Home / Health Care / Penn State selects new third-party administrators for health care benefits – Penn State News

Penn State selects new third-party administrators for health care benefits – Penn State News

UNIVERSITY PARK, Pa. — On Jan. 1, 2018, Aetna will grow to be the third-party administrator (TPA) for the University’s medical benefits, and CVS Caremark will develop into the TPA for the University’s prescription drug benefits, each changing Highmark, which has been the TPA for the medical and prescription drug benefits plans for the previous ten years.

David J. Gray, senior vice chairman for Finance and Business/Treasurer, says it’s commonplace enterprise apply to finish requests for proposals on a periodic foundation.  

“The end of the current third-party administrator contract was an opportunity for Penn State to test the market.” Gray stated. “This ensures that employees and the University are benefiting from the most competitive and favorable in-network discounts, broad access to high-quality providers of health care services, and reduced administrative costs.”                

Since final summer time, school, employees and administrators with experience in health care, health insurance coverage, finance, procurement and human assets have been collaborating and reviewing proposals for new plan administrators. The steering committee’s suggestions have been introduced to senior management and accepted.

The TPA assessment and choice processes have been accomplished with adherence to the six guiding rules for the design of Penn State’s health care plan, which have been accredited as an advisory and consultative report by the Faculty Senate in 2016, and offered a basis for all selections pertaining to the choice.

Those six guiding rules advocate that Penn State think about the next relating to health care benefits:

  • Offer option to staff;
  • Keep plans reasonably priced;
  • Maintain a good value-sharing strategy;
  • Make info accessible;
  • Provide knowledgeable use when implementing knowledge warehouse and price transparency instruments; and
  • Foster a tradition of health.

Human Resources might be speaking extra details about the new distributors within the coming months, together with answering necessary questions on ID playing cards, entry to physicians, and so on., by means of the Human Resources web site, residence mailings, the Penn State News website and Penn State Today.

For extra details about the medical and prescription protection TPA choice course of, go to the 2018 medical benefits plan design website. Learn extra concerning the Aetna and CVS Caremark, together with frequently asked questions, on the website’s TPA welcome page.

Information concerning the new TPAs

Aetna is likely one of the nation’s main diversified health care benefits corporations, serving an estimated 45 million individuals with info and assets to assist them make higher knowledgeable selections about their health care. Aetna gives a broad vary of conventional, voluntary and shopper-directed health insurance coverage merchandise and associated providers, together with medical, pharmacy, dental, behavioral health, group life and incapacity plans and medical administration capabilities, Medicaid health care administration providers, staff’ compensation administrative providers and health info know-how services.

Aetna has lengthy standing, relationships with UPMC and Pinnacle Health, and expects these relationships to stay robust and to proceed to evolve, additional securing accesses to all UPMC and Pinnacle suppliers for a few years to return.

CVS Caremark is a number one pharmacy benefits supervisor with almost 90 million plan members, almost 9,700 retail places, and greater than 1,100 stroll-in medical clinics. CVS Caremark gives a devoted senior pharmacy care enterprise serving multiple million sufferers per yr, increasing specialty pharmacy providers, and a number one stand-alone Medicare Part D prescription drug plan, the corporate allows individuals, companies and communities to handle health in additional reasonably priced and efficient methods. 

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