Adventist Risk Management
To Outsource Claims Processing
Cost savings for church seen; two departments will shrink, however
major change in health care benefits processing is on tap for Seventh-day Adventist Church employees in North America, officials of Adventist Risk Management, Inc., (ARM), said October 4, 2007. The move is expected to save the church $2 million a year.
ARM said it would outsource major functions in its health care operations and customer care services associated with employee health care benefits starting next year, resulting in a “significant reduction” in the number of in-house employees in two ARM departments. The exact number of staff positions to be cut has not yet been determined, ARM spokeswoman Paula Webber told Adventist News Network.
Starting next year, all health care claims processing currently performed by Adventist Risk Management will go to an outside contractor, including all Blue Cross and non Blue Cross health care claims, also known as “carv-outs.” The contractor will provide a single eligibility entry point for all North American Division Health Care Assistance Plan, or NAD HCAP, participants. The contractor, who was not named, will also service the customer call center for all active members and dependents, ARM said.
“We have identified a health care plan delivery system that will save the church approximately $2 million per year and allow us to return the savings to the client. We are in the final stages of processing the contract,” said Robert Sweezey, ARM president, in a news release.
This decision came on the heels of a meeting with church leadership to discuss the operations of ARM and the struggle it faces controlling health care costs.
“As we see the industry changing,” Sweezey said, “it is becoming harder and harder for us to be effective in some areas, to benefit those we serve – our clients. The North American Division leadership was involved in the decision and has agreed that this is the best direction for ARM today. With this change we are confident that ARM will continue to have a positive bottom line and as the same time save the clients money.”
Adventist Risk Management will remain as the administrator of the North American Division Health Care Assistance Plan, focusing more on administrative issues with local conference administrators.
“It is important to stress,” says Bryon Scheuneman, vice president for ARM, “that the functions of eligibility to the Plan, health care reinsurance, client billing, statistical reporting and claims appeals will remain at ARM.”
Scheunemann said that while the organization “has a highly talented and dedicated Health Care services team,” it was “economies of scale” available through an outside contractor that were “impossible to ignore.”
He said the result of the change for church entities and employees will be a net positive one: “We anticipate that the impact of the changes to our Health Care services, on both the church employer and church employee, will be enhanced service at a lower cost.”
It was in the mid 1970’s that Adventist Risk Management first worked with the church in North America to develop a self-insured program for employee health care coverage. This program grew and by the mid 1980’s ARM began offering claims administration services to denominational entities. Over the past 25 years the combined efforts have saved the church millions of health care benefit dollars. The transition to the BlueCard PPO program alone has saved the participants more than $20 million in just the past two years, ARM said.
ARM serves clients in North America, including the Adventist Development and Relief Agency, Griggs University, the church's North American administration and employees at the world church's headquarters in Silver Spring, Maryland.
-- reported by Adventist Risk Management, with Adventist News Network and AR Staff
La Sierra University SIFE Team Clinches
World Cup Championship
La Sierra SIFE team prays together at SIFE World Championship in New York with La Sierra President Randal R. Wisbey. [Photo: LSU]
For the second time in five years, a team of “Students in Free Enterprise” from Seventh-day Adventist-owned La Sierra University in Riverside, California, won the SIFE World Cup in the 2007 World Cup competition.
The award was announced October 12 at about 5:30 p.m. (EDT) in the Grand Ballroom at the Hilton Hotel in New York City, the site of this year's competition. The final round of competition included the four teams of Obafemi Awolowo University representing Nigeria; Memorial University of Newfoundland representing Canada; the University of Tirana representing Albania, and La Sierra University First runner-up was Memorial University of Newfoundland.
“I am so proud of all of the La Sierra students participating in this competition,” said Randal R. Wisbey, president of La Sierra University, after the team advanced to the semi-finals on October 11. “It has been a complete team effort, with a number of students supporting the efforts of the presentation team.”
This is the second time that La Sierra University has competed in this international event since SIFE introduced the World Cup in 2001. La Sierra won the world title in competition in Amsterdam in 2002.
— Reported by Larry Becker, executive director of University Relations, La Sierra University