Healthcare Reporting is an organization committed to delivering smart and affordable services to Plan Sponsors, Brokers, TPAs, PBMs, Captives and the Stop-loss marketplace in general.  We pride ourselves on having a high degree of technical expertise in benefits and blend that with high levels of client service.

Healthcare Reporting was originally founded in 2015 to address new compliance regulations required under the Affordable Care Act.  Since that time the compliance and administration burden of our clients has continued to grow, and we have evolved to help meet those needs.  

Our initial launch of ACA Reporting Service was a rapid success as we began to trend on Google for various search terms.  Next, we began offering State-based ACA reporting as various states added additional reporting requirements.  As the IRS increased their ACA enforcement efforts, we added compliance assistance to help Plan Sponsor respond to IRS Letter 226-J inquiries.

Our next evolution occurred in 2017 when we released Self Insured Reporting, a Claim Reporting & Analytics technology that had been in the works for a decade prior.  The platform was well received due to our full integration of the stop loss contract, robust financial reporting and stop loss reporting.  It was not long before we were receiving data from 100+ different TPAs and 40+ different PBMs.

We continued to build additional functionality into Self Insured Reporting adding a broker financial app in 2022.  For the first time ever, brokers can simply pull out their phone to easily check the financial status of their client’s plans including budget status, aggregate reports and renewal projections.

PlanWell Health was our next integration and the first member app of its kind.  This member app utilizes actual medical and pharmacy claims data of plan members to close gaps in care and save health plan dollars.  Members can view their entire claims history and gaps in care at a glance.

As the Consolidated Appropriations Act (CAA) was passed and implemented, it has brought with it additional compliance requirements as well as an increased focus on fiduciary duty by the Department of Labor.  This was the catalyst to our offering various other compliance services such as Mental Health Parity, RxDC Reporting, Air Ambulance Reporting & Gag Clause Attestation assistance.

In 2022, our compliance research led us to the conclusion that the Department of Labor is following the same road map of enforcement regarding Medical Plan Assets as it did with retirement plan assets a decade ago.  The implications of this move is that Plan Fiduciaries will have increased scrutiny regarding their management of Medical Plan Assets.  We see this scrutiny occurring both for Plan Sponsors as well as TPAs (who are often considered fiduciaries by the courts.)

For these reasons we launched various Claim Services to help meet those fiduciary duties including Dialysis Cost Containment, Subrogation and Stop Loss Claim Filing.