99%

Service Level Achievement
 

Consistently achieving above and beyond accuracy for service level achievement.

Exchanges

Since the passing of the Affordable Care Act (ACA), the health insurance industry has undergone monumental changes. After legislation passed requiring all health insurance policies be sold on a guaranteed issue basis, PAI was called upon by a number of states for advice, due in large part to our long-time involvement in the management of market stabilization mechanisms. Most notable was our involvement with the ACA’s Transitional Reinsurance Program.
Special individual programs we administer have required us to work closely with Exchange staff members or to be familiar with insurance plans sold on the Exchange. In order to ensure the program members fully understand the options available to them when purchasing health insurance, our customer service and account management teams work closely with exchange staff members to provide communications that clearly outline plan options available inside or outside of the exchange. A number of PAI staff members had been Certified Application Counselors (CAC) in Connecticut, which provided added value to the members at that time.
Additionally, our small employer reinsurance staff was called upon by the SHOP Exchange (Small Business Health Options Program) employees for guidance on the small employer reinsurance program in their state to ensure that they had met legislative requirements and adhered to the reinsurance reporting process. PAI employees are collaborative by nature and are known to be valuable and beneficial resources for information.
As these entities evolve, PAI continues to field inquiries on a variety of topics related to market stabilization, subsidy and reimbursement processing and administrative techniques.
For more information regarding services to Exchanges, please contact Karl Ideman or Nancy Doty.

  • “PAI’s commitment to effectively managing all aspects of our account relationship is evident from the first line insurance benefit consultants through to their financial and management support team members.”

    Executive Director, State Health Insurance Plan

  • “The PAI staff has been highly professional, knowledgeable and helpful. They perform their administrative functions on a timely and accurate basis and always keep the Board of Directors informed.”

    Board Chair, State Legislated Entity

  • “PAI takes initiative, problem solve and provide quality work in a timely manner. As I manage multiple programs and contracts, their ability to keep me informed while working successfully and independently has been invaluable.”

    Medical Administration Manager, State Department of Social Services