Solution Helps Healthcare Insurer Address Government-Mandated Deadline
Cranford, NJ ─ June 18, 2012 – Paragon Solutions, an advisory consulting and systems integration firm, announced today that it was selected to deliver a Summary of Benefits and Coverage Solution for a health insurer to help it meet the government-mandated deadline for fall of 2012.
The health insurer, with over 750-thousand members, engaged Paragon to provide a concise and comprehensive Summary of Benefits and Coverage in accordance with federal guidelines to current and potential health plan participants beginning September 2012. The Summary, according to the government ruling released earlier this year, must provide members with the ability to understand and evaluate their health insurance choices. The Summary must be made available to participants when coverage is initiated, modified, or as requested.
“The ruling has left a number of health insurers scrambling to determine how they can address the mandate by the September deadline,” said Tom Brennan, director of insurance solutions for Paragon. “Many of the firms we’ve spoken to were looking at stop-gap measures to address the demand until they realized there was an automated, more productive way to comply,” Brennan said.
The insurer chose Paragon because of its healthcare industry experience and expertise with EMC’s customer communications product platform, xPression. Within weeks, Paragon demonstrated how the insurer could automate the process of creating, presenting and tracking the summaries for its members.
“This insurer took a route that will significantly reduce the risk of non-compliance,” Brennan said. “The penalties for non-compliance can quickly become costly. The failure penalty is $1,000 per failure—and each enrollee can be considered an independent failure,” he said.
About Summary of Benefits and Coverage
The Summary, which can be paper or electronic, must provide members with the ability to understand their health insurance choices. The template issued as a guideline requires a number of specific content items that must be clear, consistent and comparable.
Paragon Solutions is an advisory consulting and systems integration firm that specializes in enterprise information management to help clients leverage information assets for better business results. The company does this through its industry practices, solution accelerators and specialized technology competencies that help clients achieve operational efficiency, business scalability and regulatory compliance.
Paragon works with businesses that are focused in a few key industries – communications, financial services, healthcare, insurance and life sciences. The industry-focused practices work with Paragon’s competency groups to address today’s client concerns in Process Optimization, Information Management and Information Integration.
For more information, please visit the Paragon website at www.consultparagon.com, or call 1.800.462.5582.