Collect key information and easily report back to Centers for Medicare and Medicaid Services

What is Section 111?

The Medicare, Medicaid, and SCHIP Extension Act of 2007 includes a provision, “Section 111”, that requires group health plans (GHPs) to collect certain information about when the plan is or has been primary payer to Medicare and to report that information to Centers for Medicare and Medicaid Services (CMS).  GHPs will be required to collect and report information from employers regarding social security numbers, employer identification numbers, employment status and employer size.  

Employer Data Collection Challenges

• Employer groups do not always respond in a timely manner, or at all, and may provide incomplete or incorrect information.
• Plans need to ensure that “working status” is collected each time a new Medicare-eligible employee is identified. This will require employer data collection inquiries throughout the year.
• RREs must reconfirm that retired members have not returned to work.  Although this is not a new requirement, many plans will need to alter their work-steps to ensure compliance.
• The employer survey process (to collect employee and subscriber data) is manual and time consuming for RREs.
• The shortened time frame between quarterly submissions makes it difficult to collect and validate all required employer information.

The Solution: Information Collection for Employers (ICE)

What is ICE?

ICE is a web-based tool to facilitate the collection and certification of employer group information.

 ICE has a variety of features that benefit group health plans and third-party administrators (TPAs):

• Auto generated email or letter to employer groups requesting required information
• Ability to send reminders to employer groups
• Online dashboards to track the annual certification status for employer groups
• Auto generated list of groups that have not responded and require follow-up
• The ability to analyze historical trending data
• Printable employer group data reports
• Data encryption to preserve secure information

ICE features also benefit employer groups:

• Reminders to complete certification
• A system for collecting employer required group data (employee count, multi-employer plan participation etc.), employee data (employment status, date of status change etc.) before submitting to health plan/TPA
• Easy to use interface with pre-populated employer group information
• The ability to edit/save to make iterative updates before final certification
• Health Plan/TPA correspondence and on-line help capabilities

We work with organizations in all parts of the insurance value chain—from agencies to carriers to third-party administrators—to:

• Strengthen customer and channel strategies.
• Improve business intelligence and reporting.
• Increase efficiency by redesigning and integrating business processes and systems.
• Design and implement infrastructure to support future strategies.
• Identify business process inefficiencies to achieve cost reduction.

For more information, please e-mail Kevin McCarty or Anwer Kahn.

Further details about the MMSEA Section 111 can be found by clicking the following link to a webinar conducted by Huron Consulting Group in October 2008.
http://www.huronconsultinggroup.com/download.aspx