American Indian/Alaskan Native Corporations

A dedicated team focused on the health benefit needs of American Indian and Alaskan Native populations.

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WebTPA, an AmWINS Group company, has established a dedicated team focused on the health benefit needs of American Indian and Alaska Native populations to provide an individualized service model to meet each of our  638 Tribe and Alaska Native (AN) Corporations’ cultural, health, and service expectations.

WebTPA is expert in the establishment of self-funded health plans and solutions for Tribal entities, providing groups with the ability to customize plan designs, medical initiatives, health outreach, and communication materials. As a result of these efforts, we have seen improvements in financial performance, member satisfaction and quality of health and life. 

Critical health care objectives are the growth and sustainability of Tribal and AN membership over the long term.

There are four primary aspects of self-funding that can directly benefit sovereign nations:

  • Medicare-Like Rate (MLR) Repricing for Facility and Professional Services
  • Technology Outsourcing for Tribes and Alaska Corporations to  more efficiently self-administer their Purchased and Referred Care (PRC)
  • Sophisticated Predictive Tools on a Monthly Basis as a means of moving the bulk of Tribe and AN Corporation Member Financial Risk to an ACA Health Care Exchange.
  • 340(B) Rx Drug Repricing

Medicare-Like Rate Repricing (MLR)

WebTPA keeps facility and professional at or below Medicare rates for Tribe and AN Corporation members. Our dynamic infrastructure enables us to provide Medicare-Like Rate (MLR) repricing to American Indian and Alaska Native plan members. This saves sovereign entities millions of dollars. Currently, savings from range from 70% to 85% of billed charges.

Technology Outsourcing for Purchased and Referred Care (PRC)

WebTPA’s technology outsourcing to tribes and AN corporations who self-administer their tribal member health claims.  This outsourcing has reduced the tribe’s work effort by over 50%, digitized a paper-laden process, focused on immediate health care needs of membership, and enhanced financial predictability of tribe’s expenses

Monthly Predictive Tools to Shift Risk to ACA Exchanges

WebTPA provides both the Tribe/AN Corporation and self-administered PRC programs with monthly updates on the predictive risk of their membership.  American Indians and Alaska Native Corporation members are afforded monthly special enrollment into ACA Exchanges.  The tribe or AN Corporation can shift higher risk and cost members to ACA Exchanges.  As the tribal/AN corporation plans are the “payer of last resort”, their financial burden then becomes secondary to the ACA exchange. 

340(B) Rx Drug Pricing

WebTPA will work through its partners to ensure that Tribal and AN Corporation clients benefit from 340(B) Rx drug pricing. 340(B) gives all employees and their family members what the lowest cost drug manufacturers charge the federal government. Current savings of 340(B) is 20%+ off of competitive Pharmacy Benefit Manager (PBM) rates. Implementing a 340(B) Rx Drug Pricing helps better control one of the fastest growing healthcare cost drivers facing plans today.

With more than 20 tribes/AN corporations trusting their health benefit needs to us, we are an experienced and trustworthy partner.