MyAmericasChoice.com mixes Internet and insurance
May 03, 2000 11:41 AM ET
By Peg Brickley, LocalBusiness.com

Clelland Green was one of those kids whose favorite games were on the computer.

Not so unusual these days, when parents plunge thousands of dollars into specialty game systems and manufactured video-realities to keep their little ones out of the bars and off the streets.


Headlines
"Self-directed health plans shift risk, cost to workers" - ACH in the Christian Science Monitor
August 12, 2002

"Uncovering Unbundling" - Article Featured in Human Resource Executive
May 3, 2002

"40 under 40" - Philadelphia Business Journal lists Clelland Green
March 29, 2002

ACH CEO Named to CareGain Board of Advisors
February 26, 2002

New model applies Internet to realize managed care's potential
November 1, 2001

Inc 500 rates America's Choice in country's top 500 growing companies
October 30, 2001

Philadelphia Business Journal features America's Choice
October 29, 2001

Philadelphia Inquirer features America's Choice
April 9, 2001

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But back in the 1970s, when the creator of MyAmericas Choice.com was noodling away at the keyboard, kids and computers did not go together like peanut butter and jelly. And geekdom did not automatically carry with it the promise of millions from eventual success as a technocrat and entrepreneur.

Green never gave up his fondness for computers. And succeed he did as an entrepreneur.

But it was not until the past couple of years that the two came together, that the Internet and the insurance business started looking less like two different worlds and more like a logical combination. That's when Green built MyAmericasChoice.com within King of Prussia, Pa.-based Medical Care Management Systems Inc., his benefits administration firm.

Like at least a half-dozen others, the Web site targets the world of employers that insure themselves: usually companies with 50 to 5,000 employees, working in multiple sites and multiple states.

About 53 million employees are in that universe -- people who need to enroll in insurance plans, submit claims and track their progress. On the bricks-and-mortar level, about 1,700 firms make a living as third-party administrators, charging fees to handle benefits for the self-insured.

A lush and fragmented field, it is a natural for Web start-ups that promise employers they can offer their employees full-service Internet access to their benefits, just like the big insurers offer.

Except that most of the big insurers are not there yet, not all the way on the Web. Internet and insurance mix well as concepts. But the technology is not as easy as it sounds.

It has not been until recently that Internet technology has been able to penetrate the massive old databases of insurers, which often exist on a patchwork of systems cobbled together over the years.

Compound that with the system differentials of multiple employer clients, and it is even more of a challenge to create a Web site that really works, instead of one that offers limited peep-holes into a database that exists somewhere else.

According to Green, it is technology that gives AmericasChoice.com an edge over the rest of the sites duking it out for the business of self-insured employers.

Competing sites consist largely of a collection of Web-based brochures, where employees can download enrollment forms, fill them out and mail them in and health care providers can verifiy eligibility.

AmericasChoice.com boasts full paperless enrollment over the Web, and access to claim information while it is being processed, as well as a number of other features. Only about 3 percent of employee inquiries on the site have to do with verifying eligibility, the feature that is the main attraction on rival Web sites, Green said.

The 15 years he spent in the benefits administration business before launching the Web site is evidenced in all the things his firm does that others either do not do at all, or do not do online: AmericasChoice.com produces cards, finds doctors, pays claims, bills the employer for the premium and tracks everything.

The company also sells stop-loss insurance to protect employers' insurance funds against catastrophic claims. Bringing a premature infant through the first year, for example, can run an easy half-a-million dollars. Most employers buy insurance to make sure their loss is limited to $10,000 to $20,000 or so, in such cases.

MyAmericasChoice.com collects a commission for selling stop-loss coverage, as well as fees for administering the benefits package -- usually a per employee, per month flat rate.

The portions of that service menu that employers, health care providers and employees need to see are all integral to the Web site, thanks to Green's insistence that the Internet was a tool for clients, not just a showcase.

"Other sites have basic reporting and eligibility features that are essentially bolt-on applications (Internet functions that filter limited data from in-house systems)", Green said.

He built My America's Choice Healplan's first Web site himself, back in 1997, as well as a corporate intranet program that lets customer service people tap into plan documents while on the phone with clients. The company still uses the database program he wrote to track sales.

"I don't call myself a programmer," Green said. "But maybe I'm a database designer. Definitely, I'm a power user."

COMPANY: Medical Care Management Systems Inc. Subsidiary America's Choice Healthplans is a registered trademark and owner of MyAmericasChoice.com, the Web-based business.

INDUSTRY: Benefits administration

PRODUCT/SERVICE: Health insurance plans for self-insured employers, managed over the Internet.

YEAR FOUNDED: 1994.

MANAGEMENT: Clelland Green, chief executive, has been in the insurance business since earning a degree in economics and management from Dickinson University. He started his first third party administration firm in 1988 with partner Dennis Cox. They split in 1994, each taking part of their Cox Green Assoc. Green founded Medical Care Management Systems, which spawned America's Choice Healthplans.

Others on the management team, all of them benefits industry veterans, have been with the company since the pre-Web days: Brenda Walton, director of operations; Tiffany Hummel, director of client services; Jefferson Kise, chief financial officer.

"This is not a lifestyle business intended just to support me," Green said. "This is a professional business where I have always reinvested profits in hiring top quality management."

INVESTORS: Seed money was $25,000 from Green, who also brought over business from his former firm, and $75,000 from Michael O'Neill, "a client who thought I was smart," according to Green. O'Neill continues to hold a seat on the board, joined now by a representative of The Berwind Group's Eureka Fund, a growth fund administered by a private Philadelphia collection of operating companies and investments. In mid-April, Eureka LLP bought $4 million worth of A preferred stock in America's Choice Healthplans.

EMPLOYEES: 50. Forty are in King of Prussia headquarters, including a growing technical staff. Ten, and growing, are in sales and service offices in Chicago, Raleigh-Durham, N.C; Richmond, Va.; Baltimore; New York; Boston and Minneapolis.

FISCAL YEAR REVENUES: 1998, $1.3 million. 1999, $2.6 million. 2000, on track for $4.2 million in fiscal year ending in June.

STRATEGIC PARTNERS: DoHealth.com, a Web-based collection of employee wellness programs.

SELECTED CUSTOMERS: Philadelphia Phillies, Florida Power & Light Co.

COMPETITORS: Blue Cross Co., Aetna, Cigna Corp. vie for group insurance business. The TPA and CoreSource are nationwide contenders for third-party administration business, but neither has a well-developed Web presence, according to Green.

STRATEGY: Firm intends to lead with its superior technology, offering to take more of the burden from the employer and offer more to the employee than the competition.

WHAT KEEPS THEM UP AT NIGHT: "Making sure we continuously improve our Internet capability and that we have the right focus for the future," Green said.

CONTACT: Clelland Green, America's Choice Healthplans, 700 American Ave. Suite 101, King of Prussia, Pa., 19406; Phone: 610-962-2985; Fax: 610-962-1984; e-mail: cgreen@mcmsinc.com. Web site: www.myamericaschoice.com.

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