Employee Benefit Strategic Partnership

Size: px

Start display at page:

Download "Employee Benefit Strategic Partnership"

Lorraine Paul
5 years ago
Views:

Employee Benefit Strategic Partnership Healthcare Services Employee Benefits

purchasing organization to serve our members.

Jefferson City, MO 65109 (573) 893-5300 www.hsg-group.

of Sales & Marketing 7415 W 130 th Street, Suite 200 Overland Park, KS 66213

1 Employee Benefit Strategic Partnership Healthcare Services Employee Benefits Consortium (HSEBC) Creating a best-in-class employee benefits group purchasing organization to serve our members. Healthcare Services Group Joe Moody, President & CEO 4700 Country Club Drive Jefferson City, MO (573) Vizient Insurance Services David Smith, Dir. of Sales & Marketing 7415 W 130 th Street, Suite 200 Overland Park, KS (913) Wallstreet Group Randy Lueckenotte, Co-Owner, RHU, LUTCF 1530 Rax Court Jefferson City, MO (800)

2 Advisor Expertise & Service Wallstreet Group is one of the top producing agencies in Missouri with full-service Group Benefits and Property and Casualty Departments. Formed in 1987, Wallstreet Group is an independent agency, representing numerous companies. This allows us to do the shopping for you and enables us to provide the best insurance products at the most competitive rates. We specialize working with Employee Benefit Group Purchasing Organizations. (GPO s) Over the past several years we have partnered with VHA, now known as Vizient, to serve acute hospital clients. With recent mergers and acquisitions described below. We have combined our acute and non acute advisor and insurance GPO programs together. This has created the largest nationwide Employee Benefit GPO available to our clients. Breaking News Vizient, Inc. Purchases MedAssets 2015 VHA merges with University Healthcare Consortium VHA and UHC signed an agreement to combine into a single organization that will be the largest member-owned healthcare company in the country VHA & University Healthcare Consortium become Vizient, Inc. Vizient, Inc. acquires MedAssets VHA and MedAssets is now Vizient, the largest member-owned health care company in the country representing almost $100 billion in annual purchasing volume. Vizient s unprecedented size, national scale, and market leverage allows Vizient Insurance Services to create and manage employee benefits and property & casualty pooled programs designed to spread risk and deliver savings. By purchasing insurance coverages as a group, we dramatically increase our leverage with insurance carriers to obtain better pricing, stable rates, and enhanced policies for our members. Over 250 hospitals representing nearly $300 million in paid premium are currently participating in Vizient Insurance Services.

3 Developing Provider Network Trends MEDICAL Direct Terciary Agreement with significant deeper discounts than Traditional PPO Network Discounts. Reference-based reimbursement as a percentage of Medicare; obvious concern over member disruption and balanced billing. Air Ambulance/Medical Transport Rates/Plan Document Language/Process Medically Necessary / Prior Authorization Process for Hospital-to-Hospital Transport PHARMACY Through our relationship with Vizient we provide an Independent Team of Pharmacy Advisors, who specialize in a marketplace review and benchmarking of the current Pharmacy Benefit Management pricing. We typically see savings of 10% to 15% through reviewing administrative fees, manufacture rebates, and clinical utilization savings programs. This can also include coordination with a 340-B program and maximizing the hospital client s own retail pharmacy.

4 Vizient s PBM pricing model yields significant savings. Current PBM A PBM B Ingredient Cost $402,072 $357,997 $354,039 Dispensing Fees $7,060 $6,304 $5,043 Prescription Expense Total $409,132 $364,301 $359,082 Administration Fees $983 $0 $0 Manufacturing Rebates $28,080 $34,410 $59,990 Net PBM Expense $382,035 $329,891 $299,092 Base Annual Savings Over Current $52,144 $82,943 Clinical & Utilization Savings $26,144 $26,483 Proposed Net Annual PBM Expense $303,747 $272,609 Total Annual Savings Over Current $78,288 $109,426 Note: claims repriced include the 12 months between 8/1/2015 and 7/31/2016 Total estimated annualized savings opportunity ranges from $52,000 and $109,000

5 How Our Advisor & Insurance Services Can Help You With 250+ healthcare facilities, our partnership provides enormous purchasing strength in the marketplace. With over 100,000 insured employee lives and millions of dollars of premium volume, we continually save healthcare providers cost and improve benefits within our exclusive programs. Our pooled programs are well-established with a proven track record for rate stability. Dental and Vision Insurance 10% Average Savings Life Insurance 25% average savings Disability Insurance 15% average savings Specific Stop Loss Arrangement with built-in protections such as no-laser, and cancer carve-out Renewals have been below trend with two of the last five years at 0% Over $20 million in preventable lasers from on going catastrophic claims Pharmacy utilization and contract analysis 15% average savings Healthcare Facilities retain their independence and choice, including: Freedom to choose Fully Insured or Partial Self Funded Insurance Programs Freedom to choose TPA, PBM, & provider network Freedom to chose plan designs & funding structure Freedom to choose which products to implement A wide offering of customized solutions for your hospital including: Communication & Education Enrollment Administration ACA & ERISA Compliance

Product Portfolio Choice & Flexibility Core Group Benefits Administrative Services Voluntary Benefits Health Insurance Stop Loss Insurance Pharmacy Benefit Management Basic/Supplement Life & AD&D

6 Product Portfolio Choice & Flexibility Core Group Benefits Administrative Services Voluntary Benefits Health Insurance Stop Loss Insurance Pharmacy Benefit Management Basic/Supplement Life & AD&D Short- & Long-Term Disability Dental Insurance Vision Insurance Custom Medical Network Design Third Party Administration FSA, HSA & HRA Administration COBRA & FMLA Section 125 Paperless Enrollment System Disease & Wellness Management Cancer, Critical Illness, Accident Permanent Life Long Term Care Limited Medical Plans MEC Voluntary Legal and Identity Theft Customized Benefit Communication Employee Assistance Program Benchmarking Focused on Your Industry Plan Design Comparison Expense/Premium Comparison Cost-Utilization Comparison Pharmacy Claim Management Medical Claim Management Network Management Retirement Plan Benchmarking

Title Goes Here. COBRA: Common Mistakes for HR Professionals. Banyan Consulting. Eric D. Penkert. June 4, Presented By:

Title Goes Here. COBRA: Common Mistakes for HR Professionals. Banyan Consulting. Eric D. Penkert. June 4, Presented By: Title Goes Here COBRA: Common Mistakes for HR Professionals Banyan Consulting June 4, 2013 Presented By: Eric D. Penkert Agenda Brief Overview Common Mistakes Special Rules What Does COBRA Require? Covered