Life Science Washington Health Trust. Products and Services

Transcription

1 Life Science Washington Health Trust Products and Services Effective January 1, 2017

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3 Contents About Life Science Washington Health Trust 1 Membership Benefits 3 Benefits Snapshot 4 Medical Plan 5 Dental Plan 8 Vision Plan 10 Basic, Voluntary Life, and AD&D 12 Employee Assistance Program (EAP) 14 About the Administrative Platform 16 About the Managing General Agent 17 About the Third Party Administrator 18

4 About Life Science Washington Health Trust The Life Science Washington Health Trust provides employee benefits to companies that are engaged in or supportive of the research, development and commercialization of life science technologies. Our goal is to provide plan offerings as diverse as our customers industry sectors in the life sciences so that you can provide value to your employees. We exist to support you in administrating your company employee health benefits so that you can focus on changing the world. Benefits of joining Life Science Washington Health Trust include: Diverse As the center of influence for the life sciences industry throughout the state, Life Science Washington brings together research institutions, investors and entrepreneurs to grow our economic sector and create healthier communities. Like our customers, we re bold thinkers and look for new ways to develop offerings with consumer-focused tools designed to improve health, support informed decisions and help employees become active participants in their own healthcare. The Trust partners with a variety of insurance carriers that help with decision support, price transparency and wellness. Covered employees are able to choose from a wide variety of benefit plans that include medical, dental, vision, wellness and other ancillary offerings. The Trust offers comprehensive medical plans with significant first dollar benefits and deductibles that range from $0-$5,000. Flexible pricing strategies are uniquely developed for the life science industry and exclusively available through the Life Science Washington Health Trust. Supportive Enrolling into the Life Science Washington Health Trust means also becoming a Life Science Washington member. This membership extends to all of your employees and access to commercialization expertise, industry news, purchasing discounts, governmental advocacy, and great events. The Trust is commited to making administration of your company benefits easy and painless, providing consolidated billing and an employer management web platform featuring plan booklets, summaries and forms for ease of administration. Employers have a single point of contact for all types of plan administration including customer service, billing, eligiblity and COBRA services. 1

5 About the Life Science Washington Health Trust, continued Care advice is delivered in a variety of ways, based on member preference: in person, on the phone or via telemedicine. Virtual Care provides easy and convenient access to health services outside a clinical setting. Value In addition to information regarding the life science industries, Life Science Washington hosts events and seminars regarding how to successfully run and manage your business including human resources-related topics. The Life Science Washington Health Trust benefit platform enables employers to offer leading insurance benefit options that meet demand for growing companies, with comprehensive benefits for as few as two employees or as many as 199. Life Science Washington Health Trust helps growing biotechnology, medical devices, biopharmaceuticals, health IT/digital health, global health, bio-agriculture and bio-fuel firms in Washington recruit and retain top talent with competitive and affordable health and wellness benefits. Premera is the contracted medical carrier for the Life Science Washington Health Trust to provide its comprehensive medical insurance to prospective employers in the Pacific Northwest. Benefit plans go where your team goes across the country and around the world so your employees can feel confident knowing they have one of the largest provider networks in the world at their service. Off-the-shelf product designs for an easy insurance buying experience with predictable out-of-pocket expenses for employees and their dependents. The following pages give a detailed summary of the unique 2 Omnitrade.ins@wellsfargo.com

6 About Your Trust Sponsor: Life Science Washington Membership Benefits Supporting and growing Washington state life sciences through advocacy, collaboration and investment. Life Science Washington is an independent, non-profit 501(c)(6) trade association serving the life sciences industry in the state of Washington. Our members include organizations engaged in, or supportive of, the research, development and commercialization of life science technologies. As the center of influence for Washington state life sciences, we advocate for positive public policy and private investment, bring together research institutions, investors and entrepreneurs to grow our economic sector, and create healthier communities. We provide value for our member organizations through: Advocacy Championing public policies and driving awareness to ensure life science organizations continue to grow and prosper in Washington state and beyond Collaboration Creating a community of diverse organizations and individuals to share ideas and create new innovations Investment Facilitating access to capital through commercialization and mentoring that grows companies and fosters top talent The life science industry encompasses any initiative aimed at improving the quality and standard of life. Its many industry sectors include biotechnology, medical devices, biopharmaceuticals, health IT/digital health, global health, bio-agriculture and biofuel. Life Science Washington is fully-funded through memberships, sponsorships, and event registration fees. For more information, visit 3

