Request for proposal alaska

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REQUEST FOR PROPOSAL COBRA and Direct Billing Administrative Services

RESPONSE TO: State of Alaska

Timothy Lieb | Senior Account Director 425-747-7154 | LiebT@ March, 2013

State of Alaska

COBRA-Direct Billing Proposal

Introducing Aetna

The push toward consumerism creates the need to provide consumers with new tools that will help them navigate their increasing healthcare accountability: benefit education, spending account management, analytics, financial decision modeling and wellness engagement.

Aetna provides a set of unified tools that engage consumers in their healthcare, educate them about important health and wealth issues and empower them to achieve mental, physical and financial well being.

Powered by PayFlex, this modular product suite includes four Solution Centers.

Benefit Center

The Benefit Center offers COBRA and Direct Billing clients with access to their account records. Through the center they can view documents and make premium payments. In addition, employees can keep track of their benefit details with Benefits at a Glance, a place to consolidate benefits into one easy to find area. Employees can update information as it changes and have easy access to the information on the PayFlex Mobile application.

Wellness Center

Targeting engagement, education, prevention and lifestyle behavioral management, the PayFlex Wellness Center offers our Health and Productivity Management program, PayFlex Wellness, which is a place for your employees to manage their wellness with a comprehensive set of easy-to-use tools such as personalized trackers, interactive multimedia videos and health assessments as well as customized incentive programs and online health coaching.

March, 2013

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State of Alaska

COBRA-Direct Billing Proposal

Financial Center

PayFlex's Financial Center provides an integrated solution for Reimbursement Account, COBRA and Direct Billing administration. Powered by our proprietary CBAS platform, PayFlex supports all reimbursement account types, e.g., FSA, HRA, commuter, adoption, tuition, incentive accounts, and more. Further, our integrated, next-generation HSA solution supports a bank-agnostic model, providing clients with more choice than ever before in custodian and investment partners. One platform, one debit card and one web portal with powerful financial tools all designed to provide participants with the information they need to make informed healthcare financial decisions.

Consumer Center

The PayFlex Consumer Center provides participants with access to Aetna portal features through our powerful PayFlex MobileTM Application. The application is supported on iPhone?, BlackBerry? and AndroidTM smartphones. Participants can access balances, view claims processed to date, submit claims and associated documentation, view their eligibility profile and more. The Consumer Center will also feature PayFlex Mall, an online healthcare mall where participants can make healthcare-related purchases using their spending account cards.

One platform, One debit card, One web portal, One Vendor . . . The PayFlex Solution can be deployed as value-added components with an existing health management system or as an integrated decision support system. PayFlex merges Care Planning, Financial Planning and Decision Support to optimize mental, physical and financial well being. Aetna ? it's yours!

February 8, 2013

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State of Alaska

COBRA-Direct Billing Proposal

Aetna COBRA and Direct Billing Overview

The Benefit Center offers COBRA and Direct Billing clients with access to their account records. Through the center they can view documents and make premium payments. In addition, employees can keep track of their benefit details with Benefits at a Glance, a place to consolidate benefits into one easy to find area. Employees can update information as it changes and have easy access to the information on the PayFlex Mobile application.

COBRA Administration

If you would like to enhance the effectiveness of your HR operation and ensure COBRA compliance, our comprehensive service offering will help you achieve these goals. By selecting PayFlex as your COBRA administrator, you can be assured that your program will remain in compliance, thereby mitigating the financial risks associated with noncompliance.

Our strict compliance approach allows us to offer your Qualified Beneficiaries all of the rights to which they are entitled without leniency. All elections and premium payments must be received by PayFlex on or before the last day of the grace period in order to be considered timely. As a result of our diligence we reduce the burden of excess claims on your health plan.

Comprehensive COBRA Administration

PayFlex provides all services associated with COBRA administration including:

? Initial Notification ? Receipt of Qualifying Event Information ? Mailing Qualifying Event Notice ? HIPAA Certificate of Coverage ? Election of COBRA ? Premium Collection ? Premium Distribution ? Eligibility Update ? Disability Extension ? Conversion ? COBRA Termination ? Client Reports ? Carrier Notification

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State of Alaska

COBRA-Direct Billing Proposal

? Proof of Mailing ? Billing

Employer web portal

As a client, you will have access to a comprehensive and secure employer web portal. The portal offers a variety of services to make outsourcing COBRA Administration easier than ever. It includes the following capabilities:

? Data Entry ? The web portal enables you to enter Initial Notice, Qualifying Event and HIPAA COC requests electronically. Our standard turnaround time for mailing notices that we receive online is 48 hours. You may also update COBRA participant demographic information online.

? Data Inquiry ? The web portal also enables you to view Qualified Beneficiary, Initial Rights Notice and HIPAA COC history online. In addition, you can view participant-level information, including PDFs of all notices and letters sent to each participant.

? Report Inquiry ? The portal's reporting capabilities allows you to view, print and download COBRA administration reports and monthly invoices in Excel format.

Employer reporting

PayFlex reports are delivered to the Employer web portal. Three categories of reports are provided: Remittance Reports, Periodic Reports, and Invoice Reports. E-mail notification of report delivery is also sent to the client's designated reporting contact(s).

An overview of PayFlex's COBRA reporting package follows.

Remittance reports

? Employer Remittance Check ? This is a pressure-sealed document mailed to the client receiving premium dollars. An electronic copy of this document will also be available on the Employer Portal.

? Employer Remittance Summary ? This is a document posted to the Employer Portal for clients receiving premium dollars via ACH.

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State of Alaska

COBRA-Direct Billing Proposal

? Premium Remittance Register Report ? The Premium Remittance Register Report is the supporting detail for all premiums being remitted to a specific Transfer Destination. Specific Coverage Information is detailed by Carrier, Plan Code, Coverage Level and Interval. If PayFlex is remitting premiums to multiple locations a Consolidated Premium Remittance Register Report is also created to consolidate all remittance activity for the collection cycle.

? ARRA Employer Report ? This monthly report provides detailed information regarding ARRA-subsidized participants, including participant payment amount and Stimulus Amount for the client's 941 filing.

Periodic reports

PayFlex provides a set of standard Periodic Reports. Clients identify the frequency of each report as part of the implementation process (daily, weekly, monthly, quarterly, and annually). The following Periodic Reports are available.

? Age Attainment Report ? The Age Attainment Report lists all participants and/or dependents enrolled in a benefit and near client-specified ages, as identified for each benefit. The intent of this report is to identify participants or enrolled dependents nearing a certain age that requires action. Each Age Attainment Report covers a period of approximately twelve weeks. Specifically, the report includes any participants and/or dependents turning one of the identified ages 60 days prior to or one month after the report is created.

? Deficient Payment Report ? The Deficient Payment Report identifies any payments made by participants during the reporting period that did not satisfy the entire Premium Amount Due for the interval.

? Participant Amount Billed Report ? The Participant Amount Billed Report is intended for clients who send monthly statements as opposed to traditional payment coupons. The report includes all participants who have been billed for during the reporting period.

? Participant Paid Thru Report ? The Participant Paid Thru Report details the Paid Thru Date for all participants.

? Participant Payments and Refunds Report ? The Participant Payments and Refunds Report details all cash activity in and out of participant accounts.

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