stewardship report: service commitment and performance summary
TRANSCRIPT
Service Commitment and Performance Summary Prepared for ABC Company
Presented by: Joe Producer Account Executive Better Brokers, Inc.
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ABC Company
Agenda
I. General Overview
II. Summary Review of Services & Service Performance
III. Review of Technology Resources
IV. Current Market Overview & Long-Term Strategic Planning
V. Reports & Exhibits
VI. Miscellaneous Issues & Discussion – Q&A
ABC Company Attendees: Better Brokers, Inc. Attendees
Janis Sterling Joe Producer
Peter Smith Sally Broker
Bob Walker Jim Insurance
Randy Potter Alex Supporter
Sara Miller
Dan Cooper
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Contents Section I General Overview
Commitment Account Service Team Current Programs Summary Client History
Section II Summary Review of Services
Key Accomplishments/ Cost Savings Summary Completed and Ongoing Projects & Services
Section III Review of Technology Resources
Decision Master® Warehouse Client Portal Client Document Distribution History
Section IV Current Market Overview & Ongoing Strategic Planning
Planned Actions for Benefit Plan Implementation Ongoing Action Items
Section V Reports & Exhibits
Summary of Benefits
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General Overview Our Commitment to Service We appreciate the opportunity to work with CLIENT ABC, and help you meet your insurance and employee benefits objectives. In order to adapt to the changing needs of your organization, BETTER BROKERS, INC. has invested in top-notch talent and leading-edge technology. We take nothing for granted, and will always work in the best interest of CLIENT ABC. Thank you for your business. We look forward to nurturing an ongoing relationship that brings you the best solutions in the business. We will continue to build our relationship through hard work, creativity, and assertiveness that effectively meets the needs of your business. BETTER BROKERS, INC. Account Service Team All BBI clients are assigned to a team of specialists who are dedicated to providing a wealth of resources to serve their needs. Our professionals pride themselves on excellent service, and are dedicated to using their experience and expertise to meet our clients’ benefits objectives. Your account team’s goal is to help CLIENT ABC save money through proper implementation and management of your benefits programs, and they are committed to anticipating and fulfilling your needs and concerns. In addition to our own talented professionals and specialized value-added services, BETTER BROKERS, INC. has a wealth of resources available to us through our national affiliations (examples: Assurex, Intersure, Zywave partnership). The resources available to us through these affiliations let us gain access to regional expertise and market clout. Ultimate accountability for your programs is the responsibility of JOE PRODUCER, your lead Account Executive. While a number of professional staff will be active with your account, either on a day-to-day or project-specific basis, JOE is ultimately responsible for meeting your expectations.
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Account Service Team Team Members Functional Position
Joe Producer 555-555-5555 [email protected]
Producer
Sally Broker 555-555-5555 [email protected]
Account Manager
Jim Insurance 555-555-5555 [email protected]
Account Manager
Alex Supporter 555-555-5555 [email protected]
Director, Product Support
Raymond Servicer 555-555-5555 [email protected]
Client Services Representative
(NOTE: This Account Service Team page can be created using output from ReportCenter)
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Summary of Current Programs Plan Carrier Renewal
Medical Plans
- PPO Standard
Carrier One
01/01/2011
Short Term Disability Plans
- Short-Term Disability
Carrier Two
01/01/2011
Long Term Disability Plans
- Long-Term Disability
Carrier Two
01/01/2011
Note: Detailed plan information is located in the Reports & Exhibits section of this report.
