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Our Solutions

CAS Offers Customized and Comprehensive Solutions to Help You Succeed

End-to-end programs that support clients and partners at every stage.

Choose from the following tools and services to suit your needs.

Solutions IconSelf-funded Medical Plan Administration

At CAS, we specialize in helping employers manage self-funded healthcare plans with ease, flexibility, and cost control. Our comprehensive self-funded administration services are designed to give you greater control over your benefits while reducing overall healthcare costs.

CAS provides superior claims administration services to self-funded and employer-sponsored medical, dental, and vision plans. Using state-of-the-art software, we process healthcare claims accurately and promptly, turning around a clean claim and sending payment in just days. Once a claim has been filed, members can track claims and see when a payment has been made.

We seek ways to lower your healthcare plan costs by conducting:
• Fee negotiations
• Claim edits
• Itemized bill reviews
• Clinical bill reviews
• Coordination of benefits
• Subrogation recovery

CAS is HIPAA complaint with electronic data interchange transactions and our services are performed in an office environment that meets and exceeds HIPAA standards.

To successfully navigate the complexities of government mandates and regulations, it’s important to partner with a TPA that has the insight and resources needed to stay informed.

Our compliance services include:
• 5500 reporting
• Plan document review and preparations
• SPD formatting and amendments
• ERISA attorney

HIPAA Services
• Initial rights communication
• Certificates of Creditable Coverage
• Document and respond to all HIPAA activities
• Track, maintain and report all activities

HIPAA Plan Administration
• Initial rights communication
• Track and provide Certificates of Credible Coverage
• Document and respond to all HIPAA activities

Machine Readable Files
The machine readable files are made available in response to the Federal Transparency in Coverage Rule and include negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. Each of the files may be as large as one terabyte (TB) in file size, which has significant system requirements for use. Please ensure you have the required memory capacity, hardware, and software capabilities before downloading.

The machine readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. Learn more

When managing a self-funded plan, it’s critical to know how it’s performing. Our accurate reporting offers key insights into plan performance and reveals opportunities to cut costs while improving benefits. CAS offers simple, easy-to-read, integrated reporting with unlimited access to on-demand reporting. You can choose from more than 50 reports available on the admin portal.

Our financial analysis of employer health benefit programs covers:
• Data exploration
• Historical plan modeling
• Disclosure
• Data trending
• Benchmarking modules

Employer groups have access to reports that cover:
• Member demographics
• Diagnosis analysis
• Lifestyle indicators
• Benefits usage
• Overall provider/network use

As stewards of our clients’ healthcare programs, we proactively look for ways to save you money.

Our cost containments strategies include:
• Referenced based pricing
• Independent utilization review
• Case management
• Disease management
• Pharmacy benefit managed programs
• Personal wellness plans
• Subrogation

Telemedicine

Telemedicine is a proven, cost-effective way to access quality healthcare on a flexible schedule. This technology includes 24/7 on-demand access to board-certified providers via video, phone, or mobile app who can diagnose, treat, and prescribe medications for common health issues.

We understand that controlling healthcare costs is a top priority for businesses of all sizes. That’s why we focus on helping employers, brokers, and health plans reduce expenses while improving care outcomes for employees and members. This includes pharmacy benefit management, network optimization, chronic disease management, wellness programs, and more. For example, we help prevent unnecessary emergency room and urgent care visits by routing members to more cost-effective modes of care. This reduces out-of-pocket costs for members and lowers the overall cost of care for payers and employers.

Our comprehensive approach to cost containment focuses on both short-term savings and long-term sustainability, ensuring that healthcare plans remain financially stable without compromising the quality of care.

More than $100 billion a year is spent on radiology in the U.S. radiology costs are increasing at twice the rate of prescription drug costs. By self-funding, employers can save up to 50% on advanced radiology procedures like MRI, CT, and PET scans by joining a national radiology imaging network.

This network gives employees access to a specialty panel of over 3,000 high-quality radiology imaging centers nationwide. Plus, national concierge services with multilingual staff are available to help your employees schedule an appointment.

To ensure accuracy and control costs, CAS reviews all claims before payments are made. This prevents duplicate payments, incorrect reimbursements, billing errors, and similar issues before they occur. Our process includes:

• Audits of all claims
• Peer review
• Bill negotiations
• Line-item bill review
• Case management
• Medical director services
• Pharmacy benefit manager audits

CAS works with employers on self-funded dental and vision plan administration. Employers will receive detailed financial and utilization reports each month.

CAS will provide the employer with the opportunity to forgo carrier retention costs while still allowing participants to seek dental and vision care from any licensed dental provider.

CAS administers general and event notices, disability extensions, and excellent COBRA customer service.

COBRA
• Provide initial and qualifying event notices to COBRA participants
• Bill, collect, and remit COBRA premiums to the employer
• Generate customized reports

CAS manages the following types of accounts for employers.

Flexible Spending Account
A flexible spending account (FSA) is a tax-advantage financial account that is set up by the employer. An FSA allows an employee to set aside a portion of earnings to pay for qualified medical, dental, and vision expenses for both the employee and their dependents. Money deducted from an employee’s paycheck is not subject to taxes, resulting in substantial tax savings.

An FSA offers businesses:
• FICA tax savings
• Seamless automated payroll deductions
• Daily claims processing and distribution of spending account payments
• Web access to FSA plan participant information
• Management reports
• Expert oversight of complex FSA requirements

Health Reimbursement Account
A health reimbursement account (HRA) is a federally authorized tax-favored funding program that helps employers lower their healthcare costs. Employers use the savings from lower premiums to reimburse employees for part of their healthcare expenses, typically a portion of their deductible.

An HRA offers businesses:
• Lower health insurance premiums
• Tax deductions
• Affordable way to meet employee coverage needs

Health Saving Account (HSA)
High-deductible health plans (HDHP) typically offer lower monthly premiums than traditional health plans. With an HSA-qualified HDHP, the employee can take the money saved on premiums and invest in the HSA. Although the employee is responsible for the initial healthcare costs until the deductible is met, money saved on premiums can be used to pay for qualified medical expenses. In addition, HDHPs generally provide 100% coverage for preventive care services, such as routine doctor visits and annual physical exams.