Coalition Services, LLC
Coalition Services, based in Brookfield, Wisconsin, provides management services, education and information to help self-funded NEHA members improve employee health and lower health care costs. They play a lead role in developing collaborative partnerships and contractual relationships with our regional health care providers; and work collaboratively with brokers and consultants to ensure NEHA is the right fit for the employers they represent. Coalition Services also provides and manages the NEHA provider directories that allow members to identify who is participating in the NEHA networks. The staff at Coalition Services assists employees at member companies resolve provider- specific contractual pricing issues that arise. Find out more at www.coalitionservices.com.
HDMS - Health Data & Management Solutions
NEHA has partnered with Health Data & Management Solutions (HDMS) to provide the NEHA Coalition with a new data warehouse and analytical reporting system. HDMS is a software development company on the cutting edge of health IT data solutions. Offering data warehouse, management and analysis tools for the healthcare industry, HDMS strives to improve and enhance its product suite for health plans, employers and providers through constant innovation.
Third Party Claims Administrators (TPA)
We have preferred partnerships with two TPAs: UMR (a United Healthcare Company) and Auxiant. NEHA member companies must select one of these TPAs to administer their medical claims. NEHA is not a third-party administrator.
Pharmacy Benefit Managers (PBM)
NEHA has preferred partnerships with four pharmacy benefit managers: OptumRx (a UnitedHealthcare Company), Serve You, RxBenefits – OptumRx and RxBenefits - CVS. These pharmacy benefit managers (PBMs) efficiently interface with the two medical TPAs on eligibility and claims to streamline administration. NEHA member companies must select one of these PBMs to administer their pharmacy claims.