(NOTE: This Summary of Current Programs page can be created using output from ReportCenter)
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Client History
Effective Date of Change Plan Change 1/1/12 [Description of change]
1/1/13 [Description of change]
1/1/14 [Description of change]
1/1/15 [Description of change]
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II. Summary Review of Services Provided Since our relationship with CLIENT ABC began back in 2005, we have prided ourselves on being creative, tough negotiators, forward thinkers, and a trusted advisor. Each year, we assisted with the goals/strategies and then developed action items to accomplish our initiatives. Strategies were developed and refined each year based on executive surveys, employee surveys, cost, benchmarking, and emerging trends in the industry. Both past and current accomplishments can assist with future strategies and direction. Listed below are some key accomplishments: Policy Year 2005
Medical No increase in liability compared to 2004 Implemented a carrier that offered flexibility and a national PPO network Negotiated multi-year administration fee cap Negotiated performance guarantees
Dental No increase in rates compared to 2004 Implemented a Dental plan matching prior year’s plan design Negotiated a second year rate cap of 9 percent
STD/LTD/Life/AD&D Negotiated a STD/LTD package reducing costs over $XXX Implemented an employer sponsored Life/AD&D package with the disability savings Negotiated a 2-year rate guarantee for the disability coverage Negotiated a 3-year rate guarantee for the Life/AD&D coverage
Policy Year 2006
Medical Negotiated a XX percent reduction on the Specific Stop Loss renewal Negotiated an X.X percent reduction of the Aggregate Factors Specific Stop Loss savings of $XX,XXX Reduction in overall aggregate liability of $XXX,XXX Assisted with development of network survey Researched domestic partner coverage Researched benefit options for project/part-time employees
Dental Rate cap was set at X percent but negotiated down to X percent Annual savings of $XX Analyzed option to self fund the Dental coverage
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Policy Year 2011 Medical Thorough Market Study and detailed RFP to analyze carriers/TPAs as alternatives Carrier One was selected and implemented as the new administrator Thorough market study and analysis of Stop Loss Markets Implemented NBR as new Stop Loss vendor Evaluated PPO networks via a detailed disruption/discount analysis resulting in the
implementation of X different PPO networks Realized total Medical fees and Stop Loss premium savings of $XXX,XXX Negotiated competitive claims admin fees and fee caps for the next 2 policy years Implemented dual choice medical plans Negotiated and implemented XX percent pharmacy rebates Assisted with employee contribution strategy Assisted with benefit survey for Executives Negotiated performance guarantees Coordinated the Canadian Benefit offerings for the OTHER location
Dental Negotiated reduction of renewal increase by X.X percent Annual savings of $XX,XXX Analyzed option to self fund the Dental coverage
STD/LTD Negotiated a fully insured option with UNUM (eliminated self funding first 2 weeks) Realized savings of $XXX,XXX Negotiated a X percent increase for next policy year even though poor claims experience
warranted a significant increase Negotiated performance guarantees
Life Insurance Negotiated a X.X percent decrease on the current Basic Life rate
Policy Year 2012
Medical Negotiated Stop Loss rates with Allianz Annual savings of $XX,XXX Implemented performance guarantee with stop loss vendor Researched retiree options for Executives Negotiated XX percent increase in the pharmacy rebates Reduced retail dispensing fees from $X.00 to $X.00 Continuous monitoring and changes as more favorable financial arrangements negotiated
Dental Negotiated reduction of renewal increase by X percent with minor contract changes Annual savings of $XX,XXX Analyzed self-funding Dental coverage, demonstrating again that insuring the Dental was
more favorable
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Policy Year 2013 Medical Negotiated Specific Stop Loss renewal and changed deductible to $XXX,XXX resulting in
savings of $XXX,XXX Researched feasibility of Cafeteria Plan Assisted with employee contribution strategy Modified plan designs for dual options and added closed formulary for Rx
STD/LTD Changed to MetLife and negotiated 2-year rates with a projected savings of $XX,XXX Negotiated with CARRIER TWO to waive the $XXX,XXX disability premium due from prior
years, due to underpayments Life Negotiated a second year 0 percent increase renewal rate with CARRIER TWO
Voluntary Coverages Tracking and developing initial objective to implement voluntary products on an on-going
basis Market study and implementation of Optional Life for 2011 MetPay program for 2007 CARRIER ONE LTD buy-up option for 2008, changed to CARRIER TWO for 2009 Assisted with the selection and implementation of CARRIER THREE’s EAP program for
2012 Evaluated Long-Term Care (LTC) for 2008 Reviewed Life
Policy Year 2014 Medical Changed deductible to $XXX,XXX resulting in savings of $XXX,XXX Researched feasibility of Cafeteria Plan Assisted with employee contribution strategy
STD/LTD Realized savings of $XXX,XXX Negotiated a X percent increase for next policy year even though poor claims experience
warranted a significant increase Negotiated performance guarantees
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Review of 2015 Projects & Services Below is a list that highlights some of the specific projects that we completed for 2008-2009 in each of the categories. Long Range Strategic Planning / Ongoing Customer Service Support
o Initial Strategic Plan development/Evaluate overall objectives o Measure Goals o Annual Calendar & Strategic Planning Update including Plan Design Consultation o Review and Implementation of Cost Containment Procedures where applicable o Act as a resource for difficult claim situations o Provide quick turnaround time for any employee benefit-related issue
Contract Management and Renewal Negotiations
o Meetings with ABC CLIENT and vendors when appropriate o Performance review for each ABC CLIENT benefits vendor o Develop and monitor performance guarantees for each ABC CLIENT vendor o Troubleshoot claim and administration issues on an ongoing basis o Review all plan documents and amendments for accuracy to plan specifications o Pre-renewal meeting with ABC CLIENT to discuss renewal strategy o Complete Market Study for all lines of coverage o Establish Stop Loss risk tolerance scenarios, calculate funding rates, and plan alternatives
using our actuarial services o Coordinate any vendor changes at renewal, if applicable o Ensure implementation of policy changes with carrier(s)
Medical/Pharmacy Data Analysis
o General trends in plan usage compared to industry norms and prior experience o PPO provider network evaluation – PPO analysis o Year-to-date costs vs. budget estimates o Prescription drug utilization analysis o Medical and Pharmacy plan design modeling o Review chronic illness / disease management options
Compliance Assistance with State and Federal Mandates
o Legislative Briefs on benefit law changes o Recommendation on plan provisions to comply with benefit law changes o Proactive advice on proposed benefit law changes o Provide online Legislative Guides relating to HIPAA, HIPAA Privacy, COBRA, ARRA, FMLA
and Section 125 Programs
Communication Services o Health care and related educational employee communication pieces o Pertinent benefit articles, survey and emerging industry trends o Assistance with employee surveys and online employee communication newsletters
(HealthShop) via client portal
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III. Review of Technology Resources We use leading-edge technology to provide CLIENT ABC with the latest data analysis, legislative, communication, and human resources administration tools. Using exclusive, Internet-driven applications, we provide our agency staff and ABC CLIENT with unsurpassed efficiency and access to information.
