Services

With the growing momentum for consumer driven healthcare, 3PA services also include HRA and HSA plan administration:

Health Reimbursement Accounts (HRA) are employer funded accounts as defined by section 105 and 106 of the Internal Revenue Code that reimburse employees for qualified medical expenses. The accounts allow the employee an opportunity to make choices on how their healthcare benefit is used. Funds in the account can be used to cover deductible or coinsurance amounts, co-payments and services or supplies that may not be covered by the health plan.

Employees can enjoy first dollar benefits on many medical expenses that would otherwise be an out-of-pocket cost. Contributions are excluded from gross income, providing tax incentive as well. The participant now has more choices and control over how healthcare dollars are spent; either using the money as expenses are incurred, or leaving funds in the account for future use. Unlike flexible spending accounts, the balance is rolled over each year with no requirement that you spend the full amount deposited annually.

Health Savings Accounts (HSA) are offered in conjunction with a high deductible major medical plan. Individuals may contribute up to $2850 or up to $5650 for families each year. These contributions can be used to cover the high deductible, any co-payments and services not covered through the health plan. Premiums for long term care coverage are also qualified expenses. If the employer offers a cafeteria plan, contributions can be made through that plan and are pre-tax transactions.

Unlike flexible spending plans where contributions not used within a year are lost, the balance in an HSA can be rolled over for future use. Distributions are also tax free but penalties apply if funds are withdrawn for purposes other than healthcare expenses. The account holder determines the type of account and can even invest in mutual funds for added growth. An HSA belongs to the employee so it moves with him if he changes employment.

Flexible Spending Account
A Flexible Spending Account (FSA) is a pre-tax benefit allowed under Internal Revenue Code Section 125 that offers employees the opportunity to set aside pre-tax dollars to use for non-reimbursed medical, dental and dependent care expenses. Insurance premiums, deductibles, co-payments and non-covered services are some of the items that would qualify for FSA reimbursement. Flexible Spending Accounts offer a means of saving tax dollars while enjoying the benefit of being reimbursed for otherwise non-covered expenses.

Increased take home pay. FSA deductions come out of your paycheck before taxes so for tax purposes your pay has been reduced, resulting in an increased take home amount.

Reimbursement requests through Section 125 flexible spending plans can be submitted directly to 3PA for approval and payment. Claims are verified for eligibility and account balances are monitored, relieving employers of the administrative burden associated with this benefit. Staff members responsible for Section 125 plans participate in ongoing training to keep abreast of changes to the laws that govern this benefit.

Debit Cards can also be provided in conjunction with any of the reimbursement accounts providing greater ease of use and increased satisfaction of employees.

Click here for a chart comparing HSA’s, HRA’s and FSA’s.

3P Administrators can also handle your self-funded short-term disability plan. We will review applications for short term disability to verify eligibility and effective dates. We calculate payment amounts and issue checks to the claimant while monitoring the length of the payment period.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires most employers to offer continued coverage for plan participants who no longer qualify as active participants on the plan. This federal law has gone through many changes and has numerous requirements that 3PAdministrators has followed and can handle for employers. We provide the employer with the initial notice that must be mailed to all plan participants. Election packets are sent directly to qualified beneficiaries and we monitor the election period. For those participants who choose continuation coverage, we send monthly premium notices, track timely payments, verify continued eligibility and the length of time coverage is available.

Complying with the Health Insurance Portability and Accountability Act (HIPAA) can be a nightmare for employers. 3PA has devoted a great deal of time and effort to studying this legislation to assure compliance. We will receive and review certificates of coverage for new enrollees to a plan to determine if they qualify in removing or shortening pre-existing exclusion periods. We will issue certificates to those plan participants whose coverage terminates. HIPAA security applies to the electronic data of a plan. Our network has multiple safeguards in place that more than satisfy the requirements of HIPAA. We offer education and compliance assistance to plan sponsors for both privacy and security regulations.

Online capabilities provide easy access to plan information for employers, their plan participants and healthcare providers. Employers can receive online enrollment requests from new employees and plan change information from participants. Members can view their processed claims and track the amount of deductible and out-of-pocket they have satisfied. A plan document detailing benefits available can be viewed or downloaded. Other plan-related forms are also available for downloading. Healthcare providers can have access to their patient’s benefit, eligibility and claims status information. This online service, available 24/7, can significantly reduce your human resource departments work load by answering many common questions.

Ongoing reporting is an important factor in monitoring a plan’s activity and effectiveness. 3PA provides its clients with monthly claims experience summaries showing the plan’s performance in relation to specific and aggregate contracts. Additional quarterly reports will assist in analyzing the plan on a regular basis to determine potential renewal factors or needed benefit changes. All reporting for active clients is included in the administrative fee.