Health Plans Pose Greatest Multi-Employer Plan Admin Cost

January 9, 2006 (PLANSPONSOR.com) - Health plans had the highest expense-to-asset ratio of all benefit program types, according to a recent survey on the fund office administration for 230 multi-employer plans.

According to a press release on the Segal Company survey, the health plan expenses were equal to 15% of plan assets. Segal said that corresponded to the generally increased technology, staffing and processing volumes and regulations surrounding the administration of health plans compared to other types of plans.

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Segal also said that m ore than one-third (37%) of heath funds receive 75% – 100% of medical and hospital claims in an electronic form; however, a nearly equal amount (36%) do not receive claims in that format, despite the recent requirements of the Health Insurance Portability and Accountability Act (HIPAA).

Half of the plans spend $25,000 or less on software and information technology support. The largest group (22%) spent between $10,001- $25,000 and only 5% spent more than $500,000.

The survey found that t he staffs of fund offices averaged about 338 participants each and that:

  • 13% of claims processors work on more than 150 claims per day.
  • 12% process between 101-150 claims daily; and
  • 19% process between 76-100 claims per day.

Twenty-seven percent of fund offices typically receive more than 2,000 calls from participants each month; 11% receive between 1,001-2000 calls; 15% received between 501-1,000 calls; and 14% received between 251-500 calls each month.

As far as claim turnaround, nearly 40% said it takes five business days or less and only 13% said it takes more than 15 days.

In addition, more than half (58%) of the respondents with annuity/401(k) plans reported allowing participants to self-direct the investment of their accounts and more than 60% of plans do not allow loans of any kind.

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