Administrative Work-Products


The objectives, features and advantages of Administrative Work-Products are described in the following paragraphs.

Such work-products are designed specifically (a) to provide a broad range of administrative functions as well as (b) to meet most (if not all) of the standards of accuracy and professionalism that are required of an actuarial work-product.

Such administrative work-products incorporate the very latest in information technology by using the following ways and means: (a) cybernetics (Web-based, e.g.), (b) risk management, (c) use of a debit card, (d) user-friendly (accessibility and efficiency, e.g.), (e) built-in extensive computational capabilities, (f) transparency, (g) easy auditing, (h) wide range of functions, (i) manageable by independent contractors (i.e., stay-at-home workers), (j) no hardware or software to buy, rent or maintain, (k) multiplicity of benefits (all immune from government intrusion), (l) minimal or no E & O liability to the user, (m) high level of privacy and security, (n) elimination of conflicted-interests, (o) dramatically-low fixed costs, (p) elimination of time and space limitations for global economy reasons, (q) maximum data storage, and (r) appropriate for the smaller plans (following the truth that smaller is better and bigger is worser).

The work-products are applicable only to those benefits that are (a) self-funded with an independent TPA doing the plan supervision, (b) not anticipated to be covered by a national health plan, (c) not network-dominated, (d) not subject to predatory (or anti-competitive) marketing activities and (e) not normally needful of stop-loss.

The reader is reminded that self-funding results in reduced fixed costs which is consistent with the Federal mandate to reduce the national costs of health care plans.  The reader is also reminded that the MetLife v Glenn Supreme Court decision held that benefit plans that were either (a) fully insured or (b) ASO-administered were tainted with conflicted interests thereby lowering their basis of review status with the court.  Such tainting would not apply to a self-funded plan administered by an independent TPA.