TPA Briefing
December/January 2009
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In This Issue
Retail Clinics Added to The Alliance Network
New Case Study: Health Care Vigilance Pays Off for Rock County
Do You Know Who to Contact at The Alliance?
Holiday Donation Supports Second Harvest Foodbank
Real Savings on Stop-Loss Coverage
Alliance Provider Update
QualityCounts for Employees
News You Can Use
About the TPA Briefing
Retail Clinics Added to The Alliance Network
You have no doubt heard about retail-based clinics that have opened or will open in the next few months. The Alliance has worked with these clinics to allow access to members. The following immediate care clinics have been added as participating in-network Alliance providers:
 
Beaver Dam Community Hospital Fast Care Clinic
Locations:
·   Shopko  - Beaver Dam
·   Marshland Pharmacy - Mayville
 
Meriter Fast Care Clinic
Locations:
·    Shopko - East Madison
·    Shopko - West Madison
 
Monroe Clinic Fast Care Clinic
Location:
·    Shopko - Monroe

Employees who choose to receive care at a Fast Care Clinic will be required to pay the fast care clinic fee at the time of service. At that time members have been instructed to ask the clinic to submit a claim to The Alliance, using the address provided on the back of their health plan identification card. We anticipate that your payment will be made to the provider and members have been told to expect to be reimbursed by the provider. We are working with these providers to ensure that these refunds are made within 30 days of receipt by the hospital or clinic.
 
We are also currently in negotiations with other retail clinics and will provide you with information about these clinics as available. If you have any questions about retail clinics, please contact Carlene Boehmer, 800.223.4139, x 6601.  

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New Case Study: Health Care Vigilance Pays Off for Rock County
In this new case study, John Becker, director of human resources, talks about how Rock County saw a reduction in health benefit costs after joining The Alliance.
 
Becker discusses the importance of "diligence and vigilance" to ensure continued cost savings for self-funded plans. You'll read more about how in their first year, Rock County saw a reduction in health benefit costs of $1.2 million. Be sure to read it today.
 
Do You Know Who to Contact at The Alliance?
The most up-to-date information and contact information can always be found on The Alliance's new Web site, www.the-alliance.org. For a complete list of contacts by need, click here and be sure to bookmark it for the future.
Holiday Donation Supports Second Harvest Foodbank
Did you know that on any given day, an estimated 103,000 people, including nearly 39,000 children, may go to bed hungry in southern Wisconsin? Second Harvest Foodbank of Southern Wisconsin is one organization devoted to helping feed those who are hungry.
 
This year, The Alliance is proudly making our annual holiday donation to Second Harvest. Instead of sending cards or gifts to our business associates, each year The Alliance makes a donation to a charitable organization as a way of giving back to the communities in which our members live and work. This year's donation of $500 will help Second Harvest fight hunger in southern Wisconsin.
 
We thank you for your continued support and wish all our members and business partners a happy and healthy holiday season and a prosperous new year! 
 
Real Savings on Stop-Loss Coverage
One benefit of membership in The Alliance is access to significant discounts on stop-loss rates. We are able to offer this preferred pricing by leveraging the collective purchasing power of our member companies.
 
More than a dozen stop-loss carriers have agreed to offer additional discounts for employers that are members of The Alliance. The discounts range from 8 to 45%, and are based on a thorough evaluation of our contract effectiveness with health care providers and facilities.
 
The following carriers recently evaluated The Alliance:
  • Alliance Underwriters
  • Best Re
  • BP Inc
  • Hartford
  • HCC Life
  • Intermediary Insurance Services Inc.
  • ING
  • Meritain Health
  • Medical Risk Managers
  • Optum Health
  • RE Moulton
  • SLG
  • SunLife
  • Vista Underwriting
As part of their membership Alliance members are also able to access preferred pricing on prescription benefit management with Wisconsin Rx, dental benefits through Delta Dental, and vision benefits via DeltaVision.
 
For specific details on the stop loss discounts or if you know of additional carriers who are not on this list, please contact Jill Mathison, 608.210.6644.
 
Alliance Provider Update
 
provider directory iconThe Alliance encourages employers to distribute the Provider Update listing to their employees. 

Just a reminder - always check the online provider directory for the most current provider information!

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QualityCounts for Employees
 
QC logo
 
 
 
The Alliance encourages employers to distribute the QualityCounts for Employees information piece to their employees. 
  • Tips When Getting Medical Tests - Taking an active role when doctors order blood tests, X-rays, and other tests is an important step to ensuring good care. 
     

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News You Can Use
 
The Alliance highlights health care and benefit management news for employers in News You Can Use with a link to take you to the original story or report.  
  • Wellness Programs and Employer Opinions - To provide current information about the nature of employer-sponsored health benefits, the Kaiser Family Foundation conducts an annual national survey of private and public employers with three or more workers.
About the TPA Briefing
 
Each month, The Alliance TPA Briefing delivers the latest news to third-party administrators about Alliance services, programs and events as well as information on health benefit trends, issues, and ideas of interest to our mutual clients.

Subscriptions are available on a complimentary basis. To subscribe, please send an e-mail message with your name and agency to the Sales and Member Services Department
 
Reader comments, suggestions, and topics are always welcome. 

Cathy Lanser, Editor
Melanie Cannon
, Designer
Mary Borland
, Director, Sales and Member Services
Carlene Boehmer, Manager, Claims and Customer Services

Be sure you don't miss an issue of the TPA Briefing. Set any spam filters you may have to accept e-mails from @the-alliance.org.
 
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