7 Benefits Snapshot Medical 12 Preferred Provider Plans (PPO) and three Health Savings Account (HSA) products Medical plan deductible options of $0 to $5,000 with significant first dollar benefits Underwritten by Premera Blue Cross Provider Networks Heritage Prime Network: Low-cost, narrow network available with all plans Heritage Plus Network: Robust, comprehensive network including access to all major facilities and physician groups available with all plans BlueCard: Offers access to providers across the nation at in-network benefit levels; international provider access is available as well Dental Five PPO Plans with optional orthodontia riders for groups of 10 or more employees Underwritten by Delta Dental of Washington (DDWA) Vision Plan includes an exam, hardware, and contact lens benefit, as well as an optional safety glasses rider Underwritten by VSP Vision Care Inc. Basic Life and AD&D, Disability, and Voluntary Life Basic Life: Options include flat benefit amounts, as well as multiples of salary Disability benefits are available to groups of 10 or more employees Voluntary term life for employers with 10 or more employees with a guarentee issue of $180,000 Underwritten by Unum Employee Assistance Program Three-visit model embedded in all medical plans Six visit buy up option available Administered by Wellspring Family Services Billing and Eligibility Administration Consolidated billing COBRA Administration Online enrollment Electronic invoicing Administered by Benefit Solutions, Inc. (BSI) 4 Omnitrade.ins@wellsfargo.com

8 Medical Plan About Premera Blue Cross Premera has a history of helping generations of Washingtonians. At Premera, we serve nearly 1.9 million people from individuals and families, to Fortune 100 employer groups. Our mission is to provide peace of mind to our members about their healthcare coverage. A rich set of tools and applications makes it easy to manage employee health, care, and costs, and Premera is known for customer service dedicated to resolving questions in just one call. Support for smart healthcare decisions Premera plans include consumer webbased tools and health support programs. They help employees maintain good health and change unhealthy behavior. Personalized service and online tools include: Find a Doctor tool, which includes provider and facility qualifications and user reviews Health assessments Treatment cost estimator Spending activity report 24-Hour NurseLine is available to members so they can speak to a registered nurse free of charge anytime. Order prescriptions online and have them delivered by mail Customer service that s well trained, and focused on getting to an answer in one call Health support programs include: Smoking cessation and substance abuse programs Exclusive discounts on fitness club memberships, weight loss programs, and more Personal health outreach program Pregnancy and newborn support program Provider network built for value and quality Premera Blue Cross offers a comprehensive network in Washington. The Premera network of doctors, hospitals, and other healthcare providers is designed to offer ready access to safe, effective, highquality care at affordable prices. Our strong relationships with our provider partners help maximize healthcare dollars by: Focusing on quality and cost-effective care Helping control rising medical costs Providing resources for improved healthcare When outside Washington, members can access Premera s national network of preferred providers, offering the same high standards of quality and economy. Corporate citizenship At Premera, we re committed not only to improving the health of our members, but we re also dedicated to making a difference in the communities we serve. Premera supports community programs and events each year with financial and in-kind donations, as well as volunteer time. 5

9 Plans A H January 1, 2017 through December 31, 2017 Deductible* (individual/family) Out of Pocket Maximum* (deductible included) Plan Benefits Coinsurance Office Visit Preventive Care Plan A Plan B Plan C Plan D Plan E Plan F Plan G Plan H $0 / $0 $200 / $600 $250 / $750 $300 / $900 $500 / $1,500 $750 / $2,250 $1,000 / $3,000 $1,500 / $4,500 $2,000 / $6,000 $3,200 / $9,600 $3,750 / $11,250 $4,300 / $12,900 $4,500 / $13,500 $4,750 / $14,250 $6,850 / $13,700 $6,850 / $13,700 In Network 100% 100% 90% 80% 80% 80% 80% 80% Non Network 50% 50% 50% 50% 50% 50% 50% 50% In Network $20 copay then 100% $25 copay then 100% $25 copay then 100% $30 copay then 100% $30 copay then 100% $35 copay then 100% $35 copay then 100% $35 copay then 100% Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived Non Network Preventive Lab/Xray/Mammography In Network 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Diagnostic Lab & Xray In Network 100% deductible waived 100% deductible waived 90% deductible waived 80% deductible waived 80% deductible waived 80% deductible waived 80% deductible waived 80% deductible waived Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Rehab Inpatient Hospital Inpatient 30 days Outpatient Hospital In Network 100% after deductible 100% after deductible 90% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Outpt 45 visits Inpatient Mental Health Outpatient Mental Health Emergency Room (copay waived if admitted) Chiropractic (12 visit max) Acupuncture (12 visit max) In Network $20 copay then 100% $25 copay then 100% $25 copay then 100% $30 copay then 100% $30 copay then 100% $35 copay then 100% $35 copay then 100% $35 copay then 100% Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network 100% after deductible 100% after deductible 90% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network 100% after deductible 100% after deductible 90% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network 100% after deductible 100% after deductible 90% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network $20 copay then 100% $25 copay then 100% $25 copay then 100% $30 copay then 100% $30 copay then 100% $35 copay then 100% $35 copay then 100% $35 copay then 100% Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible $200 copay, then 100% after deductible $200 copay, then 100% after deductible $200 copay, then 90% after deductible $200 copay, then 80% after deductible $200 copay, then 80% after deductible $200 copay, then 80% after deductible $200 copay, then 80% after deductible $200 copay, then 80% after deductible In Network $20 copay then 100% $25 copay then 100% $25 copay then 100% $30 copay then 100% $30 copay then 100% $35 copay then 100% $35 copay then 100% $35 copay then 100% Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network $20 copay then 100% $25 copay then 100% $25 copay then 100% $30 copay then 100% $30 copay then 100% $35 copay then 100% $35 copay then 100% $35 copay then 100% Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Prescription Drug Retail $10/$30/$60/$250 $10/$30/$60/$250 $10/$30/$60/$250 $10/$35/$70/$250 $10/$35/$70/$250 $10/$35/$70/$250 $10/$40/$80/$250 $10/$40/$80/$250 Mail Order $20/$60/$120/$250 $20/$60/$120/$250 $20/$60/$120/$250 $20/$70/$140/$250 $20/$70/$140/$250 $20/$70/$140/$250 $20/$80/$160/$250 $20/$80/$160/$250 This benefit summary is not a contract or a complete explanation of covered services, exclusions, limitations, or reductions. *Deductibles and Out of Pocket Maximums shown are for In Network services 6 Omnitrade.ins@wellsfargo.com

