Tailored benefit plan helps decrease health care costs

By Lisa Kime

Trussway is one of the nation’s largest manufacturers of structural building products. Its projects range from single or multi-family family homes to large commercial buildings. Trussway’s ability to mass produce quantities quickly and on time helps its customers be more profitable.

Trussway had a one-size-fits-all benefits plan that didn’t meet its needs. The company also experienced issues with claim lag time, customer service and payment accuracy. It was searching for a third-party administrator (TPA) that could create a customized self-funded benefits plan, alleviate the administrative burden on its human resources staff and provide attentive customer service.

Trussway selected UMR, which worked with the customer and its broker to determine the best benefit plan and network solution for Trussway’s demographics. Because it had multiple facilities throughout the US, Trussway needed a plan that would provide adequate coverage as well as accommodate its Spanish-speaking members. UMR secured both national and regional networks that reached across the country and filled the gaps for Trussway’s multi-location membership base. UMR also provided Spanish-speaking representatives and assisted with document translation.

Upon signing with UMR in July 2002, Trussway implemented medical and dental administration. Over the years, it added additional products, such as flexible spending accounts and UMR’s integrated utilization management and case management programs. UMR also provided student verification and multivendor payment services, which freed up Trussway’s human resources staff. After a short period of time, Trussway began to see savings and a dramatic improvement in customer service.

“We were looking for a larger operation with a small-size mentality ... a TPA that really knew Trussway inside and out,” Vice President of Human Resources Dorice Aytes said, adding that UMR gave Trussway the service and accuracy it expected and was quick to respond to inquiries or issues.

Human Resources Manager Melinda Harris believes customer service is what sets UMR apart.

“I have three or four different contacts at UMR that I work with on a frequent basis that provide great service,” Harris said. “If they don’t have the answer immediately, they seek it out and keep me abreast of the progress. They contact the provider, member, vendor and me, providing end-to-end customer service.”

One example of that service is when Trussway eliminated online enrollment because of budgetary constraints. “UMR went above and beyond the call of duty and worked with us to tailor reports to make sure we captured all eligible participants,” Harris said. “They accommodated our situation and helped us find a solution to make it as efficient as possible without the online tool.”

UMR’s strategic account executive (SAE) has been instrumental in making sure the account runs smoothly. The SAE has helped Trussway create custom notices to employees, interpret plan performance reports and explain new regulations and services.

“UMR customizes things with our input to fit our needs,” Harris said. “That flexibility is very important as every company is uniquely different.”

To make sure the client’s plan is on track, UMR provides Trussway with monthly and annual reporting metrics.

“The savings with UMR are amazing…it blows me away,” Aytes said. “Their reports allow us to project claims funding and keep me abreast of our finances. When I get asked questions, I have the information available to answer them.”

Customer: Trussway, Ltd.
Industry: Structural Building Product Manufacturing
Challenge: Reduce claim lag time, improve customer service and payment accuracy while alleviating the administrative burden on human resources.
Solution: A customized, flexible benefit plan that included a provider network solution consisting of national and regional networks to accommodate the customer’s multi-location membership base. Implementation of a customer service program, complete with Spanish-speaking representatives and Spanish member materials.
Benefits: A continuously evolving benefit structure that includes the addition of several new products and services, dramatically improved customer service, reduced human resources administrative responsibilities and significant year-over-year plan cost reductions and savings.

Biography

Lisa Kime is Vice President of Account Management for UMR, the third-party administrator (TPA) unit of UnitedHealthcare. Kime has over 20 years of health care industry experience, including the last 15 with UMR. Prior to joining UMR, she held various positions at Kaiser Permanente, including patient advocate and account executive.