Third Party Administrator (TPA) Change
The AlaskaCare health insurance plans will be administered by Aetna for PERS, TRS, JRS, and EPORS retirees and certain state employees. Moda Health, formerly Oregon Dental Service (ODS), will administer AlaskaCare’s dental plan.
Aetna demonstrated it would provide the best value to the state in terms of total cost, provider network, sophistication of operations, and quality of customer service through a one-point of contact concierge approach to customer service.
The selection of Aetna as the state’s Third Party Administrator (TPA) followed an extensive procurement process that began in November 2012. The Department of Administration’s procurement process sought bids from vendors in four areas: medical network and administration, pharmacy benefit management, healthcare management, and dental network and administration. The Department selected Aetna for medical network and administration, pharmacy administration, and healthcare management. In submitting its proposal, Aetna partnered with CVS Caremark, one of the largest pharmacy benefit managers in the country, for pharmacy benefit management.
The Department selected Moda Health for dental network and administration. With the addition of Moda Health, AlaskaCare will now be a part of the Delta Dental network, the largest dental network in Alaska and the U.S.
The change will be effective January 1, 2014, the beginning of the 2014 benefit years. Members will receive welcome packets from Aetna later this fall and open enrollment will start November 4 and continue to November 22.