In 2003, when Fringe Benefits Management Company (FBMC) decided to acquire/create a medical TPA with a focus on delivering Health Reimbursement Arrangement (HRA) offerings, they knew that information and data sharing with clients would be the key to their success.
FBMC had been in business since 1976 as a TPA serving the public sector exclusively and supporting payroll distribution for ancillary products. They began their business shift in 2003 by acquiring Florida-based United Benefits from Brown & Brown, Inc., one of the largest Property & Casualty Brokers in the country, positioning themselves as a full-service health and welfare employee benefits TPA. This past January, they acquired another TPA based in Cherry Hill, NJ and remain privately owned with their corporate headquarters located in Tallahasee, FL.
According to Russ Brown, Senior Vice President of Medical TPA Services for FBMC, "We saw the self-funded market begin a migration from traditional employer-focused strategies toward an environment that educates employers and employees on the cost drivers of care. This was an opportunity for FBMC to not only help employers better manage these expenses, but also deliver tools employees could use to better manage their healthcare."
The company had programs and procedures available to help them achieve their goals, but they were insufficient for the company's forward-thinking strategies and required continuing program modifications to achieve the results FBMC was seeking. They wanted to establish a partnership with their clients and plan participants that would support consumerism thinking in healthcare services and alternatives, as well as provide educational resources.
The Benefit Analyzer® solution from Benefit Informatics had what FBMC needed to address a growing employer interest in HRA and HSA programs in the mid-employer sized market. With this online management information tool, FBMC was prepared to better assist employers in managing costs. In addition, other online informational tools would help shorten the traditional learning curve and get employees more familiar with the true cost of care. This technology was designed to help employees adapt when the HRA and HSA programs were put into place.
In early 2005, FBMC implemented the Benefit Analyzer online information management service and is very pleased with the results. Through this service, FBMC is able to give each of its employer clients a personalized Web page that provides employers with on-demand access to the following:
- Claim payment details
- Historical utilization trends
- Current utilization patterns
- Ad-hoc management reports
- Customized data exports
- Comparative benchmark data
According to Brown, "Our employer groups enjoy the online capabilities and tell us that phone calls to the HR department have been reduced. This has also helped us preserve business in a price-sensitive market. TPAs can be at a disadvantage when large carriers are offering discounted services. Greater intimacy of interaction and flexible plan design is where we can set ourselves apart."
Brown also notes, "Health benefits are moving to more of a defined contribution role - TPAs are best able to guide employers and employees in what can be a complex decision-making process. Benefit Analyzer gives us the tools to offer more cost-effective solutions without requiring additional customer service personnel."
From supporting case management to helping manage prescription drug costs, this solution is working for FBMC. And, a strategic alliance with The TriZetto® Group, Inc. provides integration of Benefit Analyzer with the QicLink Extended EnterpriseTM claims administration system - increasing the value of this service considerably for FBMC and other QicLinkTM clients. "Founded by former TPA executives, Benefit Informatics is highly responsive and proactive with a long-term dedication to service. We see that just getting better with this new partnership with TriZetto, our claims administration system vendor," states Brown.
For more information on the Benefit Analyzer and its integration with the industry-leading QicLink system, please click here or call Ted Tamul at (630) 428-5326.
