1. Providing trusted and valued relationships to reduce healthcare costs
Presented by:
Paul Schafer

2. About BRMS
BRMS is a nationwide Third-Party Administrator helping employers manage costs with exceptional claims administration, superior customer service and innovative TPA services.
Established in Privately held, family owned and managed.
Proprietary Claims, Billing & Eligibility technology solutions that allows for a more streamlined approach to claims administration, online communication, enrollment, management, billing and reporting.
“…an early technology leader in Employee Benefit membership and eligibility space…” – U.S. News & World Report
Conducted first online enrollment in 1997 for NEC Packard Bell (8,000 EEs)
Located in Folsom, CA and Honolulu, Hawaii :
Account Management Team, Claims Administrators, UR, Case Management, IT and Customer Support.
All services are handled in house.

3. Nationwide Benefits Administration
Nationwide Licensing
PPO Networks
Anthem Blue Cross
CIGNA
FirstHealth
HealthSmart /Interplan
MultiPlan/Viant/Beech Street
First Choice Health
MagnaCare
Internal UR/Case Management Team
Strategic PBM Relationships
PartnersRx/Magellen Rx
Express Scripts
WellDyneRx
Cigna
Reinsurance Partners
SunLife
Voya / ING
Optum Health
Symetra
HCC Life

4. About BRMS – Statistically Speaking
545 Clients
627,816 Claims Processed
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Total Number of Clients in Vbas
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Claims processed for all Lines of Coverage
121 Claims Clients
8-10 Day Turnaround
Number of BRMS Claims Clients
Average Turnaround Time for Claims being processed
……………………...
……………………...
450 Member Lives
50-60% Off Billed Charges
Average BRMS client size
Average savings on Billed Charges
……………………...
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240,596 Employee Lives
60,000 Lives
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Total Employee Lives Managed by BRMS
……………………...
Largest BRMS Customer
497,764 Member Lives
150+ Transfers
Total Member Lives Managed by BRMS
Monthly National Carrier EDI Transfers

5. About BRMS – Sampling of Our Clientele

6. BRMS – Dedicated Service Team Approach
BRMS’ service team encompasses the client and offers complete department participation and accountability. Client specific, trained service representatives in each department.
Matthew Schafer
Chief Executive Officer
Paul Schafer
Vice President
Chad Bragonier
Account Executive
Deann Prefling
Director
Client Administration
Vanessa Pahlberg
Finance and Operations
Bill Hardison
Information Technology

7. BRMS – TPA Services

8. Claims Administration
The Tantara Claims system is a proprietary fully integrated claims, UR/CM, Online Enrollment & Eligibility system
Client dedicated claims examiners who are routinely audited and monitored for financial and procedural accuracy.
BRMS processes and manages all medical claims efficiently and accurately with an impeccable turnaround time of typically 8-10 business days.
Ability to receive claims via 837; paper claims received are scanned, examined and adjudicated.
Client designated check runs, weekly or bi-weekly.
Large claim notification and monthly or quarterly client claims review meetings.
Individual negotiations for claims that fall outside of the network.
Automated reporting distributed monthly through our proprietary data warehouse.
Individual claims access to EE & Dependent information available through or
Online provider access to eligibility, claims, requests and notifications through our ProviderGateway !

9. Medical Management and Utilization Review
In-house registered nurses, contracted board certified medical director and practicing physicians make up our UR team.
Quality assurance standards that will ensure most cost effective, quality-driven treatment available
Monitor services to ensure the effectiveness and cost-saving results of treatment
Established national Milliman guidelines to evaluate the medical necessity for services and the appropriateness of treatment
Protect against over, under and inappropriate utilization of services in terms of medical necessity and level of care
Negotiation for out-of-network hospitals and contracts
Pre-Authorization & Continuous Review
Ensure all members have access to timely and appropriate care through a direct toll free number
For every CM dollar spent we save our clients on average $5!

