Regulatory Compliance for Consolidated Appropriations Act, the No Surprises Act, and Transparency in Coverage

The regulations for Consolidated Appropriations Act (CAA), the No Surprises Act (NSA), and Transparency in Coverage have been designed to provide greater consumer protections for your employees and their families. Beginning January 1, 2023, new regulatory requirements were placed on plan sponsors for self-funded groups.

 

HealthComp has been working hard with provider networks to make sure that the data needed is being compiled. As a result, HealthComp is well-positioned to assist our clients in gaining access to the information they need to make the best decisions regarding benefits for their members. We have made excellent progress with our provider networks, but some have not provided the data needed to ensure that we can assist our clients and keep them compliant with federal law. We have reached out to some of these organizations and received no response, so it’s important for us to let our clients know which partners are acting in their best interest and which are not providing the resources needed to remain compliant with CAA and NSA.

 

Below you will find a table detailing our partner organizations and their response to our requests for information. Partners listed in green have provided all data needed to keep our clients fully compliant with all federal regulations. Partners listed in yellow have provided some information needed to keep our clients compliant with federal regulations but have not yet provided all data needed. Partners listed below in red have either ignored requests for information or refused to share the information needed to keep our clients compliant with federal regulations despite repeated requests from HealthComp.

What can you do to ensure your compliance with federal regulations?

If your partners are listed as yellow or red on this list, we encourage you to reach out to your contacts or use the information listed below and encourage them to assist us in gathering the data needed to prepare the information needed per CAA and NSA.
CarrierCompliance Status Contact(s)
Americas PPO1 – Non Compliant, Provider Demographics Data Not Shared Derek Bettini
derek.bettini@americasppo.com

Jack Keiser
jack.keiser@americasppo.com

Megan Chrz
megan.chrz@americasppo.com

Robert Obrien
robert.obrien@americasppo.com
Sagamore1 – Non Compliant, Provider Demographics Data Not Shared Melvina Williams
Melvina.Williams@Cigna.com

Kristi Baker
Kristi.Baker@Cigna.com

Stephen Loy
Stephen.Loy@Cigna.com
Community Health Network1 – Non Compliant, Provider Demographics Data Not Shared Dennis Shelton
dennis.shelton@mychn.org

Derek Tefft
dtefft@ascendanthealthcare.com
First Choice1 – Non Compliant, Provider Demographics Data Not Shared Jamie Sebek
jsebek@fchn.com
Midlands Choice1 – Non Compliant, Provider Demographics Data Not Shared Patty Venuto
pvenuto@midlandschoice.com
AMPS – Dignity Health, PNOA, Prime Health2 – Compliant; Data Transfer Completed Carolina Cruz
ccruz@amps.com
Frontpath2 – Compliant; Data Transfer Completed Pat Beham
pbeham@frontpathcoalition.com
ELAP INN, RBP2 – Compliant; Data Transfer Completed Jenna Merrill
JMerrill@imagine360.com
HealthLink2 – Compliant; Data Transfer Completed Judy Dawson
Judy.dawson@healthlink.com
Medical Mutual Ohio2 – Compliant; Data Transfer Completed Diane Malcom
diane.malcom@medmutualservices.com

Maureen Terrell
Maureen.Terrell@medmutualservices.com

Peggy Buntin
peggy.buntin@medmutualservices.com

Stephanie Nagy
Stephanie.Nagy@medmutual.com
Multiplan (MRF Files -In-Network :PHCS, HEOS, PHCS Practitioner Plus Ancillary
MRF Files -Out-of-Network: Data iSight, Negotiations, MultiPlan		2 – Compliant; Data Transfer Completed Craig Penney
craig.penney@multiplan.com

