About Us

Services:

UOSS Plan Benefits offers the ability for employers to offer the following benefit plans to their employees with seamless claims integration and detailed reporting. The result - unmatched client satisfaction.

Self-Funded Welfare Benefit Plans

  • Reinsurance procurement
  • Provider Network analysis & negotiation
  • Claims payment, resolution, reporting & analysis
  • Medical & Disease Management
  • Prescription cost containment services
  • Claims integration - one claim paid through multiple plans
  • ERISA compliance training
  • HIPAA compliance training
  • Online billing & eligibility management
  • Online claims management including:
    • Status Reporting: Received, Pending, Processing, Paid
    • Explanation of benefits
    • Benefit accumulators
    • Creditable Coverage Letters

Flexible Spending Accounts (FSA)

  • Integrated or Standalone
  • Online eligibility
  • Online claims reporting
  • Stackable with HRA & Welfare Benefit Plans

Health Reimbursement Arrangements (HRA)

  • Integrated or Standalone
  • Online eligibility
  • Online claims reporting
  • Stackable with FSA & Welfare Benefit Plans

COBRA Administration

  • Integrated or Standalone
  • Streamlined from the point of termination
  • Employee notification, billing, reconciliation & payment

Self Funding:

Is Self-Funding right for you?

Self-funding is an effective method for taking control of health care expenditures and creating financial & operational efficiencies that inure to the benefit of both the employer and its employees. These benefits require a long term commitment which, like any long term fiscal decision, requires a sound understanding of both the advantages and potential disadvantages of self-funding.

Contact DCA to determine if self-funding is a good fit for your organization.

Advantages

Disadvantages

  • Overall Control
    Complete flexibility of plan design, funding & reserve margins
  • Monetary
    Money previously held in the form of reserves, incurred claims & reserve/claims profit margin is held in your accounts and earns interest for you
  • Reduction of Premium Tax
    Self-funded plans are not subject to the premium taxes fully-insured plans pay
  • Elimination of State Mandated Benefits
    State mandates are not enforced as plan is governed solely by ERISA
  • Administrative Efficiencies
    By utilizing a Third Party Administrator eligibility, billing, claims payment & claims resolution is streamlined through one location. Client satisfaction is increased and plan performance is maximized
  • Reduced Operating Costs
    Administrative fees incurred by TPAs are often lower than in fully-insured arrangements
  • Reporting
    Accurate, detailed claims utilization reporting & analysis is available to self-funded plans that is not readily available to their fully-insured counterparts
  • Cost and Utilization Controls
    The plan dictates how much or little medical management to incur within the plan
  • Financial Risk
    While current Reinsurance contracts create minimal risk overlap,
  • Increased Employer Education
    A successful self-funded plan requires Management buy-in in the form of health care education. Medical trends, claims analysis & employee communication is critical to ensuring the maximum benefit from self-funding
  • Decreasing Population
    If an employer incurs a large downward swing in enrollment, the concurrent claims lag, decreased premium and census change can cause cash flow issues as well as jeopardize Reinsurance contracts.
  • Return to Fully-Insured
    In the period a plan sponsor returns to fully-insured, it is responsible to fund both run-out claims as well as fully-insured premium. This can cause a double-expense effect in the first few months of the new plan.