HCTC: Health Plan Administrators (HPAs)- Your Responsibilities
Once your plan is enrolled to receive monthly payments from the HCTC Program, we rely on your active involvement to ensure accurate and timely payments. This page outlines your responsibilities as a partner to the HCTC Program.
For detailed information on your responsibilities in the HCTC Program, please review the HPA Operations Guide.
Returning Funds to the HCTC Program
An HPA can return funds to the HCTC Program for the following reasons:
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Member's coverage ended or was cancelled
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Member's premium amount changed
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Member changed HPA or Third Party Administrator (TPA)
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Member is no longer eligible for the HCTC
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Member is receiving Medicare benefits
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Incorrect HPA or TPA was paid
Prior to returning funds to the HCTC Program, you should:
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Contact your HCTC HPA Analyst to inform them of the pending return.
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Fill out the Return of Funds Form in its entirety.
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Fax copies of the completed Return of Funds Form to your HCTC HPA Analyst with the returned funds.
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Reference the Return of Funds Form to determine the correct mailing address for the type of funds you are returning. Include a copy of the Returned Funds Form with the check, and send to the appropriate address.
Read the Returning Funds to HCTC Job Aid for detailed instructions.
Submitting Bulk Premium Changes
Please notify the HCTC Program of any bulk premium changes no later than the first week of the month prior to the effective date of the change. This timing will enable us to invoice our participants correctly, and send accurate payments to you.
To submit bulk premium changes, you must:
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Notify your members; you should notify your members of premium changes prior to submitting changes to the HCTC Program.
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Create a spreadsheet; submit requested changes in a spreadsheet format. Refer to the Submitting Premium Changes Job Aid for detailed instructions, including the proper format for the spreadsheet.
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Write an email to accompany the spreadsheet; the email must provide the effective date of the premium changes and include identifying information for the person submitting the spreadsheet, such as as title, company name, and contact information.
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Submit the email and spreadsheet to the HCTC Program; use a secure transmission method, such as a password protected WinZip file, to limit access to the information contained within the spreadsheet.
Making Administrative Changes
If your company’s banking information changes while you are enrolled to receive monthly HCTC payments, complete an Administrative Changes Form. This form is available from your HCTC HPA Analyst and is also included in the appendix of the HPA Operations Guide.
Read the Administrative Information Updates Job Aid for detailed instructions. You might consider printing this Job Aid to use for your future reference, and distribute it to all HPA staff members who work on HCTC payment issues.
Return to the Information for Health Plan Administrators page.
Go to the HCTC Program home page.
Go to the HCTC Quick References page to view a glossary of terms, frequently asked questions (FAQs) and additional resources.
