Integrated Health & Benefits, LLCMark Bodnar, President
CompleteHealth & Benefit Consulting Services
June 2005
1. Overview of Integrated Health & Benefits
2. Service Team
3. Comprehensive Health & Benefit Services
4. Compensation Arrangement
Content
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.
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
Consultative Process
Team Chart
Mark BodnarBusiness Development
Senior Consultant(817) 690-7400
Mark BodnarBusiness Development
Senior Consultant(817) 690-7400
All OtherAll OtherIHBIHB
ResourcesResources
Strategic planningFinancial analysis
Benefit plan managementAdvise on benefit and industry
trends
Denny WrightSenior Partner877.755.4010
Denny WrightSenior Partner877.755.4010
Draft plan documentEnsure Federal & State
complianceLegislative updates
Determine tax effects on plan design
Legal compliance review
Daily service needsMarketing coordinator
Carrier reviewCoverage questions
Claims assistance
Belinda BrooksSenior Analyst
419.873.0619 / [email protected]
Belinda BrooksSenior Analyst
419.873.0619 / [email protected]
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
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
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
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
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
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
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
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)
Core Consulting Services (Continued)
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
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
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
Integrated Health & Benefits, LLC
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Winning Habits
Disease Mgmt
Pharmacy Benefit
Manager
CDHPSystem
ACSAncillary Network
HRA / HSA Programs
Utilization Review / Pre-certification Fully Insured
CDHPs
Ancillary Market
IHSM
IHST
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