Integrated Health & Benefits, LLC Mark Bodnar, President Complete Health & Benefit Consulting Services June 2005.

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  • CompleteHealth & Benefit Consulting ServicesJune 2005Integrated Health & Benefits, LLCMark Bodnar, President

  • ContentOverview of Integrated Health & Benefits

    Service Team

    Comprehensive Health & Benefit Services

    Compensation Arrangement

  • Overview of Integrated Health & Benefits, LLC

  • 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.

  • Consultative Process

    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 ImplementationOngoing Account ManagementProgram AuditRequest for Proposal/Market NegotiationsConsultative Process

  • Team Chart

    Mark BodnarBusiness DevelopmentSenior Consultant(817) 690-7400hdsnms@earthlink.netStrategic planningFinancial analysisBenefit plan managementAdvise on benefit and industry trends

    Denny WrightSenior Partner877.755.4010dennywright@dedwardwrightinc.com

    Draft plan documentEnsure Federal & State complianceLegislative updatesDetermine tax effects on plan designLegal compliance reviewDaily service needsMarketing coordinatorCarrier reviewCoverage questionsClaims assistance

    Belinda BrooksSenior Analyst419.873.0619 / 419.344.7694bbrooksihs@aol.com

  • Strategic Services

    Strategic Objective SettingObtain clear understanding of client goals and needsIdentify short-term and long-term strategic plans

    Strategic Annual Planning MeetingService Agreement working document that provides action plan for the year

  • Strategic Services Modeling

    ContributionsPlan DesignIncrease co-pays and deductibles Evaluate appropriateness of each offering Service related offeringsVendor ManagementCompetitive bidding Medical, Rx, Dental, VisionEvaluate non-medical vendors (including voluntary)Vendor performance guarantees

    FinancingAdopt defined contribution approachImplement gain-sharingFully-Insured / self-insured / stop-lossEmployee ContributionsPlan steerage strategies Re-tier single/family ratios Salary-adjusted contributionsOpt out credits / requirementsStrategic Services

  • Strategic Services - ModelingBest Price and ServicesImproved pharmacy management High performance / efficient networksClinical and operational auditCollective purchasing Promote a Healthy WorkforceComprehensive health and productivity management approachHealth risk appraisalsSelf-care assistanceLifestyle interventions/ wellnessHealth risk managementPromote Consumer AccountabilityRaise cost awareness / education Consumerist plan design / cost sharing Access to and incentive to use tools CDHP and/or HSA plansFocus on High Cost PopulationsBest in class disease management mandatory?Best in class case management mandatory?Chronic self careStrategic Services

  • Strategic Services (continued)Plan Audit / BenchmarkingReview total cost, employee contributions, plans offered, and benefit plan designReview of plans vs. other employers of similar sizePerform benefits audits to determine alignment with corporate objectives, gaps in coverage or overlaps in coverage

  • Core Consulting ServicesBenefit Plan Consulting for:Medical, dental, vision, life, AD&D, disability, long term carePrescription Drug carve-outsDisease Management Programs, Wellness ProgramsEmployee Assistance Plans, Mental Health carve-outsVoluntary Benefits, Work/Life ProgramsFlexible Spending Account/COBRA AdministrationDefined Contribution Medical Design

  • Core Consulting Services (continued)Assistance with vendor relationshipsAdvocate for improved service levelsAssistance with billing or claim issuesPolicy interpretationMaintain regional and national relationships for client advocacyReview applications, contracts, and reporting proceduresAssistance with open enrollment logistics, meetings, and communications

  • Core Consulting Services (Continued)MarketingCustomize bid specificationsMarket and negotiate vendor responsesAnalyze and report findings in detailed spreadsheet and narrative formatFinalist negotiations, recommendationsImplementation

    NegotiationFair but firm negotiationsStaff includes former underwritersRelationships both locally and nationally with major carriersExpertise of benefit professionals

  • Core Consulting Services (Continued)Pre-Renewal MeetingEstablish renewal (or marketing) objectivesUpdate on market trendsRenewal projectionsRequest renewal minimum 120 days in advance of renewal date (varies by client and vendor)Prepare to draft Request for Proposals, as neededRenewal MeetingPresent negotiated renewal or market study resultsFinalize meetings / service meetings (as required)Review renewal objectives / evaluation criteriaModel and analyze employee contribution scenariosFinalize renewal decisions to begin communication phase

  • Core Consulting Services (Continued)Financial Analysis/ReportingRegular claims reportsPlan utilization analysisFunding alternatives analysis (self insured, fully insured, etc.)Financial accounting/reconciliation (participating contracts)Renewal ReportsIBNR/Funding Reports projectionsCost ProjectionsNetwork Pricing analysis

  • Compliance AssistanceLegislative and Administrative Overviews and Compliance AssistanceSummary plan description reviewsContract reviewsAssistance with preparation of Form 5500Periodic seminars and bulletins on pertinent legislative topicsAssistance with HIPAA, ERISA, COBRA, FMLA, and other compliance questions as needed

    Monitor carriers for financial solvency

  • Compensation ArrangementsService Agreement basis of Integrated Health & Benefits Compensation

    Fee and/or Commission (built into premiums)

    Integrated Health & Benefits philosophy: full disclosureOur objective is to invest in long-term, mutually beneficial relationships with our clients

  • Integrated Health & Benefits, LLCPPO NetworkStop LossMarketMedPartnersOhio HealthGroupScreening & Health Risk AssessmentGW AccessIntraHealth Data Solutions(IDS)IHSOIntegrated Health & Benefits, LLCIntaHealth Solutions Inc.IntaHealth Solutions Ohio, LLCIntegrated Medical ManagementWinning HabitsDisease MgmtPharmacy Benefit ManagerCDHPSystemACSAncillary Network HRA / HSA ProgramsUtilization Review / Pre-certificationFully Insured CDHPsAncillary MarketIHSMIHST

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