Scott Holder
scott.holder@multiplan.com
Aetna2 – Compliant; Data Transfer Completed N/A
HealthSmart2 – Compliant; Data Transfer Completed N/A
BCBSAZ PPO2 – Compliant; Data Transfer Completed N/A
BCBSAZ Alliance2 – Compliant; Data Transfer Completed N/A
Arizona Foundation2 – Compliant; Data Transfer Completed N/A
Cofinity2 – Compliant; Data Transfer Completed N/A
First Health2 – Compliant; Data Transfer Completed N/A
Medcost2 – Compliant; Data Transfer Completed N/A
The Alliance2 – Compliant; Data Transfer Completed N/A
Ohio Health (Ohiohealth, Frontpath, Northwest Ohio Health Partnership)2 – Compliant; Data Transfer Completed N/A
Healthcare Highways2 – Compliant; Data Transfer Completed N/A
ProviDR’s Care2 – Compliant; Data Transfer Completed N/A
Blue Shield of CA2 – Compliant; Data Transfer Completed N/A
Anthem2 – Compliant; Data Transfer Completed N/A
ComPsych2 – Compliant; Data Transfer Completed N/A
Cigna OAP/PPO2 – Compliant; Data Transfer Completed N/A
MagnaCare2 – Compliant; Data Transfer Completed N/A

Questions?

Please do not hesitate to contact your Account Manager should you have any questions regarding carrier status information. HealthComp is here to partner with you and your members to navigate these new regulations.

Chad Harris

Chief Executive Officer

 

Chad Harris serves as the CEO of HealthComp and is a value-driven healthcare leader with over twenty years of experience running business process and information technology businesses as a senior executive. Chad has a reputation for creating and controlling rapid growth by focusing on the intersection of customers, market dynamics, and the new digital world.

 

Chad has held many senior executive positions and led global teams of more than 10,000 people across dozens of counties. Chad has grown both large and small businesses, from those with less than $100M of revenue to those producing multiple billions of revenue, focusing on delivery, customer satisfaction, and innovation to create market leadership.

 

Chad's philosophy is to inspire change by doing what comes naturally, putting the needs of others before his own, working incredibly hard, and focusing on "how" to accomplish things, never "if they can be accomplished."

Thomas Martel

EVP of Partnerships and Strategic Accounts

 

Tom serves as the EVP of Partnerships and Strategic Accounts at HealthComp. In this role, Tom focuses on strategic initiatives aimed at accelerating HealthComp’s growth nationwide. His passion lies in assessing market and enterprise structures and creating efficiencies that enable teams to deliver best-in-class performance.

 

Previously, Tom led Cigna’s largest employer segment, largest region which was comprised of several health plans including the two largest health plans. He worked closely with Market Presidents and their leadership teams to develop and execute local market strategy and deliver growth for the enterprise. Tom earned his degree from Saint Anselm College and holds certifications from The Wharton School and the Darden School of Business at the University of Virginia. In his spare time, he enjoys sailing and holds a Master Captain’s license with the U.S. Coast Guard. He is also active in community outreach programs including local food bank and shelter services.

Sanoj Balakrishnan

Chief Technology Officer

 

Sanoj Balakrishnan serves as the Chief Technology Officer at HealthComp. In this role, he oversees the company’s overall technology strategy and architecture, building secure and highly scalable distributed systems.

 

Most recently, Sanoj served as Head of Healthcare Digital Business and Technology at Cognizant, working with payers and providers in developing solutions that reduced healthcare costs and provided a best-in-class experience for members. Earlier in his career, he worked at technology organizations in a variety of software engineering and architecture roles. Sanoj earned his B.S. from University of Mumbai and Computer Systems Management from National Institute of Information Technology.

Justin Tran

Chief Growth Officer and EVP of Product Strategy

 

Justin serves as the Chief Growth Officer and EVP of Product Strategy at HealthComp. He has 8 years of experience in developing and delivering solutions that reduce health care costs, improve quality, and provide a best-in-class experience for members. Most recently, Justin was an Associate Partner and business unit leader at McKinsey & Company where he helped large carriers and healthcare technology companies build new clinical services and solutions for fraud, waste, and abuse. Justin earned his B.S. in Accounting and Data Informatics from Indiana University, Bloomington.

Tucker Stein

Chief Financial Officer

 

Tucker serves as the Chief Financial Officer of HealthComp. Tucker previously worked for The Boeing Company in a number of finance and strategy roles, most recently as a finance lead for the Transactions and New Business Development group. In this role, Tucker led investments and strategic partnerships for Boeing’s Space and Communications portfolio. Tucker earned his MBA at Stanford’s Graduate School of Business and his Bachelors of Science at the University of Redlands.

