Consulting Services | Benefitdecisions

Employee Benefits Consulting Services

Benefitdecisions' services include actuarial, underwriting, benefit modeling, and claim predictability, coupled with account management services. Our needs-based, time-tested, multi-step methodology is the cornerstone to every client engagement.





Process Summary The employee benefit environment is complex, competitive, and dynamic. Our goal is to work with you to positively direct the course of your benefit programs through strategic planning, insight and execution. In these complex times, the demands and challenges on Human Resources are greater than ever, requiring the involvement of an experienced benefit consultant. Our firm is uniquely qualified in employee benefits and human resources areas, and our knowledge and expertise allow us to consistently deliver results that will exceed your expectations - guaranteed!

Goals & Objectives
Benefitdecisions' bases the goals and objectives of our process on your company's needs. Sample goals:

Develop Request for Proposals (RFPs) for insured, stop loss, ASO, disease management, PBMs, etc.
Evaluate HSA plan designs
Conduct market survey to review, evaluate and negotiate ancillary programs
Determine appropriateness and need for voluntary benefit/product offering
Evaluate comprehensive employee communications and develop new materials if needed
Create effective plan designs and provider arrangements to maximize utilization within networks, while potentially lowering the overall benefit program costs.

Plan Audit
Benefitdecisions will perform an in-depth audit of costs (fixed and claims), plan utilization, plan documents, contracts, communication materials and general processes (if appropriate). Areas that will require immediate review include:

Analyze current and past claim experience
Analyze benefit plan utilization
Utilize predictive modeling tools for the purpose of identifying large claims at their early stages.
Evaluate network penetration, and effectiveness of contracts/discounts
Evaluate the plan's utilization of your providers and facilities
Compare actual costs to paid premiums, and to relevant benchmarks
Compare plan design and contributions to relevant benchmarks

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Request for Proposal (RFP)
Benefitdecisions will perform a thorough market analysis to validate its own underwriting assumptions/projections and the renewals of each vendor. This exercise could provide negotiating leverage with the current vendors for the upcoming policy year. Specific areas that will be addressed include:

Validate incumbent's renewal methodology
Evaluate alternative programs and pricing offered by incumbent vendor
Conduct a thorough analysis of similar alternative vendors (i.e. TPAs, stop loss, PBM, disease management)

Analysis
During this phase, Benefitdecisions will carefully analyze the proposed contracts and identify strengths and weaknesses that may exist. In addition, our analysis will ensure the appropriate underwriting methodology was used for pricing purposes. Our comprehensive marketing report will include:

In-house underwriting to ensure proposal integrity
Initiate underwriting negotiations
Disclosure of all proposal contingencies
Comprehensive financial analysis
Provide benchmarking comparisons

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Recommendations
Based on the results of our marketing efforts, Benefitdecisions will provide unbiased recommendations. Our recommendations are based on overall proposal strength and each carrier's ability to meet strict criteria set forth in the RFP process. Once the field is narrowed, we determine which carrier or vendor best meets your goals. Key items included during this phase are:

Finalist selection
On-site due diligence
Performance guarantee (if appropriate)
Financial negotiations
Implementation strategy

Implementation
Working closely with each vendor and your company, Benefitdecisions will coordinate the implementation, enrollment and communication of all programs, if needed. This is critical phase that includes:

Conduct implementation strategy meeting with all parties
Develop employee communication materials
Review enrollment materials
Conduct employee educational meetings
Proof and sign off on contracts
Roll out your benefits website

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Account Management
Once the benefit programs are implemented, Benefitdecisions will provide ongoing services to your company. The account management involves resolving day-to-day problems via a center and providing quarterly experience and utilization reports for each program for forecasting purposes. Other key services include:

30 day review of implementation
Update/change technology
Monthly claims analysis - reported quarterly
Quarterly strategy and service meetings
Mid-year projections for upcoming plan year
Daily access to dedicated account team
Compliance guidance

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