1. Agency Blue Print
So if you think insurance is not a commodity you’ll have some issues with my presentation. If you still disagree, ask an employee

2. What is Your Long Term Agency Strategy?
Account managers are stuck cleaning up mess created by producers….This is very stressful & inconsiderate

3. Paper Based Agencies Have a Strategy, They Just Don’t Know it
Carrier Selection
Long term relationships with carrier reps
Avoid carriers with poor customer service
Avoid carrier that are buying business
Customer Support
Conduct employee meetings for large clients
Create customized materials for large clients
Pay staff when they sell new lines of coverage

4. An Ounce of Prevention is Worth a Pound of Cure
Agencies w/ Strategy
No Strategy
Less Work
More Work
Paper

5. Avoid Situations Which Create More Work
Having plans renew on different months
Paper: just let us know if something changes
Online: a plan must be renewed with new rates
Customizing the enrollment messages for each customer regardless of revenue
Total cost of ownership: Understanding the rate is only a part of the total cost of offering a plan

6. Agencies with a Blue Print are Becoming More Efficient and Growing Rapidly
Get the entire staff using the system
Product design
Teach them the system
Create an implementation strategy
Deadlines
Group structure
Develop a product/carrier strategy
Define a support strategy: Tie the amount of support to commission (or potential)
What areas of the system will you support?

7. Automating enrollment management
Forms
Population:
Coming this Fall
Excel
Self-Bill
Wall: Key
Enrollment
HIPAA 834
EN’s
Marketplace

8. Let’s Get Started

9. Consider An “Organizational Blue Print”
HR Services
Benefit Enrollment
Dedicated Staff
Webinars
Client demos
Onboarding
Call center support for HR
Customer Team
Configure enrollment
Carrier & plan selection
Enrollment to carriers that are not centrally managed

10. Implementation: Get the Whole Team to Help
Producer
Admin
Accounting HR
Add company X
Learn department & class structure
Add carrier, rates & plan year
Pay periods
Communication materials
Employee contributions x
Import employees (it’s more secure)
Customize employee experience
Payroll deduction reporting
Importing

11. Have a Implementation “Game Plan”
HR has a 5 day administrative period after OE
Paperwork Due: X days before OE
OE must close 25 days prior to e-date
Enrollment is sent to carriers 20 days prior to renewal
Train HR 10 days before e-date

12. Candidates For the Service Should Meet Certain Guidelines
Establish recommended # of class structures (3-5 maximum)
Payroll
Number of payrolls & pay schedule should not be too excessive
Have a consistent # of deductions for all benefits
Be careful with 26 pay periods and 24 deductions
What will your guidelines for high turnover companies be?
Are there a high number of:
Grandfathered employees (try to handle them outside of the software)
Grandfathered plans
Exceptions made by HR

13. Candidates….continued
Computer:
Availability for employees
Capability of employees
Capabilities of HR (has HR had a prior bad experience?)
Optimal time of the year for an implementation
Get renewals dates in sync
Recommend 1st of the month eligibility & consistent end of policy for terms
Would you recommend another plan if it didn’t work in EN?

14. Considerations For Companies
Employee population
HR person
Single classes: eligibility, contributions
Time of the year
Get the renewals in sync
DC plans must have benefits in sync
The HR has to follow their own benefit rules
Grandfathered employees
Eligibility, 1st of the month
Which carriers are easy to set-up regardless of size

15. Producers Should Consider A Product Strategy
GOOD
BAD
Strategically target carrier consolidation and get HR buy-in
Broker helps HR become self-sufficient
Keep all existing plans & carriers when converting to digital enrollment
Broker does everything for HR

16. Carrier Strategy: Maintenance Costs Correspond Directly to the Number of Carriers
Minimize the # of carriers used by companies
Use Employee Navigator’s automated COBRA & FSA and other integrated partners
Sell a same voluntary life plans & carriers since these care the most complex to set-up
Modernize Policies: some cases may have been won by “duplicating benefits” and the policies are very old

17. Create a “Box” for the Sales to Work Within, But Allow Exceptions
Use Employee Navigator’s integrated COBRA & FSA
Ancillary
Self-bill with carrier
Combine lines of coverage
Medical, dental & vision
Determine threshold for 834 data file feeds
Caution on bundled plan strategy
Building and reusing plans
Customize when necessary

18. Supported Plan Designs
Worksite Plans
Group contract vs. individual
High, Low, No (Avoid EOI)
Avoid employees selecting riders individually
Bundled Plans
Creates COBRA issues
Avoid non-carrier or custom bundles
Medical and life on a single 834

