instant approval and payment
for medical tests and treatment.
These QuickMedx clinics, currently located at Cub
Foods stores and select corporate headquarters, are
staffed by licensed nurse practitioners and physician’s
assistants who offer a wide range of diagnostic procedures
ranging from strep, sinus and ear infections tests
to cholesterol and glucose screening. Prescriptions
are provided when clinically justified. Standard
charges at these clinics are only $38. No appointment
is needed, and clinics are open seven days a week.
Most patients are treated, including wait time, in
fifteen minutes.
OutsourceOne, a privately held, Minneapolis-based,
national leader in the benefits outsourcing field,
is providing the payment and support systems that
allow employees to access the QuickMedx clinics with
a simple individualized plastic debit card. This
debit card also acts as an immediate reimbursement
for flexible spending accounts. This permits a payment
of the prescription drug co-payments when purchasing
their prescription drugs, without waiting for reimbursement
out of their Flexible Spending Accounts.
Longer term, this debit card is expected to be programmed
to be the prescription drug identification and payment
card, with the prescription benefits administered
by Innoviant, an employee prescription management
services provider for self-funded employer plans
across the country. All combined, this is a one-of-kind
in the healthcare industry. “Innoviant is dedicated
to providing unique prescription benefit plan designs
and options for employers”, said Innoviant
CEO Mark Campbell. “This innovative program
with OutsourceOne and QuickMedx aligns the medical
services side of health care business with the financial
services side, enabling employees to maximize their
health care benefits and providing employers with
an efficient and effective program”.
This week, the system is being tested with employees
of a major Minnesota manufacturing company, Lake
Region Manufacturing, based in suburban Chaska. Lake
Region has 700 employees at its headquarters location.
The 56-year-old company, which also has plants in
Pittsburgh and New Ross, Ireland, is a leading contract
and OEM manufacturer of minimally invasive medical
devices.
Clayton Benish, Lake Region’s Vice President
of Human Resources said, “ Our Company continues
to be a successful leading edge organization. Since
Lake Region is very labor intensive, the human side
of our enterprise is very significant requiring a
focus and concern on all aspects of an employees
career and dedication to enhancing life styles and
health requirements.”
Lake Region employees, who received their debit
cards earlier this week, expressed enthusiasm and
excitement regarding the convenience of this benefit
enhancement. The Company hopes that employees along
with their families obtain the medical care necessary
to be healthy and free of the common ailments, which
are treated at the Quick Medx facilities. The entire
visit is paid by simply “swiping” this
card, making it even simpler for people to use. This
cost-effective convenience is another initiative
in promoting employee wellness.
Mark Campbell, CEO of Innoviant, a prescription
benefits administrator stated “This program
will help an employee get the full value out of their
benefits, with savings, in the most convenient way
I have seen yet. It is time for our industry to get
to the next level, and this is a great start by getting
the medical services side of the health care business
in sync with the financial side of the health care
business”.
QuickMedx CEO, Linda Hall Whitman called the new
venture, “OutsourceOne and Lake Region Manufacturing
recognize the importance of ensuring convenient,
high quality healthcare access for employees and
at the same time substantially reducing healthcare
costs. Limiting the scope of services to common family
illnesses and screenings, allows QuickMedx to provide
top quality services at a fraction of the cost of
a clinic, urgent care or emergency room visit. QuickMedx
provides services that are adjunctive to those provided
by the individual’s primary healthcare provider.
Based on the results of this beta test with Lake
Region Manufacturing, QuickMedx and OutsourceOne
plan an aggressive marketing program to bring their
joint health care diagnostic and payment debit
card system to other companies and organizations
in Minnesota, the region and, eventually, the entire
country. They also plan to quickly add other features,
such as the prescription drug card, to the program.
Bill Mehus, CEO of OutsourceOne says, “The
future of health policy is to bring the patient and
providers closer together to achieve financial efficiencies
and healthcare effectiveness. This model gives the
patient choices for their families needs (costs and
delivery), in a convenient and cost efficient model.
We believe that this is one of the first phases in
bringing “alternative delivery” models
to the healthcare market.
