Tml Multistate Intergovernmental Employee Benefits Pool

TML Intergovernmental Employee Benefits Pool Mission Statement-To provide excellent service offering competitive health benefits and administrative services to eligible municipalities and other governmental entities in Texas by utilizing innovative, viable and affordable alternatives while maintaining financial integrity.TML IEBP Milestones2010 - 2011 Provider Electronic Payment/Member EOB Electronic Option-Medication Therapy Management Program-Healthcare Reform Implementation-International Centers of Excellence-2009 - 2010 55.3 Million in Assets-Staff Count: 123-Extension and Expansion of American Recovery and Reinvestment Act of 2009-Member Report Revision-Evidence Based Prescription Utilization Analysis-Healthcare Reform Review-Pre Sixty-five Retiree Pool Development-Population Health Management Healthy Lifestyle Guides-ODS ASP converted to TML IEBP Host-On-Line Enrollment Improvement: EBS Data Expansion and Error Report-COBAL Member Database Conversion to SQL--HealthX Expansion 2008 - 2009 55.3 Million in Assets-Staff Count: 118-American Recovery and Reinvestment Act of 2009 Implementation-Phone Information Technology Upgrade-On-Line Enrollment Upgrade-Disease Management Improved Reports: Accountability-Measurement of Personal Health Engagement ROI Stratification Active Participation Expansion of Return of Investment Report Evidence Based Medicine Medically Justified Non-Evidence Based Medicine Business Continuity Test-Group Individual Plans/Defined Contribution-Specialty Medical Management-Valued Tiered Prescription Access 2007-2008 62.5 million in assets-Staff Count as of February 27, 2008: 145-Service Improvements: Claim Adjudication System Upgrade to 3.3 Healthy Initiative Program D2 Hawkeye Prochaska: Healthy Lifestyle Stages of Change Claim Integration Clinical Stratification/Adjusted Risk Index Healthy Initiatives HealthPlan: Community Based Biometric Screenings/Health Risk Appraisals/Incentive Plan Multidisciplinary Medical Management Team Intake Specialist Behavior Specialist Nutritionist-Nurse Medical Consultant Nutritional/Diabetic Specialist Be Well at TML IEBP/Healthy Lifestyle Management Program Web Wellness Portal Return on Investment Incentive Plan with compliance of Biometric Screenings and Health Risk Appraisal Navigating GASB Liability Risk Transition: Retiree Reimbursement Account and Access for Life Program Defined Benefit vs. Defined Contribution OON RBRVS Reasonable and Customary 100% participation requirement was updated to exclude: the requirement for employees who are on their spouses plan, TRICARE, or have retired from a previous employer, employees who access a Documented Spouse Plan, and employees who access a Retirement Plan due from prior employer Data Warehouse: Milliman Creditable Coverage Recognized to offset pre-existing limitation 2006-2007 $62.0 Million in Assets Staff Count: 14K-Service Improvements: Be Well at TML IEBP Underwriting Consultant Ernst & Young Section 125 Debit Flex Card/MBI HealthX Section 125 Exante Relationship Storage Area Network Expansion D2 Claim Stratification Healthy Acute Chronic Catastrophic October 2006: United Medical Resource Alliance Partnership Options PPO Network Claim Adjudication System Transition PEBA Administrative Services: Disease Management 10/06 Pharmacy Benefit Manager 10/06 Retiree Advantage Program 1/1/07 EAP Services-Deer Oaks 10/1/07 Cancer Supplemental Benefits-Colonial 10/1/07 Critical Care Supplemental Benefits-AFLAC 10/1/07 Accidental Supplemental Benefits-Colonial 10/1/07 Life/LTD/STD Benefits-The Standard 10/1/07 Wellness Benefits-Circle of Health 10/1/07 -------------------------------------------------------------------------------- 2005-2006 $58.0 Million in Assets Staff Count: 154Service Improvement: NHBC Claim Audit Alliance -------------------------------------------------------------------------------- 2004-2005 $51.6 Million in Assets Staff Count: 153Service Improvements: On-Line claim status look-up January 2005: TML IEBP and Texas Association of Counties assumed administrative services for Public Employee Benefits Alliance (PEBA). PEBA Administrative Services: PEBA@tmliebp.org Onsite wellness with external vendor Disease Management external vendor - Asthma Supplemental Secondary Repricing Network at Out of Network Benefit Percentage Patient Advocacy Program -------------------------------------------------------------------------------- 2003-2004 $45.7 Million in Assets Staff Count: 156Service Improvements: In-House professional negotiations Onsite wellness with local providers Specialty claims adjudication procedure Health Reimbursement Account plan designs Health Saving Account plan design Contribution/Non Contribution Medicare Supplement Option -------------------------------------------------------------------------------- 2002-2003 $42.5 Million in AssetsStaff Count: 153Service Improvements: In-House professional negotiations Automated Pre/Post-duplicate Identifier Wellness program implementation HIPAA Title II Compliance Loss prevention analysis expansion Out of Network Hospital usual & customary fee schedules Provision of Chapter 172 Trustee training for self-funded members External professional negotiations -------------------------------------------------------------------------------- 2001-2002 $37.4 Million in AssetsStaff Count: 153Service Improvements: Claims Cost Management Disease Management New organizational goals & objectives Auto-Audit, contract compliance, nurse claims liaison personnel FastStart mail service reminder program Three-tiered prescription copay plan Access PHCS out of state network -------------------------------------------------------------------------------- 2000-2001 $33.5 Million in Assets Staff Count: 161Service Improvements: Full-time Collection Specialist Part-time Medical Director Increased electronic claim adjudication process Enrollment online services Website update with benefits online Operational Guidelines: TML Group Benefits Risk Pool transferred all of its assets and obligations to TML Intergovernmental Employee Benefits Pool (TML IEBP), a successor Trust with identical purposes to the original Trust, April 1, 2000. -------------------------------------------------------------------------------- 1999-2000 $33.0 Million in Assets Staff Count: 141Service Improvements: In-House Right of Recovery Website enhancement Continued relationship development with reinsurance carriers -------------------------------------------------------------------------------- 1998 $30.3 Million in Assets Staff Count: 133New Benefit: Nurse On-CallService Improvements: Administrative Manual Design infrastructure of workflow processes Expansion of Preferred Provider Network Out-of-State Network Expanded administrative services to self funded Independent School Districts -------------------------------------------------------------------------------- 1993-1995 By 1995: $22.5 Million in Assets