Archive for March, 2018

Can Outsourcing Your Member Marketing Materials Production Pay for Itself?

March 27th, 2018 | by Brad Boyer

Materials Creation, Print & FulfillmentTags: , , No Comments »

Many health plans are currently considering how to manage creation and distribution of marketing materials due to members September 30. The reality is, health plans have two options:

  1. Develop materials in-house, and outsource printing and fulfillment to a vendor; or
  2. Outsource the entire materials production process – materials creation, and print and fulfillment – to a vendor

The prospect of not having to create materials in-house may appeal to many marketing directors. However, with health plans operating on tight budgets, many may think that outsourcing the entire process would be too costly.

But, if outsourcing your member materials production could pay for itself, wouldn’t it be worth considering?

Read more »

Are you Outsourcing your ANOC and EOC Creation to the Best People for the Job?

March 19th, 2018 | by Brad Boyer

Materials CreationTags: , , , , , , , , No Comments »

Preparing materials for the Annual Enrollment Period (AEP) – namely Annual Notice of Changes (ANOC), Evidence of Coverage (EOC), and Summary of Benefits (SB) documents – can be a time-consuming, labor-intensive process wrought with compliance risk. As a result, many health plans opt to outsource the creation of these documents to a third-party vendor.

There are several benefits to outsourcing the creation of ANOC, EOC and SB documents. But not all vendors are created equally. Below are three things to look for when hiring a third-party vendor to create your ANOC and EOC documents. Read more »

How to Avoid FDR Oversight Issues in a CMS CPE Audit

March 1st, 2018 | by Tonya Teschendorf

ComplianceTags: , No Comments »

First Tier, Downstream or Related Entity (FDR) Oversight continues to be a hot topic for the Centers for Medicare and Medicaid Services (CMS) and plan sponsors. CMS auditors annually find deficiencies in FDR oversight and monitoring activities in program audits, with poor oversight of FDRs trending as a common condition in yearly audits.

Many plan sponsors consider an FDR as a risk only if a problem materializes. This is a mistake. All FDRs are operational and compliance risks. The extent of the risk exists in the type of functions the FDR performs, potential and actual member impact, and FDR issues.

Read more »