Tom Georgouses

General Counsel

 

Tom is involved in multiple areas of HealthComp including Operations, Compliance and Legal Affairs. Tom was admitted to the California Bar in 1990 and started his legal career with Stammer, McKnight, Barnum and Bailey, LLP. When he left the firm to join HealthComp in 2014, he was the Managing Partner (he had represented HealthComp since 2003). In private practice, Tom’s areas of focus included healthcare and transactional work. Tom holds a Bachelor of Science Degree in Business Administration-Finance from California State University Fresno and received his Juris Doctorate from San Joaquin College of Law.

Rishab Bansal

Chief Transformation & Operations Officer

 

Rishab serves as the Chief Transformation & Operating Officer at HealthComp. Rishab focuses on transforming and modernizing HealthComp’s operations to provide delightful and distinctive experiences to its members, providers, and clients. His agenda includes integrating all entities towards a One HealthComp vision, driving profitable growth, and delivering value and business outcomes.

 

In his former work over the last 2 decades, he has helped clients across industries to transform themselves by bringing industry-leading practices and digital and data-led disruption. As the trusted advisor to the C-suite, Rishab helped his clients leapfrog on their transformation journey to accelerate business outcomes and helped them unlock new opportunities to drive profitable growth, profitability, and enhanced experience for their employees and clients.

Member Forms

 

Online Forms
Claims — Request for Other Insurance Information
Claims — Request for Medical Information
Claims — Request for Vision Information

Downloadable Forms
COVID-19 Questionnaire

Claim Forms
Group Enrollment/Change Form
Group Enrollment/Change Form (Spanish)
Group Medical Claim Form
Group Dental Claim Form
Group Vision Claim Form

FSA / Flex Benefits Forms
Flexible Benefits Enrollment/Change Form
Flexible Benefits Plan Claim Form
HRA Claim Form
HRA Enrollment/Change Form
Direct Deposit Instructions
Direct Deposit Authorization
Direct Deposit Cancellation
Eligible Medical Expenses

Health Savings Account
Welcome Guide
Transfer Form

Other Forms
Authorization to Release PHI
Authorization to Obtain Medical Records (Spanish)
Claims - Pre Cert Form
Claims - Request for Accident Details
Claims - Request for Accident Information (Spanish)
Claims - Request for Other Insurance Information
Claims - Request for Other Insurance Information (Spanish)
Claims - Request for Primary EOB/Secondary EOB
Request for HIPAA Certificate
Request for HIPAA Certificate (Spanish)
PCP Selection

Elaine Davis

Chief Human Resources Officer

 

Elaine Davis is a seasoned executive with deep experience in human resources, mergers and acquisitions, divestitures and transformation in large and small companies. Elaine has over 25 years of experience in human resources, marketing and communications in a range of industries that include information technology/business process services, life sciences/medical devices and financial services. Elaine brings focused expertise in governance, leadership coaching, branding and messaging with a focus on supporting female and minority leaders and emerging leadership talent.

Judy Schott

Chief Operating Officer

 

Judy Schott serves as the Chief Operating Officer and is a customer-focused healthcare leader who transforms operations to simplify the experience and deliver excellence. With deep knowledge of third-party administration, claims, eligibility, customer service centers, and compliance, Judy’s focus will include integrating all entities of HealthComp while driving profitable growth.

Kim Randazzo

Chief Customer Officer

 

Kim Randazzo serves as the Chief Customer Officer. In this role, she oversees account management for all divisions and HealthComp clients. Kim brings a wealth of strategic experience in account management to the HealthComp executive team, along with a practical understanding of the insurance business and what it takes to be the nation’s leading TPA.

Prior to joining HealthComp, Kim oversaw sales, account management, wellness, marketing, and implementation teams for Gilsbar LLC’s self-funded, association and affinity clients, and worked as an underwriter with Ochsner Health Plan and as an account representative with USI Services, Inc. She has over 26 years of experience in the healthcare insurance industry. A graduate of the University of New Orleans, she received her Bachelor of Science in Management in 1997 and her Master of Business Administration in 2002.