Introduction for Brokers and Consultants
Welcome to Tucker Administrators, Inc., the experts in employee benefit risk management. We provide a comprehensive portfolio of employee benefit products to serve the employer, broker and consultant community.
We are not just a claims payer. We have developed tools to evaluate and predict increased risk. That is, who is more likely to get sick and help them become healthier. Our goal is to identify cases before they escalate into catastrophic claims, and prevent many claims entirely. We focus on reducing the number of claims by wellness intervention and helping employees at increased risk to become healthier.
Using proprietary software, we monitor every self-funded medical and drug claim submitted. We also actively promote healthier lifestyles on a case-by-case basis with your employees. Most importantly, this software was created specifically for the medical insurance industry using algorithms and case studies produced by experienced physicians in the field.
Our relationship with quality carriers and our expertise in the employee benefits industry allows us monitor factors that influence healthcare costs, and offer a cost-effective and flexible solution to the employer.
Our commitment to you is to approach each assignment with objectivity and strict adherence to ethical and professional standards. We consider each client a long-term business partner.
Tucker Administrators offers:
- Plan design consulting and service for self-funded and fully insured plans
- Innovative plan designs using proven incentives and CDHP concepts
- Underwriting services and stop loss administration
- Pharmacy benefit management evaluation
- Every self-funded claim is analyzed using AWAC by using over 80,000 algorithms to detect potential large claims before they happen. Claims are reviewed on a daily basis
- COBRA, HIPAA and other relevant regulatory compliance services
- Healthy employee programs
- Disease management
- Health risk assessment programs
- On-site clinic programs
- Customized interactive web enrollment and administrative services
- Section 125 services including debit cards
- Consolidated billing services
- “Charlotte’s Best” in the TPA category
Here are three steps you can take right now to begin to control your employee benefit costs:
- Have us assess your needs with a no-obligation confidential consultation
- Ask us to explain the tools and techniques we use to manage your plan to the best advantage for your employees and your business.
- Compare the long-term cost savings that our plan will bring you
Member Web Access Demo
Tucker Administrators, Inc. allows members and group administrators 24/7 access to their employee benefits information through our secure website customized for each client.
Members have access to their own information on pending and paid claims, deductible and out-of-pocket information, covered dependent information, FSA activity/balances, plan document, PPO and pharmacy information.
Group plan administrators have access to all aspects of plan claims activity and includes numerous reports specifically designed for plan performance analysis.
To view a demonstration of our website capabilities for employees and employers use the login form below.
Use login name: tucker and the password: tucker5kt
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Health Care Reform-the Affordable Care Act (ACA)
Health care reform, sometimes referred to as the Patient Protection and Affordable Care Act (PPACA) or simply, the Affordable Care Act, has tri-agency guidance through HHS, the DOL, and the IRS. Listed below are the governmental websites that contain accurate information for employers, employees, brokers and consultants.
HHS consumer health care website. This website is the “web portal” required under health care reform and provides information for consumers about both public and private health coverage options available in their states.
HHS Center for Consumer Information & Insurance Oversight (CCIIO) website. CCIIO is charged with helping to implement many of health care reform’s requirements (see our article). You can access HHS regulations, fact sheets, FAQs, letters, news releases, and other resources regarding health care reform using the links at this website.
DOL Affordable Care Act website. This website provides links to health care reform regulations, other guidance (including model notices), research studies and surveys, archived webcasts, and additional resources.
IRS Affordable Care Act website. This website provides information on health care reform’s tax provisions, as well as links to related guidance, Q&As;, IRS forms, tax tips, and other resources.
Health Reform Implementation Timeline
The Health Reform implementation timeline and specific requirements may be granted grace periods and revised as agency regulation writers consider responses to their call for comments. Please call us at 704-525-9666 to discuss any questions you may have about these guidelines.
Requirements For Self-Funded Quotes:
- Name of Business
- Industry Classification
- All locations
- Current Carrier
- Current Provider Network
- Current and Renewal Specific Level and Premiums (N/A for current fully-insured group)
- Current and Renewal Aggregate Attachment Point and Aggregate Factors (N/A for current fully-insured group)
- Current PBM
- Current and Renewal Specific Coverage (N/A for current fully-insured group)
- Medical
- Rx
- Dental
- Current and Renewal Aggregate Coverage (N/A for current fully-insured group)
- Medical
- Rx
- Dental
- Copy of Current Plan Document and any renwal changes to benefit schedule
- Census
- Current and Renewal Premiums (for current fully-insured group)
- Current lasers (age, gender, diagnosis) (N/A for current fully-insured group)
- Current 50% report (age, gender, diagnosis) (N/A for current fully-insured group)
Requirements For Level Funding Quotes:
- Name of Business
- Industry Classification
- All locations
- Current Carrier
- Renewal Rates
- Claims History*
- Benefits Schedule
- Census
* For Level Funding Quotes: If there is no claims data available, we will provide a preliminary proposal that will require individual apps to bind coverage. Rates may be adjusted after underwriting of individual applications.
Please contact us for more information or questions about your RFP submission:
Call 704-525-9666, or email tucker@tuckeradministrators.com