TPA Solution for the Small Group

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TPA Solution for the Small Group

• Presented by
• American Trust Administrators, Inc.
• Tom Stein

2
American Trust Administrators

• A full service Facility
• Established in 1972 over 30 years of experience
• Specializing in self-funded medical plans for
  groups with 10 to 99 employee lives
• Headquarters in Overland Park, Kansas (suburb of
  Kansas City)
• Most TPAs want to do business on groups with
  100 employeesATA wants to serve your small
  group needs.

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American Trust Administrators

• ATA offers cost savings through
• National and regional PPOs
• ATA Rx Pharmacy Benefit Management program
• Returns 100 of collected manufacturers
  formulary rebates and market share rebates
  quarterly
• HSA-qualified and other high deductible plans
• Dual option plans

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ATA Products

• Medical
• Vision
• Dental
• Life, ADD, Dependent Life
• Weekly Income

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Specific Deductible Options

• Amount selected by the employer
• Function of companys size, risk tolerance,
  financial resources, plan of benefits and claim
  history
• AmeriShare 2,000 to 50,000 (varies by state)
• May be per person or 3x cap per family
• Since ATA is initially on the risk specific
  deductibles get reimbursed quicker than normal.
• Some carriers add new lasers at renewal ATAs
  carrier does not!
• We will also review and consider removing lasers
  at renewal

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Aggregate Deductible

• Calculated as a Monthly Aggregate Factor x number
  of covered units x 12 months
• Monthly Aggregate Factor will be either a2-tier
  or a 4-tier rate
• Matches the rating method chosen for calculating
  the Fixed Costs under the plan

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Monthly Aggregate Accommodation

• Provides monthly protection against unpredictable
  claim fluctuation
• Advances funds to cover heavy claims utilization
• Paid if accumulated claims exceed monthly
  aggregate accommodation point
• Must be repaid
• When accommodation point again exceeds
  accumulated claims, or
• On termination, if accommodation point is less
  than the aggregate deductible

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Specific Aggregate Options
AmeriShare
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Funding Options

• Minimum group makes periodic deposits to claims
  account as needed to fund claims
• We advise depositing an amount equal to two
  months estimated aggregate deductible to
  establish reserve and avoid claim delays
• Maximum group funds up to the monthly
  accommodation point amount shown on their bill
• Funding option can be changed on request

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Plan Surplus

• Excess money in the Claims Fund can be
• Rolled over to cover the next years claims or
  used to reduce future Claims Fund contributions
• Change from maximum funding to minimum funding
• Used to add benefits to the plan
• Used to fund run-out liability (discussed later)
• Used to fund any other employee welfare benefit
  plan established pursuant to ERISA, such as
• Dental, vision, LTC, life, disability income,
  unemployment plans, vacation plans, pre-paid
  legal plans
• Returned to the Plan Trustee at termination