10. Data Warehousing & Analytical Reporting
To manage your health care benefit program effectively, you need to know how well your current plan design and services work. Our analytical reporting shows you where you’ve been, to make meaningful comparisons and to anticipate future trends and plan change needs.
Automated monthly reporting sent via secure mail
Claims reporting including historical comparisons, risk scores, benchmarking
Health Plan Key Metrics Analysis 
Network Savings Reporting
In-Network/Out-of-Network Provider Analysis 
Large Claims Analysis
Auto-Schedule & Online Access to Reports

11. Customer Support and Health Advocacy Team
Personalized Customer Support Team with a dedicated client 800 number and inbox for training, tracking and reporting purposes.
Member Outreach
Bi-Lingual Representatives
Call Tree Capabilities
Call Recording
Phone Enrollment
Online Chat Features
Dedicated Nurse Line
Teladoc Options

12. EOP, EOB, ID Card and ePay Solutions
RedCard redefines the basic design of claims and enrollment communication by enhancing the EOP, EOB and healthcare ID card allowing employees to better read and understand the information that is important to them.
Client rebranded EOPs/EOBs available in English & Spanish
Online and mobile access for both members
Ability to adjust frequency to weekly, monthly, or quarterly distribution
Customizable, durable ‘plastic’ card, high quality with color printing
E-Payment to providers
Access to DOCS™ which streamlines fulfillment with the ID Cards

13. Vbas – Benefit Administration System
Virtual Benefits Administration System

14. The Benefits Supply Chain
Employees
HRIS
Payroll
Partners
Broker
Carrier
Wellness
Business
Analytics
Total
Rewards
Vbas was engineered to be the hub of the benefit supply chain. By developing a centralized database, employers utilizes Vbas to improve communications, streamline data exchange and increase cost efficiencies for all organizations.

15. Vbas Employer Portal

16. Vbas Employee Portal

17. Vbas OE Employee Portal – Spanish Version

18. View Claims Information Online
Provides you with access to claims history and details in a simplified, user friendly format for any self-funded benefit plan or flexible spending account that BRMS administers.
Online access to your claims information 24 hours a day, 7 days a week.
You will have the ability to view the following claims information:
Date of Service
Date the claim was received and paid
Allowed and non-allowable amounts

19. VbasMobile
VbasMobile is now available on your phone! The Vbas app is available free of charge and allows members access to their benefits information via their mobile devices.
View Company Benefit Summaries
Check Claims Status and History
Submit FSA Receipts
Browse FSA Claims
View Personal Information
View Company Resources
Easy access to ID Card
Available on Android and iPhone

20. Vbas Custom Branding

21. Vbas Benefits Center
Custom Benefit Portals are available allowing employers to house additional resources and information for employees.

22. Business Analytics & ACA TRACK
Business Analytics provides employers with an easy to use tool that combines benefits:
Planning
Budgeting
Forecasting
Benchmarking
Employers are able to perform predictive analysis and review cost details that assist in making planning and budgeting decisions that can result in:
Benefits cost awareness
Higher efficiency and profitability
Educated employees
ACA Track provides ACA compliant software with the ability to track time for 100% of your employees!
Management of stability periods and hours worked
Historical snapshot reporting
Status Alerts for at risk employees
ACA reporting for IRS code 6055/6056

23. Total Rewards Dashboard
The total Rewards Dashboard allows employees to view their Total Compensation online, anytime.
Single sign on through Vbas
Interactive EE dashboard
Displays all components of employee compensation
Cash Compensation, Statutory Benefits, Health & Welfare, 401K Retirement and Other Benefits
Custom Branding Available

24. Additional Services Billing and Eligibility Maintenance through Vbas
RX, Dental & Vision Claims Management
HRIS/Payroll Data Exchange
Consolidated Billing & Reconciliation
Paper Enrollment Data Entry & Processing
Retiree Billing & Administration
HR Support Toolbox
FSA and Debit Card Administration
HSA/ HRA Administration
COBRA/ HIPAA Administration
Employee Surveys
Wellness Placement
Leave Administration
Fulfillment Services
Dependant Auditing

25. The BRMS Advantage Position: “Building Trusted & Valued Relationships”
California based TPA; Nationally licensed
Independently owned and family operated for over 20 years
All systems are proprietary and integrated
Dedicated Client Management Staff for ongoing support, oversight and training
Access to Anthem Blue Cross and Cigna’s premier medical PPO networks
Proven people, service and technology