OutsourceOne, is a Minneapolis-based, national leader
of benefits administration. OutsourceOne serves the
rapidly growing business process outsourcing market
segment. The market segment is populated by a highly
fragmented set of service providers. OutsourceOne
is a full-service provider with state-of-the-art
integrated web-based capabilities, including web-enrollment,
eligibility, carrier data transfers, voluntary benefit
marketplace, billing and reconciliation, COBRA and
FSA administration, and medical claims administration.
Information is available at www.outsourceone.com.
Innvoiant provides employee prescription benefit
management services for groups ranging in size from
100 employees to midsize, national accounts. Innoviant
spun off from former parent Wausau Benefits on August
1, 2002. The company has been in business for more
than four years. Innoviant manages group prescription
programs for self –funded employers and health
plans, including taking responsibility for group
setup, benefit structure, preferred products list
management, customer service and electronic claim
processing. The company offers its own national pharmacy
network as well as retail and mail order services
at reduced rates. Innoviant is headquartered in Wausau,
Wisconsin. For more information please visit the
company web site at www.innoviant.com.
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An alliance between Eldorado Computing, Inc. and OutsourceOne, Inc.
With Eldorado Computing and OutsourceOne technologies and competencies, the National Claims Center was implemented March 1, 2003. This venture concludes months of discovery into the needs of claims administrators for the future. The primary issues are how TPA's can compete profitably in today's marketplace. The issues can be broken down into four categories.
- Administrators internal costs
- Administrators need for updated technology (internet, HIPPA, automation)
- Administrators need to create efficiencies, new revenues and profitability.
- Administrators need to create stability in marketplace.
The National Claims Center has established a national presence with quality Third Party Administrators ALL utilizing the Eldorado HEALTHpac 4 platform. The TPA's are strategically located around the country to provide regional services, in a national environment. The HEALTHpac4 platform is an ASP model, internet driven, creating a national network of TPA's, not requiring hardware, software, or IT staff. Eldorado currently services over 200 administrators with over 10 million employee lives.
OutsourceOne, a national provider of benefit administration services, utilizes WebOne, as their eligibility platform. This is a fourth generation proprietary system on an ASP model, providing employer and employee self service. WebOne is connected to HEALTHpac4 for eligibility along with all traditional benefit administration tools (enrollment, eligibility - all lines), communications, claims and administration. OutsourceOne has built OneMarketplace, a voluntary benefit portfolio of guarantee issue, no participation requirements, point & click and buy module. Employees can enter and select the benefits that are right for them and their families. Benefits include Life, Accident, Critical Illness, Vision, Pet, Legal, Medical and Dental. All are with name brand carriers. This internet environment with product distribution and the blend of Webeci and WebOne is available for all HEALTHpac clients. WebOne can be integrated to work with other systems.
The benefits for claims administrators to outsource their claims to the National Claims Center are in order of the needs listed above:
- Cost, our costs are low through our economies of scale and our virtual model. Also, HEALTHpac4 is strong in Auto adjudication. With this system, the cost to you is determined based on manual claims, and auto claims are at a fraction of the cost. It is possible to achieve 70% plus auto adjudication rates.
- Technology, our technology is advanced to include internet capabilities, adjudication, lookup, eligibility, enrollment, etc. at a low PEPM ASP cost.
- Employer and Employee self service providing your customers' greater access, therefore, reducing your time on telephones, faxes, emails etc.
- Stable marketplace is achieved by outsourcing to a group of administrators in a plug and play environment. This provides your customers greater stability because we have created an environment that system conversions or TPA changes are a thing of the past. This then allows you to get back to what's important like sales, relationships and marketing.
The four keys in the marketplace success of the partnership between the National Claims Center and our Administrator clients are:
- Client/Employer/Employee access to information real time
- Auto adjudication and efficient claims processing
- Webeci/WebOne and OneMarketplace commitment
- Current TPA maintaining control with
- Customer Service
- Marketing and broker relationships.
- Stop Loss and other products
- Eligibility
Then the National Claims Center will adjudicate claims at a pace and quality second to none. The National Claims Center can increase your profitability, stability, revenue, and put you ahead of your competitors that are still in the age of paper, people and manual processes. We and our clients live in a virtual world of EDI, connectivity, and the need for immediate information. Let WebOne and the National Claims Center virtually change your business to a robust high margin model.
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Future of Benefits
As employers struggle with the increasing burden of health insurance costs, more and more employers are questioning not only the financial cost of sponsoring health plans, but the ancillary administrative costs. They also tire of the losing game of attempting to develop one program that meets the needs of every employee.
