HRA's

[ABC]

I have only sold a few HRA plans and used the health insurance carriers custodial company to admi the HRA funding. The problem I am having is that they are not giving many differnt options for the funding. Either up front or back end.

When you guys set up HRA plan do you use a TPA for the funding?

If so how did they perform and what was the cost?

THX

 

[speckled horn]

The TPA usually ends up being cheaper and always more flexible. With some TPA's you can get creative which helps employees with the sticker shock of taking away copays. However, it also appropriately makes them feel the pain if they overutilize. If you have good spreads between Copay plans and HDHP's in your market, the HDHP/HRA combo almost always works (mathematically, at least).

As far as performance, well you probably get what you pay for. I didn't say this, but a former 401k TPA/Broker I used to work for once said..."TPA's are like cockroaches. Kick over a rock and a hundred scatter for cover". I haven't used enough to form that opinion. Same could be said of independent insurance agents, i suppose.

 

[Sam]

my favorites are TASC, ChoiceCareCard and FlexAmerica, but we use CCC most because they allow a debit card with a HRA. Fees run around 5 to 8 bucks a head with a set-up fee that can sometimes be waived.

 

[Delta76]

I also like TASC, I have a great local rep. They also now allow debit cards for prescriptions, anything else usually requires an EOB anyway. The cost depends on the size of the group.

The thing I like about TASC, and maybe others do this too, is that they will cover the gap between employee expenses and plan funding. For example, if a small ten person group was on the hook for $10,000 ($1000 per person) and all ten employees reached their deductible the next day, TASC would pay the $10,000 and wait for you to fully fund the $10,000 over 12 months (basically a 0% loan). Now the odds of that happening are low, but I've had it be a deal breaker more than once.

 

[NewHealthStrategies]

Try a company out of Atlanta called AdminAmerica.

Great pricing on set-up contracts and admin fee's and the owner is a great guy. Plus your clients get great customer service.

 

[ABC]

One more question on this topic.

Do the insurance carriers frown when you use a TPA for the HRA admin?

Technically I could take a non HRA plan from the insurance carrier and turn it into an HRA with the TPA.

Anyone ever do this?

 

[Delta76]

I do it all the time. I don't see why the insurance carrier would care, it doesn't change their outlay or risk exposure. It seems like the way the carriers price their plans that they encourage groups to go to a higher deductible (at least in my area).

 

[Delta76]

It looks like I was wrong, thanks for letting me know. I would rather find out here than somewhere else. My carriers haven't cracked down on this yet, but maybe it's coming.

 

[somarco]

Fully insured carriers are always the last to figure out what is going on. Stop loss carriers figured out years ago that an HRA (or similar arrangement) coupled with a "high" deductible meant just as much utilization as you get with a typical copay plan and lower deductible.

 

[NewHealthStrategies]

Hmmm, again Somarco hits the nail on the head... he's like a walking-Wiki-Insura-Pedia



REMINDER:

An HRA has got nothing to do with insurance... don't mix the two together.

You can have an HRA WITHOUT the insurance component. It just happens to make a neat little package when you "combine" the two together.