19. Standardization Reduces Overhead
Medical: Companies select any carrier
Ancillary: Combine as many lines as possible
Worksite: Preferred carriers and plan designs
Add-ons: Create a list of supplemental service providers:
Telemedicine
Legal
Identity theft
Preferred Carriers
Which ones do you find easy to work with
Avoid carriers that require paper applications

20. Some HR Want To Be Involved… others will retire sooner or later
Let HR
Manage their own documents
Set-up on boarding
Empower HR to manage employees
Importing of new employees
Adds, terms & changes
Exceptions
Sending out bulk employee communications
Require HR to configure the employee experience
Home page news and articles
templates
Logo

21. Managing Enrollment

22. Data Transmission Options
Spreadsheet
HIPAA 834 Data Feed
Self-bill
2nd Generation Data Feed
Paper ➔ key into portal
Carrier or TPA

23. EDI & HIPAA 834 Is Still Not Very Scalable
Hello Everyone,
A Welcome to e-Exchange Conference Call is scheduled for Employee Navigator - Group #146E
We will begin the implementation process for the automated enrollment move
to e-Exchange using the automated enrollment vendor Employee Navigator
Please forward this call invite to others as you see appropriate.
Listed below are some activities that maybe discussed:
an overview of e-Exchange
exception reports
the file layout
how the file will be processed
Attached is the group structure that will be referred to during the call.

24. Is Keying Data Into A Portal Cost Effective?
10 Life Events
Assuming 3 carrier feeds
Data Feeds
Key enrollment
Set-up file feeds
21 hours
0 hours
Manage error reports (4 minutes per carrier per week)
10.4 hours
Manual Change (5 minutes per change)
10 hours
Create Open Enrollment Excel
2 hour
Total Hours
31.4 12
Labor $30 per hour
$942
$360
EDI Software ($0.45 PEPM)
$810 $0
Total Cost
$1,752 ($0.97 PEPM)
$360 ($0.20 PEPM)

25. Keying Data Into A Portal
Receive alerts and key change into carrier portal
Employees Enroll Online
Send OE Elections to Carrier on Excel

26. Carrier Will Modernize in the Next 5 Years
Management of enrollment will decrease
The decrease will not be measurable as brokers put more groups online

27. Blue Print: Minimizing Projected Labor Costs
Regardless of data transmission method:
Strategy to minimize the # of carriers
#1 Medical
#2 Dental
#3 Vision
#3 Core Ancillary
#4 Worksite
#5 COBRA & FSA
#6 Identity protection/health advocacy
#7 Telemedicine

28. Analysis of Ways to get Enrollment to Carriers
Carrier EDI file feed support costs (based on 3 carriers)
Requires weekly review of carrier error reports
15 Minutes per week: (13 hours per year)
Setting up carrier feeds takes
30-50 hours per group in year 1
20 hours in year 2
Best case year 1 labor costs: 43 hours

29. How Many Changes Can Be Completed Manually in 43 hours?
172:
3 minutes per change=15 minutes
100 life company time estimates (10% turnover)
Compile spreadsheet for OE: 1 hour(s)
10 new hires
10 terminations
5 Life events
Total Time ~7.25 hours

30. Administrative Cost to Manage Groups
Let’s round the 7.25 hours to 10
Hourly rate for employee $30
Labor costs for 10 hours $300
Monthly cost per employee $0.25 PEPM

31. Costs to Manage 10% Turnover: Review of error report not included+ 13 hours per error reports
Hand Key
Optimized hand key
Carrier Feed
Carrier Feeds
Medical 5
420
Dental
120
Vision
With dental
Core ancillary
Self bill
Worksite
Hand key
FSA& & COBRA
Total Time
25 minutes
20 minutes
2,100 minutes
540 Minutes
20 Changes per year
8.3 hours
6.6 hours
35 hours
11.25
100 Life group
11.25 hours
250 Life Group
20.75 hours
16.5 hours

32. Financial Analysis of Managing groups
Hand Key
Optimized hand key
Carrier Feed
Carrier Feeds
100 Life group
8.3 hours
6.6 hours
35 hours
11.25 hours
Labor costs (60K)/$29/hr
$240
$191
$1,015
$326
2 Year Cost (EDI 80% less)
$480
$382
$1,218
$391
250 Life Group
20.75 hours
16.5 hours

33. Product Blue Print HR: Making life easy for HR
Dedicated support team to help get HR start using the software
Onboarding configuration support
Standardize 2-3 COBRA/FSA & give clients choice
Already have over 1,000 companies using integrated partners
Preferred payroll relationships
You’ll see us add in more payroll integrations than anyone in the industry over the next 12 months
Negotiate simplified product issue and underwriting
Core ancillary
Voluntary products’
Block underwriting is coming

34. Questions?