What if employers eliminate their involvement in employee benefit programs, and offer them in the same way they sponsor retirement plans? What if employers simply contribute monies to employees' benefits (Defined Contributions), and employees are then directed to a marketplace to purchase ALL their benefits, with a full range of choices? What if employees had complete control and options over their customized benefit selections? What if the employer could cap their benefit spending from year to year, and make it predictable?
These are questions being studied today. We can no longer keep trying to make a system work that was designed for the Ozzie and Harriet generation through negotiation with the traditional market. Even the most sophisticated employers are struggling with strategy, implementing plan changes such as increases to prescription drug co-pays. Try as hard as we might to design, negotiate, and adjust pricing and funding models the same issues remain: the consumer of healthcare has no real responsibility or means to control the cost.
Three major structural changes are required. The question is, can the many stakeholders with vested interests, agree to compromise. First, the legal system must be changed to reduce the cost of malpractice protection. Second, the medical insurance community must agree to change the method by which people/insureds are assigned to pools for pricing purposes. And third, there must be incentives for people/insureds to make more cost-effective healthcare decisions.
The new mantra of health care programs is Consumer Directed Health Plans (health reimbursement arrangements and health saving accounts). Employers recognize that patients have to be involved in the purchase of health care to ultimately control utilization. Employees also need tools and information to help them make good purchasing decisions. New studies have shown that through incentives (saving accounts, large deductibles), employees can reduce utilization, but in some cases, at the expense of their own health. As a Wall Street Journal article last May 12th reported, some patients are foregoing prescribed medications to save health dollars This could lead to more health care costs and utilization from these patients. What is beyond todays Consumer Directed Health Plans?
In the future, these plans will be similar to retirement programs, i.e. "Defined Contribution". Employers will make contributions to employee benefit saving accounts; employees would access their benefit portal to make benefit selections, customized to their family needs, paying for it out of the benefit savings account. These portals would be regional, with regional and national health insurance carriers participating. This one portal, or marketplace will offer ALL types of benefits: health, lower benefit health, dental, vision, life, interest sensitive life, accident, critical illness, Rx cards, travel accident, annuities, long term care, disability, concierge services, and health saving accounts. This one marketplace, would administer all facets of employee participation, enrollment, premium collection, employee inquiries, saving accounts, carrier interfaces, carrier negotiations, and COBRA.
Employers will have the ability to more accurately establish their benefit contributions from year to year. They can also set the inflationary increase to their contributions to the employee benefit savings account according to their financial ability, employee market pressures, competition, etc. Employers will use this employer premium contribution, along with wages, to compete for and retain employees. All employers compete on the same benefit program basis, through this one marketplace, and compete solely on total compensation. Employers also save on greatly reduced internal requirements on administration and fees to third parties, brokers.
All employers could participate in this environment, large, medium small. In fact, this strategy would drastically benefit employees at companies that presently do not offer or sponsor benefits to their employees. This uninsured/employed American represents a large sector of our total uninsured. The lower benefit plans would be very attractive and affordable to this population.
Employers are already moving towards more employee responsibility and accountability in benefits. During this transition of empowerment, it is important for employers to mentor employees. This can be staged with online enrollment, HSA's, and voluntary marketplaces. In this One Marketplace, employees would have freedom to design their own benefit program, matching their benefit buying strategies with carrier/plan choice, HSA's, HRA's, high deductible, catastrophic plans, co-pay plans, and provider choice, disability, life etc.. Since these benefits are tax free individual policies, and would not be tied to an employer, but rather the One Marketplace, these benefits are essentially portable i.e. the employee does not lose these benefits when changing jobs. Rather, the employee receives a new employer contribution into their benefit savings account to continue the benefit plan of their design.
If you think this is years away, think again. Web based marketplaces are in place today to accommodate all types of voluntary benefits. Health, Dental and vision carriers can offer voluntary policies today. Companies are implementing a marketplace with guarantee issue and no participation requirement, with no market solicitation, investigation or negotiations required, where employees buy by credit card, with little or no sponsorship from the employer.
"What if", is now "When"
William P. Mehus, is CEO of OutsourceOne, Inc., a benefits technology, transaction and administration company, with web tools for employee benefits, communication, procurement, and full plan eligibility and management. See www.outsourceone.com
