May, 2011
UGLY!!
Perhaps that’s the “nicest” term that can be employed to describe the medical benefits renewal process that we have endured over the past few years. For renewals that became effective in 2010, and continuing with those we have already “completed”, and for those that are a continuing work in progress for implementation in calendar year 2011, this timeframe has been, without a doubt, the most stressful and challenging I have experienced since I began my professional career in the field of medical benefits back in 1977!
In the vast majority of Client situations, we are observing double digit rate increases in medical renewal plans, that are due in part to the state of the economy, where layoffs or reductions in force have reduced the number of covered participants in an Employer’s plan (which can be a good thing), but often at the cost of eliminating those younger and healthier people and leaving a somewhat older and more costly (from a medical risk perspective) population insured. There are, of course, many other underlying reasons for the cost escalation we are observing, including account specific claims experience. Please speak with your EBS Foran Group Account Manager about more reasons specific to your Plan.
Coupled with what’s happening at both the Federal and State levels in response to the concept of “healthcare reform”, the pressure on both our healthcare delivery and distribution systems is enormous and the consequences are being felt by the consumer in the form of cost increases.
With this letter I want to assure you that despite all of the “challenges” that we are confronted with on a daily basis we take most seriously our role as your advocate, and we are working harder than ever to ensure that we follow your directives and work with you to ensure that your specific needs and desires are addressed to the best degree possible within the constraints of today’s medical benefits marketplace.
Oftentimes, our role has become “contentious”, as we are “negotiating” renewal rates, cost reductions, and benefits modifications with health insurors and their underwriters. This level of contention at times also “spills over” to employee and retiree populations where we are unfortunately the “bearer of bad news” in terms of cost increases and benefit changes that are required either due to mandates, or in order to be certain that the cost of medical benefits is within a level of fiscal sanity (if possible) for any particular Employer. As noted above, our staff is working diligently to ensure that your specific benefit goals and objectives are satisfied. What was in the past a few months for a “renewal cycle” has now virtually become for many (most) of our Clients virtually a year round proposition!
We want to assure you that we treat each individual Client’s expenditures as if it were our own. We understand today’s economy, and we understand the pressures that are upon you. We are working with our individual Clients to ensure you are aware of benefit options, be it in plan design, carrier or funding mechanism payment methodologies (premium funding vs. self-insuring, etc.). If you have any questions, please do not hesitate to raise them with your EBS Foran Group Account Manager, or myself.
Also, during the “heat of battle” we sometimes become so involved in what we are doing that we don’t take the time to say “thank you” to each of our valued Clients. We greatly appreciate and fully understand the confidence you have placed in us, and we thank you for the opportunity to be of service to you. I hope you share our belief that our Organization has the experience, talent and vision to work with you on an individual basis to help you through the “maze” of employee benefit challenges to find something that perhaps won’t be perfect, but is as good as it can be in these challenging days.
*IMPORTANT*
Over the course of the past few months, a number of our Clients have asked what else we can offer to provide assistance in the area of Employee Benefits. A few years ago, we surveyed our Clients about the possibility of our providing on-site administrative support services. At that time, there was not a significant level of interest, but perhaps this is an area that might be worth considering once again. I would like to ask that you take a few moments to review the summary below and provide me with your feedback. It may be that “outsourcing” these administrative services may be of interest to you for one of several reasons. Please send your comments to jpforan@ebsforan.com.
It may be that, due to the economy, the staff that formerly handled these duties is no longer available to do so as a result of a lay-off or a reduction in hours. Perhaps the staff handling this function is “stretched thin” while handling other necessary internal functions in addition to these on-going responsibilities.
Whatever the situation may be, evaluating the outsourcing of these services may make sense, as it would ensure necessary work is completed in a cost effective and professional way.
An overview of the services we may be able to offer is as follows:
Benefit Areas : Medical-Dental-Life-Disability-Voluntary Plans
*At this point in time, retirement plans are not included in scope of services.
