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Published byMoris Griffin Modified over 9 years ago
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Integrated Health & Benefits, LLC Mark Bodnar, President Complete Health & Benefit Consulting Services June 2005
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1. Overview of Integrated Health & Benefits 2. Service Team 3. Comprehensive Health & Benefit Services 4. Compensation Arrangement Content
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Overview of Integrated Health & Benefits, LLC
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Our Mission: To develop and deliver creative benefit solutions and services that make our clients more successful. To use our consulting and services in assisting our clients in resolving human resources problems. To deliver the above as a long term business partner.
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We have embraced a “process” approach to working with our clients in a consultative manner, from understanding their needs to developing and delivering creative Benefit solutions. Strategic PlanningProgram Implementation Ongoing Account Management Program Audit Request for Proposal/ Market Negotiations Consultative Process
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Team Chart Mark Bodnar Business Development Senior Consultant (817) 690-7400 hdsnms@earthlink.net Mark Bodnar Business Development Senior Consultant (817) 690-7400 hdsnms@earthlink.net All Other IHBResources Strategic planning Financial analysis Benefit plan management Advise on benefit and industry trends Denny Wright Senior Partner 877.755.4010 dennywright@dedwardwrightinc.com Denny Wright Senior Partner 877.755.4010 dennywright@dedwardwrightinc.com Draft plan document Ensure Federal & State compliance Legislative updates Determine tax effects on plan design Legal compliance review Daily service needs Marketing coordinator Carrier review Coverage questions Claims assistance Belinda Brooks Senior Analyst 419.873.0619 / 419.344.7694 bbrooksihs@aol.com Belinda Brooks Senior Analyst 419.873.0619 / 419.344.7694 bbrooksihs@aol.com
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Strategic Services Strategic Objective Setting Obtain clear understanding of client goals and needs Identify short-term and long-term strategic plans Strategic Annual Planning Meeting Service Agreement – working document that provides action plan for the year
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Strategic Services – Modeling Contributions Plan Design Increase co-pays and deductibles Evaluate appropriateness of each offering Service related offerings Vendor Management Competitive bidding – Medical, Rx, Dental, Vision Evaluate non-medical vendors (including voluntary) Vendor performance guarantees Financing Adopt defined contribution approach Implement gain-sharing Fully-Insured / self-insured / stop-loss Employee Contributions Plan steerage strategies Re-tier single/family ratios Salary-adjusted contributions Opt out credits / requirements Strategic Services
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Strategic Services - Modeling Best Price and Services Improved pharmacy management High performance / “efficient” networks Clinical and operational audit Collective purchasing Promote a Healthy Workforce Comprehensive health and productivity management approach Health risk appraisals Self-care assistance Lifestyle interventions/ wellness Health risk management Promote Consumer Accountability Raise cost awareness / education Consumerist plan design / cost sharing Access to and incentive to use tools CDHP and/or HSA plans Focus on High Cost Populations Best in class disease management – mandatory? Best in class case management – mandatory? Chronic self care Strategic Services
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Strategic Services (continued) Plan Audit / Benchmarking Review total cost, employee contributions, plans offered, and benefit plan design Review of plans vs. other employers of similar size Perform benefits audits to determine alignment with corporate objectives, gaps in coverage or overlaps in coverage
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Core Consulting Services Benefit Plan Consulting for: Medical, dental, vision, life, AD&D, disability, long term care Prescription Drug carve-outs Disease Management Programs, Wellness Programs Employee Assistance Plans, Mental Health carve-outs Voluntary Benefits, Work/Life Programs Flexible Spending Account/COBRA Administration Defined Contribution Medical Design
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Core Consulting Services (continued) Assistance with vendor relationships Advocate for improved service levels Assistance with billing or claim issues Policy interpretation Maintain regional and national relationships for client advocacy Review applications, contracts, and reporting procedures Assistance with open enrollment logistics, meetings, and communications
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Core Consulting Services (Continued) Marketing Customize bid specifications Market and negotiate vendor responses Analyze and report findings in detailed spreadsheet and narrative format Finalist negotiations, recommendations Implementation Negotiation Fair but firm negotiations Staff includes former underwriters Relationships both locally and nationally with major carriers Expertise of benefit professionals
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Pre-Renewal Meeting Establish renewal (or marketing) objectives Update on market trends Renewal projections Request renewal minimum 120 days in advance of renewal date (varies by client and vendor) Prepare to draft Request for Proposals, as needed Renewal Meeting Present negotiated renewal or market study results Finalize meetings / service meetings (as required) Review renewal objectives / evaluation criteria Model and analyze employee contribution scenarios Finalize renewal decisions to begin communication phase Core Consulting Services (Continued)
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Financial Analysis/Reporting Regular claims reports Plan utilization analysis Funding alternatives analysis (self insured, fully insured, etc.) Financial accounting/reconciliation (participating contracts) Renewal Reports IBNR/Funding Reports projections Cost Projections Network Pricing analysis
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Compliance Assistance Legislative and Administrative Overviews and Compliance Assistance Summary plan description reviews Contract reviews Assistance with preparation of Form 5500 Periodic seminars and bulletins on pertinent legislative topics Assistance with HIPAA, ERISA, COBRA, FMLA, and other compliance questions as needed Monitor carriers for financial solvency
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Our objective is to invest in long-term, mutually beneficial relationships with our clients Compensation Arrangements Service Agreement – basis of Integrated Health & Benefits Compensation Fee and/or Commission (built into premiums) Integrated Health & Benefits philosophy: full disclosure
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Integrated Health & Benefits, LLC PPO Network Stop Loss Market MedPartners Ohio Health Group Screening & Health Risk Assessment GW Access IntraHealth Data Solutions (IDS) IHSO Integrated Health & Benefits, LLC IntaHealth Solutions Inc. IntaHealth Solutions Ohio, LLC Integrated Medical Management Winning Habits Disease Mgmt Pharmacy Benefit Manager CDHP System ACS Ancillary Network HRA / HSA Programs Utilization Review / Pre-certification Fully Insured CDHPs Ancillary Market IHSM IHST
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