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Health Care - OCSEA / AFSCME Local 11 / AFL-CIO

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Your source on union-negotiated health care benefits

Medical Mutual will keep Administering the Ohio Med PPO

April 18, 2005 - Last fall the state, in conjunction with the JHCC, issued a Request for Proposals to determine who will be the third party administrator (TPA) for the Ohio Med PPO.

The RFP is an extensive process that asks bidders about such things as customer service, quality measures, network of doctors and hospitals and price.

Marianne Steger, OCSEA Director of Health Care Policy, explained, "Responses from all vendors are scored and the bidder with the highest score is selected. In this round of bidding Medical Mutual of Ohio received the highest score and was recommended by the JHCC to be selected as the TPA. "

Steger co-chairs the Joint Health Care Committee (JHCC) for Labor.

The TPA is responsible for putting together a network of doctors and hospitals and negotiating discounted rates with those providers. It also provides customer service and claims administration to enrollees.

Many health care open enrollment fairs are scheduled throughout the state between April 19 and 30. Such fairs provide an excellent opportunity to learn more about benefit choices from the health plans’ representatives.

A complete schedule of dates and locations was distributed with your paycheck on April 2 and published in the open enrollment edition of Pathways, which will be distributed in mid-April. In addition, please look for posters identifying the fair(s) closest to your work location.

 

See Related

More HMOs available; Aetna is back, Kaiser and SummaCare are gone

Medco is back for Ohio Med Enrollees July 1st

Kaiser enrollees options; Chart below compares HMOs, Ohio Med PPO

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