FCP Insurance Department Works with Other Tribal Nations
by Lori Thomas, Potawatomi Traveling Times Reporter

The Forest County Potawatomi Insurance Department has long been providing quality benefits services to the Forest County Potawatomi Community. The Forest County Potawatomi Community is one of a very few tribal nations to self-administer benefits for both tribal members and employees.

The positive outlook of having an in-house benefits administration is the quality of service that they are able to provide to their customers. The FCP Insurance Department provides two types of services. One line of service is Benefits Administration, which includes claims processing, customer service, COBRA/HIPAA administration, Flexible Spending Accounts, life insurance, stop loss administration, subrogation recovery, custom plan designs and benefit consulting. The FCP Insurance Department changed from a Benefits Customer Services department to Benefit Administrations in 2002. This type of service is offered specifically to tribal nations and serves as a revenue stream for FCP.

The other service that is offered is re-pricing facility claims to Medicare Like Rates for Tribal CHS Clinics. Natalyn Gardner, FCP Insurance Department Director stated, “Due to the ruling by the federal government, tribal nations are allowed to reimburse hospitals at the same rate as Medicare for members covered under CHS. This provides an enormous savings for tribal nations; however, the federal government did not provide a way for the tribal nations to obtain the Medicare rates data.
   
“There was a need for the Medicare rates for tribal nations. Some nations have insurance companies or TPAs handling their re-pricing. Many are paying a percentage of savings for the data to insurance companies and TPAs. This adds up to thousands of dollars that can be used for services to tribal members.” Gardner also stated, “Our service is cost-effective to the tribal nations and we provide excellent turn-around time.”

Around eight months ago, Gardner was contacted by two major consulting firms that represent over 90 percent of tribal nations in the Bemidji area. Their main focus was to see if the FCP Insurance Department would like to become benefit administrators to other tribes.

The FCP tribal administrator encouraged the FCP Insurance Department to pursue the possibilities of providing services to other tribal nations.

“Initially, the FCP Insurance Department had to meet with stop loss carriers to be approved for not only benefits administration, but also approved to self administer the FCPC benefit plans,” stated Gardner. “Some of the items that had to be reviewed were resumes of the staff, technology, work flow, accounting, plan document review, COBRA and HIPAA compliance along, with the general knowledge of the staff.”

Once they received the go ahead, the FCP Insurance Department started to receive requests for proposals from a few tribes that were interested. The way this form of business works is that the Insurance Department is contacted by each tribal nations’ consultant and asked if they are interested in doing business with the tribe.
The FCP Insurance Department has to compete in this part of the country with Blue Cross Blue Shield and their associated benefit administrators - Auxiant and United Health Care, to name a few.

Gardner stated, “The FCP Insurance Department has been working with a few tribes in hopes to becoming their benefit providers. As of October 1, 2008, we have started administering Lac du Flambeau’s benefits and there are also other tribes looking into working with us.”

During her time, Gardner has watched the FCP Insurance Department grow and expand its services to other tribes. Gardner, who has been with the tribe since 2002, has 28 years of experience in claims and benefit administration. 

Currently, the FCP Insurance Department has a staff of 12 employees. The average number of years each employee has worked in the department is 5.5, and the employee with the longest length of service has been with the department for over nine years.
For more information about the FCP Insurance Department, please visit www.fcpotawatomi.com

Mission Statement: The Forest County Potawatomi Insurance Department is dedicated to providing superior customer service and administration services to tribal nations. Our tribe’s experiences with other benefit vendors has made us aware that the needs of unique and custom plan designs, levels of customer service and creativity needed to use all health care assets to the greatest benefits of the tribal nation are often times not met with mainstream claims administrators. As representatives of the Forest County Potawatomi Community, we are directed by our tribe to provide all tribal nations the excellent and quality services we provide to our tribal members and employees.