Phase
I: Client Needs & Program Analysis
Phase
II: Vendor Selection & Implementation
Phase
III: Monitoring Plan Performance
Plan
Delivery:
Phase
I: Client Needs & Program Analysis
| 1. |
Interview
management to develop a results-oriented agenda consistent with
your company overall objectives. |
| 2. |
Analyze
current/proposed plan design for managed care alternatives. |
| 3. |
Assess
the current/proposed rate structure, contributions, and financial
strategy. |
| 4. |
Evaluate
current/proposed funding mechanisms. Assist your company management
team in determining appropriate risk funding alternatives. |
| 5. |
Analyze
your company claims and loss experience, for the purpose of
self-funded analysis and appropriate stop loss levels. |
| 6. |
We
will draft Bid Specifications that incorporate all of your company
specified objectives, including the requested plan design, performance
criteria, network configurations, and financial guarantees. |
| 7. |
After
preparation, we will meet with your company to review and make
appropriate edits before its release to the selected vendors. |
| 8. |
Once
approved, we will release to the vendors and then encourage
vendors to engage in questions or concerns that each may have
with the Bid Specifications and respond accordingly. |
9. |
We
will analyze each of the vendor proposals for all Service, Network
and Administrative Capabilities, as well as Underwriting/Financial
offers. Our analysis will include preparation of a report that
documents the following: |
Objective
Overview
- We will compare the objectives of the request for proposal to
the responses received, develop a view of the preliminary financial
results, and prepare a summary that outlines the core competencies
of the vendor offers.
Plan
Design - We will detail each of the vendors’ plan
designs and compare each against the Prototype, and highlight the
differences.
Service
Capability - We will provide an independent opinion of
each of the vendor’s ability to deliver upon their proposal
commitments for service including implementation, plan administration,
network performance, and telephone access. In addition, we will
highlight advances in Technology that would enhance the vendor relationship.
Network Capability - We will develop an overview
of the vendors’ capability to support adequate provider (hospital,
physician, pharmacy, etc.) geographic access to the employees and
families of an organization through a Network Profile.
Financial
Overview - We will prepare a review of each of the vendors’
financial offers and the corresponding impact that each would likely
have on current costs.
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Phase
II: Vendor Selection and Implementation
| 10. |
We
will meet with your company to review our report and interim
recommendations. |
| 11. |
Examine
the completed employee benefits program to confirm it is the
correct response to your company requests and needs. Confirm
with your company that their goals have been achieved. |
| 12. |
Once
we have jointly developed a profile of the vendor(s) that can
best deliver on the defined objectives, we will assist your
company in the process of narrowing the group of “finalists”
and invite this group to further refine their offers. |
|
13.
|
Review
plan transfer issues. |
|
14.
|
We
would anticipate that your company would then be in a position
to make a selection of a vendor or vendors, if appropriate.
All Financial offers and Funding arrangements will be verified
and References validated. |
|
15.
|
Implement
the program. |
|
16.
|
It
is our standard business practice to actively participate in
the implementation and transition process. Our purpose in doing
so is founded upon our interest in ensuring a “problem
free or problem minimized” transition to the selected
vendor(s). |
17.
|
Attend
employee benefit plan educational meetings. |
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Phase
III: Monitoring Plan Performance
| 18. |
Monitor
performance of the plan. Make certain funding agreements are
in order and that claims are being paid effectively and in accordance
with the plan document.
|
|
19.
|
Keep
your company management staff advised of new benefit developments,
legal issues, and other conditions affecting the employee benefits
industry. |
| 20. |
Resolve
problem claims. There will be a Customer Service contact that
will be responsible for ongoing administrative service and
claims assistance that may need additional service. |
21. |
Submit
an annual stewardship report summarizing year-to-date services,
claims activity, statistical analysis, loss ratios and administrative
costs for projection of future plan costs and utilization. |
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