Decision Master® Warehouse (DMW) DMW is a Web-based claims analysis and decision support system designed for today’s benefits manager who wants to save money and manage plan design with technology. What Can Decision Master Warehouse Do for CLIENT ABC?
Lets us show you where and how you can save money by making plan design changes. Your carrier/TPA provides the claims data; we use DMW to produce a comprehensive
Health Plan Management Report. DMW’s exclusive Drill-Down and Alternative Modeling modules help you uncover root
causes and develop money-saving solutions. Offer a sophisticated modeling or “what if” tool to help measure the impact and
effectiveness of plan design changes Compare your claims experience to benchmarks Provide complex information in an easy-to-use and understand format Help you make faster and more effective decisions
DMW Reports – Client History
Report # Company Name Division Name Dates of Report Completion Date 18501 JFK Company Division 1/3/05-1/3/06 2/20/06 118403 123 Company Division II 3/5/09-8/31/09 9/15/09
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Client Portal The client portal is a Web-based information center that facilitates information exchange between BBI and our clients. Your client portal provides you access to valuable HR resources, such as Legislative Guides and updates on HIPAA, HIPAA Privacy, COBRA, ARRA, FMLA and Section 125. With a simple point and click you can get answers to common questions, useful forms, and links to other helpful sources of information.
HIPAA - Portability mandates - Certificates of creditable coverage - Privacy
COBRA
- Compliance - Determining a qualifying event
FMLA
- Impact on disability plans - Impact on workers’ compensation plans
Legislative Briefs
- Retirement Plan Fees - Dollar limits for qualified retirement plans
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Client Document Distribution History Date Client Portal Postings 1/13/2015 Women’s Health: Mammography 2/6/2015 The Benefits of Youth Sports 3/4/2015 Smoking and Your Health 3/4/2015 Sleep Disorders 3/4/2015 Colorectal Cancer 4/5/2015 Vision Care: UV Protection 4/5/2015 Heart Disease 5/4/2015 Emergency Room or Urgent Care? 6/4/2015 Your Medicine Cabinet 6/4/2015 Women’s Health: Ovarian Cancer 6/4/2015 Fitness First: Exercise and Healthy Eating 7/15/2015 Heart Disease 8/2/2015 Men’s Health: Preventive Screenings, Part 1 9/2/2015 Children’s Health: Vaccinations 9/2/2015 Child Vaccinations: Measles, Mumps & Rubella
Date Documents Emailed 1/1/2015 Health Care Reform Chart 1/1/2015 Health Care Reform Timeline
3/1/2015 Health Care Reform: Applications for Early Retiree Reinsurance Program Now Being Accepted
7/4/2015 Health Care Reform: Open Enrollment Compliance Checklist
7/4/2015 Health Care Reform: Small Business Health Care Tax Credit Presentation
(NOTE: This Client Document Distribution History page can be created using output from ReportCenter)
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IV. Current Market Overview & Update on Strategic Planning
Market Overview & Update We continue to see health insurance costs at our client firms rising at an average of X%. Consequently, a trend toward PPO plans with more options becoming available is becoming prevalent. Over the next six to twelve months we expect the health care industry to remain unstable and in transition. Pharmacy trend also continues in the mid-teens after a high of 20-22 percent for the last 2 years. Many new drugs are entering the market. There are 1,258 new specialty drugs currently in the Rx pipeline targeting over 300 diseases (ex. fertility, oncology, hepatitis, MS). The average cost of specialty drugs is $1,500 per month. This, coupled with an increase in script volume, is a big contributor to pharmacy cost increases. For self-funded employers, the reinsurance market continues to be rigid, making negotiations difficult. Lasering is a common practice with many reinsurers, which involves “selective underwriting” of potential high cost insureds. Health care provider systems are under constant scrutiny. Competition among systems is very keen, spurning mergers and acquisitions along with many building expansion projects, all under the guise of maintaining/growing patient base. Providers are also being pressured to disclose both price and quality information, which could be both valuable and dangerous at the consumer level. Health insurers (including managed care companies and TPAs) are repositioning in the market. The largest insurance companies are getting larger by acquiring smaller, regional vendors. Many insurers are divesting from non-core operations. This shift impacts vendor market strategies, pricing deals, administration processes, and ultimately creates service challenges for the broker and employer. Strategic Planning Careful strategic planning includes ongoing evaluation of your plan’s characteristics to ensure that a comprehensive and competitive benefit package is offered to your employees. We approach strategic planning by defining your objectives and developing an organized action plan based on meeting those objectives. The economic pressures that employers face when setting priorities are evident in the relative importance they assign to employee benefit goals. Following is a list of several strategic ideas to be incorporated into your overall benefits strategy, as well as a list of goals/objectives to consider. You will also find a copy of the 2015 action items that we developed based on the 2014 strategy, and a list of suggested 2016 action items. The 2016 list is still a work-in-progress until the strategy is finalized.
