El Paso First Healthplans selects ikaCarrier 3.5 Enterprise Solution

El Paso First Healthplans, a proven leader in improving access to affordable health care in El Paso, Texas has implemented ikaEnterprise to deliver savings and increase new sales revenue. “It’s amazing, I never thought that it would be possible to perform so many functions in a 100% online environment," said Norberto Correa, Chief Information Officer, El Paso First Healthplans. ikaSolutions can do it for less time and money than any other technology company,” added Correa.

El Paso Healthplans believes the ikaEnterprise products are the most sophisticated enterprise solution available in the insurance marketplace.

ikaEnterprise will deliver savings and increase new sales revenue by utilizing a series of integrated web portals that are part of healthcare-focused smart BPM solutions that intelligently manage employee’s and customer’s business interactions across the payer enterprise. ikaEnterprise enables all the MCO functions performed by employees and customers to be handled online. On average, Enterprise return-on-investment is reached in 21.7 days.

Utilizing the most advanced Business Process Fusion methodology allows effective automation of enterprise functions including sales, member, employer, underwriting, administrator, and finance. “The ikaSolutions team took our information and way of doing business and transformed it into a new high-tech highway of smart business process management that will enable our new business to be generated in the most cost effective manner,” according to according to Donald Hairston, COO for El Paso First Healthplans.

The new El Paso First Healthplans functionality will be performed on an ASP (Application Service Provider) basis, resulting in lower IT costs. The Massachusetts based servers at the ikaSolutions corporate headquarters have system redundancy in Orlando, FL.

A leading insurance industry consultant reviewed and analyzed the ikaCarrier Enterprise Solution and stated, “ikaCarrier will decrease the need for Insurance Carrier employees to perform those same functions.” His projected savings include:

Underwriting 7% savings
Finance / billing 22% savings
Sales / enrollment 37% savings
Claims submission 6% savings.

Broker – Sales Portal provides ultimate power to brokers/agents to quote, generate proposals, enroll, clients online in real-time. Brokers also have the ability to manage the books of business along with prospects in a method that has been a dream to most. Throw away the paper and multiple databases. All you need is at your finger tips with the ikaCarrier sales portal. Other features include client renewals, where brokers simply update the census, and with a click of the mouse renewal rates appear. You have the option of tweaking the rates online in real-time with the underwriter. Brokers can ask for 10% discount and get 7% whatever the case may be - no more waiting weeks for renewal rates. Brokers also can view their commissions status in a comprehensive or customizable format, they can see who has paid what and who has yet to pay and can also make various forecasting reports.

Broker Managers, or BMs can manage and monitor all sales activity and have the ability to add, modify or terminate sale personnel. Potential brokers can register online and enter their license information for broker managers to view. BM’s can transfer accounts between the sales force and approve commission splits and other broker/agent activities. BMs can generate various sales reports and commissions reports across the entire sales force.

The Underwriter working in the Carrier Portal is able to view RFQs for large groups, analyze group risk factors along with claims history and adjust computed rates online in real-time (online underwriting). Underwriters now have the power to interact with the brokers/agents as they always needed to, giving power to the broker to close new business!

Online underwriting is a powerful tool that has been analyzed by leading consultants that show saving range from 10-20%. This application allows for the elimination of the old way of doing business: faxes to carrier; carrier personnel re-entering the data into their systems which is then put in a queue for the underwriters to analyze; underwriters send the application to the administrator to put into a proposal and fax to the broker; broker re-enters the rates into their own proposal format.

Small Group quoting is done today with EL Paso Healthplans underwriter opening his portal of brokers, rates the cases and the system automatically creating proposals for the broker to download and pass along to the client. The broker can also enroll the case online at the client site.

Large groups are quoted in a similar fashion - the sales force enters the data online into the Sales Portal. Information then goes directly to the MGU and reinsurance carriers systems or can be held for review at the TPA Underwriter level. The Reinsurance Underwriter Logs into their Portal, rates the cases, whereupon proposal preparation is done automatically in a predetermined format, enabling the underwriters and staff to respond online, in real-time to the submitting brokers.

The Member Portal allows employees to enroll online and view their plan selections at any hour. They can also update their PCP and Pharmacy benefits, search for providers, view claims and deductible status from anywhere. Members can manage their medical saving accounts in the most secure environment.

The Employer Portal allows Human Resources personnel to manage group benefits, plans, and products. The portal makes it much easier to manage the enrollment of employees with the ability to add, modify or terminate members. HR now can utilize a Comprehensive COBRA management system online with an additional billing and payment system that works together with the Finance Portal - and any other applicable system in a fully integrated environment.

The Carrier Portal handles all company billing and reconciliation including forecasting with a special report feature that enables custom and comprehensive reports.

Real-time execution across the enterprise is what all the leading analysts have been saying for years and now it's a reality in El Paso, Texas. Executives can now effectively manage and report across the enterprise and see exactly what is transpiring in all departments.

The Carrier Portal has the ultimate power to control the sales operations. Administrators can add, terminate and map managers and sales