Phase I : Conduct Positive Re-Enrollment for each Line of Coverage
Conduct a totally new “positive enrollment” for each line of coverage (so we
know the enrolled population is correct and data and age information is up-to-
date. This would also recapture the data for Medicare requests, etc.).
Phase II : On-Going/On-Site Services at the Client’s worksite.
1) Handle all enrollment (add, delete and change) transactions.
2) Handle COBRA… outsource to EBS Foran COBRA services.
3) Resolve any administrative problems.
4) Assist employees with claim problems.
5) Prepare monthly bills for payment.
6) Educate new enrollees of benefit and coverage selection options.
Handle enrollment.
7) Notify employees of benefit changes (prepare notice/any mailing
Cost is the Employer’s responsibility).
8) Coordinate Annual Open Enrollment and work with Client’s payroll
department (vendor) to ensure new withholdings are correct.
9) Be primary interface with carriers and other vendors (i.e. Third Party
Administrators, etc.).
10) Coordinate Health Fairs.
11) Interact with Retirees, as necessary.
Depending upon the responses we receive, we will then determine if it is practical for our Organization to move forward with the hiring of an experienced benefit professional to handle some of these tasks for our Clients. Of course, the cost for these services is most critical to you and while we anticipate our per Client fee would be modest, until such time we can evaluate the interest and determine the workload volume, we cannot commit to a definite cost. After we review the level of interest, we will follow-up with an update.
Have you visited our website lately? While we are in the process of updating the same, I again want to remind you that for those of our clients that are on a commission basis the most up-to-date commission statements can be found on our website. In addition, we have Webinars and links to helpful sites. Please speak with your EBS Foran Account Manager for more details.
The Health Insurance Portability and Accountability Act of 1996, better known as HIPAA, has set standards for the security and ensured confidentiality of your Plan Participants health information. The scope of the standards, and the Federal enforcement of the same, continues to expand.
As part of the services available to our Clients, we can assist you in evaluating your HIPAA training and compliance to both the HIPAA Privacy and Security rules. As we are not attorneys, these evaluations should always be reviewed by your counsel. All Employer sponsored health plans that are self-insured are a “covered entity” and thus subject to the HIPAA rules. However, many fully insured Employer sponsored health plans have become covered entities by their participating in either the Medicare D Retiree Drug Subsidy, the Early Retiree Reinsurance Program or by the implementation of federally defined health plans, such as Flexible Spending Accounts (FSAs) or Health Reimbursement Arrangements (HRAs). Many Employers that are not “covered entities” as defined by the HIPAA rules also find it beneficial for Human Resource or Benefits departments (or in the case of public sector clients “First Responders”) to conduct HIPAA training as well. This service is available to all of our Clients.
For further information, please speak with your EBS Foran Account Manager, or contact Vin DiBenedetto, our Project Manager, at 508-385-5135 extension 23.
Lastly, I would like to request that you provide me with any candid feedback you feel would help our Organization. I would like to know if we are not performing up to the level of your expectations, or ideally exceeding the same. That is our goal, and if that isn’t happening I need to know so I can work to resolve the situation.
In a similar way, if we are working at a level that meets or exceeds your expectations, your feedback is always welcome so I can share it our employees. Today, our employees are in the “trenches” working diligently on your behalf. If they are doing something you feel is exceptional, it’s always good for them to receive such feedback.
More importantly, if you feel we are performing at a level that is of value to you, I would appreciate your referring us to any other Public or Private sector Employer that you know that may be in need of similar Employee Benefit services. Our business is based in large part upon Client referrals, as this is the most effective way of our obtaining new business. In today’s challenging environment we really don’t have the opportunity to go out and “canvas” the marketplace for new Clients. However, we are accepting new Clients on a referral basis, so anyone you could direct in our direction would be greatly appreciated.
Again, thank you for selecting our Organization to be your benefits partner. We take this responsibility very seriously and our on-going commitment to you is that we will work tirelessly on your behalf to ensure your benefit needs and goals are implemented.
Thank you for allowing us to be of service to you!
Sincerely,
John P. Foran
President
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