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The complete action used to implement your employee benefits plans follows.
Planned Action Status
1. Planning Phase/Meeting
Identify/introduce team members completed
Establish communication channels through company flowchart/contacts completed
Furnish list of all coverage lines and vendors completed
Determine objectives completed
Determine scope of project completed
Discuss timetable completed
Identify information needed for market specifications completed
Send Employee Benefit Data Request to main contacts completed
2. Information Gathering
Review historical information in files completed
Determine missing information completed
Request missing information completed
Historical claims data completed
Summary Plan Description completed
Master Plan Document and Amendments completed
Rate, benefit and financial history completed
Develop benefit summary matrix (CRITICAL) completed
Review funding alternatives completed
Determine funding alternatives to include in market specifications completed
Discuss potential plan design changes completed
3. Develop Vendor Bid Specifications
Inventory current services provided completed
Review contractual obligations of current vendors completed
Finalize list of desired vendor services completed
Determine other bidding requirements completed
Review any prior bid specifications completed
Draft/edit/refine completed
Meet to confirm market specifications completed
Prepare final specifications completed
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4. Vendor Solicitation Identify vendors completed
Copy & mail our specifications completed
Answer vendor questions/provide additional information completed
Receive proposals completed
5. Vendor Selection Conduct preliminary review of proposals completed
Request clarification/missing information completed
Conduct reference checks completed
Evaluate proposals completed
Develop report & recommendations regarding finalists completed
Conduct onsite review of finalists completed
Evaluate results of onsite visits completed
Conduct rate negotiations with finalists completed
Review contracts of finalists completed
Negotiate contractual provisions completed
Select successful bidders completed
6. Employee Communications
Review prior communications & current goals completed
Suggest theme & develop plan completed
Decide on approach/medium completed
Review draft text completed
Modify text as needed completed
Obtain input from successful vendors completed
Assist finalizing text completed
7. Enrollment
Determine enrollment information needed completed
Facilitate arrangement to furnish enrollment data to vendors completed
Decide on billing format completed
Determine ongoing method for maintenance of eligibility information completed
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2015 Ongoing Action items:
• Determine voluntary benefits to offer for 2016 o 4 different options
o To be completed by 3/1/15
• In discussion with 2 other AD&D carriers o LifeLine and Excel both offer plans less than what is currently in place
o To be determined by 6/15/15
• Creating monthly employee benefits e-newsletter o Keeps employees in-the-know about their benefits
o Get staff together
o First issue to be completed by 3/1/15
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V. Reports & Exhibits Summary of Benefits Plan: Medical PPO Carrier: Carrier One Policy No: 1281 Original Effective Date: 1/1/2010 Renewal Date: 1/1/2011
Benefit In-Network Out-of-Network Individual $250 $500 Family $500 $1000 Coinsurance 90% 70% Out-of-Pocket Maximum $750 $2000 Individual $1500 $4000 Family $3000 $8000 Hospitalization Ded then Coins Ded then Coins Emergency Room $50 copay $50 copay Urgent Care $35 copay $35 copay Office Visit $20 copay $20 copay Preventive Care $20 copay $20 copay Prescription Drugs Deductible $150 $300 Generic $15 $15 Preferred Brand $25 $25 Non-Preferred Brand $40 $40 Deductible $0 $0 Mail-Order $30 $30 Non Formulary $50 $50 Provider Network HCN HCN Plan Notes None None
(NOTE: This Summary of Benefits page can be created using output from ReportCenter) Content © 2004-2010 Zywave, Inc. All rights reserved. The information contained herein, including its attachments, contains proprietary and confidential information. Any distribution of these materials to third parties is strictly prohibited. Decision Master® Warehouse is a registered trademark of Zywave, Inc.