James Shipp, ATC, COO
Established in 1983, A-G Administrators is a leading managing general agency and third-party administrator in the sports and special risk accident medical insurance space. The Pennsylvania-based company delivers tailored products through cutting-edge technology and pro-active risk management strategies for universities, colleges, K-12 school districts, and general participant accident groups.
Since its inception, A-G has been keenly focused on insuring athletes and perfecting its core business to effectively serve interscholastic, youth, collegiate, and Olympic sports programs. By fostering relationships with clients, partners, and service providers alike, A-G navigates dynamic medical expense environments, ultimately simplifying the process and generating savings while delivering superior customer service.
With four decades of expertise in the industry, A-G understands that the biggest challenge in the special risk medical insurance space revolves around the communication gap between educational institutions, insurance providers, and claimants. “We pride ourselves on being able to bridge the communication gap by individually speaking to all three parties in a language they understand,” says James Shipp, ATC, COO at A-G Administrators. The vision for effective solutions starts with a comprehensive understanding of the entire system and how it works. The company’s in-depth knowledge of the niche enables them to curate unique solutions that satisfy the specific demands of the clients and the athletes they represent.
A-G’s solutions focus on three factors—service, savings, and technology integration. The company’s service model encompasses these three pillars to reduce the financial and administrative burden on families, institutions, and insurance programs when a student or student-athlete is injured.
A-G’s solutions are also directed toward reducing liability for schools. Schools often lack the knowledge of insurance-related proceedings or even the resources to administer an insurance program themselves. Also, as accidental injury plans are secondary insurances, they are paid only after obtaining an explanation of benefits (EOB) from the primary health insurance provider. Claimants, including students and parents, are completely unaware of this and other insurance proceedings.
A-G simplifies the process for the claimant by integrating directly with the healthcare provider to obtain EOBs and the additional necessary documents. With advanced EDI capabilities, A-G accepts and stores the digital documents collected from the medical providers. The paperless method also enables easy and efficient data extraction in contrast to the time-consuming, labor-intensive conventional methods.
The company’s proprietary, web-based claims management system acts as a reservoir of data, providing clients with a real-time update on the pending and paid amount, check number, and other relevant information through an intuitive user interface. As part of their technology ecosystem, A-G also leverages BI capabilities for reporting and data visualization.
A-G has also developed a unique savings model to map out the best strategy for cost savings on claims. The company negotiates directly with the providers or through a boutique repricing network, as well as other PPO networks to help clients with better claims experience and more savings.
The upper hand in technology has allowed A-G to customize solutions based on specific risks— all using the power of data. This was evident in their successful client partnerships with a K-12 school district. Most students in the school district did not have primary health insurance but had a government-based insurance plan in place. The school district also had a hospital system that was very prominent in their community. When the large healthcare provider expanded through mergers and acquisitions, A-G directly negotiated with the provider for better claim rates, driving further cost reduction on the claims. A-G also customized the plan to optimize the claims experience and drive down costs.
Scripting similar success stories, A-G envisions providing customers with a stellar experience in years to come. “We are focused on enhancing our services by finding the right mix between automation and human interaction,” remarks Shipp.