Do your reports look like this?
Actual data from another vendor report:
|% of Claims Processed||41.04%|
|Separation Info Requested – No Response||118|
|% of Claims Processed||14.9%|
Does your vendor report process-failures as “Compliance & Educational Issues? Are you questioning the value of a service that routinely accommodates “Late Claims, Separation Information–Not Provided” as acceptable losses, on your dime? Does your vendor have a pattern of blaming response problems on your organization, or the state? If the exchange of information between you and your vendor has been inaccurate, too slow or incomplete, how much more are you paying in benefits? What is your vendor doing to correct these problems?
Significant changes in the UI marketplace, consolidation and the elimination of competition between agents, has been directly associated with declining service standards and failure to adequately respond to state inquiries. The FTC fined the nation’s largest vendor for anti-trust activities and deteriorating service. Since these changes took place, record overpayments (billions erroneously paid) have prompted the UI “Benefit Integrity” regulations.
What does this mean to my organization?
Not Using a Vendor
If you are managing your UI program in-house, Benefit Integrity regulations present challenges, additional cost exposure and future compliance risk. It is critical for an employer to evaluate their internal process, develop reliable metrics and understand compliance standards. An employer must be well prepared to meet response obligations and have a program in place for managing this risk area.
Using a Vendor
If your organization has accepted error and omission costs related to process-failures, with little understanding as to it’s impact on the claims management segment of your service, it will no longer be something you can afford to ignore. As defined by each individual state, Benefit Integrity measures penalize the employer for failures incurred by your agent (TPA) for 1.) An individual failure and 2.) A pattern of failures, even if the pattern of failure established by your “agent” does not relate to your individual account. Unemployment vendors who have done little to address systemic failures, other than reporting these as “Educational Opportunities” to meet disclosure obligations, have already undertaken steps to further migrate process risks to their clients. State agencies report these same vendors are going on record directly attributing “no response” claim matters to their clients! Can you afford to be in the dark?
UTCA can provide a real “Educational Opportunity”. For a no-obligation risk assessment Contact Us.