10 Plans I L & HSA Plans January 1, 2017 through December 31, 2017 Deductible* (individual/family) Out of Pocket Maximum* (deductible included) Plan Benefits Coinsurance Office Visit Preventive Care Preventive Lab/Xray/Mammography Plan I Plan J Plan K Plan L H S A 2000 H S A 3000 H S A 5000 $2,000 / $6,000 $2,500 / $7,500 $3,000 / $9,000 $5,000 / $12,700 $2,000 / $4,000 1 $3,000 / $6,000 1 $5,000 / $6,550 1 $6,850 / $13,700 $6,850 / $13,700 $6,850 / $13,700 $6,850 / $13,700 $6,550 / $13,100 1 $6,550 / $13,100 1 $6,550 / $13,100 1 In Network 80% 80% 80% 80% 80% 80% 80% Non Network 50% 50% 50% 50% 50% 50% 50% In Network $40 copay then 100% $40 copay then 100% $40 copay then 100% $40 copay then 100% 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived Non Network In Network 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived 100% deductible waived Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Diagnostic Lab & Xray In Network 80% deductible waived 80% deductible waived 80% deductible waived 80% deductible waived 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Rehab Inpatient 30 days 30 days 30 days 30 days 30 days 30 days 30 days In Network 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Inpatient Hospital Outpatient 45 visit limit 45 visit limit 45 visit limit 45 visit limit 15 visit limit 15 visit limit 15 visit limit In Network $40 copay then 100% $40 copay then 100% $40 copay then 100% $40 copay then 100% 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible In Network 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Outpatient Hospital In Network 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Inpatient Mental Health In Network 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Outpatient Mental Health In Network $40 copay then 100% $40 copay then 100% $40 copay then 100% $40 copay then 100% 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Emergency Room (copay waived if admitted) $200 copay, then 80% after deductible $200 copay, then 80% after deductible $200 copay, then 80% after deductible $200 copay, then 80% after deductible 80% after deductible 80% after deductible 80% after deductible Chiropractic (12 visit max) In Network $40 copay then 100% $40 copay then 100% $40 copay then 100% $40 copay then 100% 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Acupuncture (12 visit max) In Network $40 copay then 100% $40 copay then 100% $40 copay then 100% $40 copay then 100% 80% after deductible 80% after deductible 80% after deductible Non Network 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible 50% after deductible Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Prescription Drug Retail $10/$50/$100/$250 $10/$50/$100/$250 $10/$50/$100/$250 $10/$50/$100/$250 80% after deductible 80% after deductible 80% after deductible Mail Order $20/$100/$200/$250 $20/$100/$200/$250 $20/$100/$200/$250 $20/$100/$200/$250 80% after deductible 80% after deductible 80% after deductible This benefit summary is not a contract or a complete explanation of covered services, exclusions, limitations, or reductions. *Deductibles and Out of Pocket Maximums shown are for In Network services 1 Aggregate Family Deductible/ Embedded Family Out of Pocket Maximum 7

11 Dental Plan About Delta Dental of Washington Delta Dental of Washington (DDWA), a member of the nationwide Delta Dental Plans Association, is the state s leading dental benefits company, providing comprehensive coverage both locally and nationally. DDWA offers the largest network of dentists more than 3,938 in Washington state, and more than 142,000 across the country. This is a benefit no other company can match. A focus on prevention: DDWA coverage focuses on preventive care, which improves oral and overall health, and reduces long-term costs. Hassle-free coverage: Participating DDWA dentists complete claim forms and submit them directly to DDWA, so you don t have to deal with time-consuming paperwork. MySmile personal benefits center: Want to find a dentist nearby, check your benefits or find out whether a specific treatment is covered? MySmile personal benefits center, your patient portal on Delta Dental of Washington Web site, is customized to your individual needs and provides you with answers to your most pressing questions about your dental coverage. This interactive patient portal provides immediate access to the dental benefits information you need most, such as: A Find a Dentist search feature that lets you locate dentists in your plan network. It allows you to search by radius and provides a map marking dentist locations within your designated area. A snapshot of your recent dental activity, including an explanation of benefits summary Details about your plan coverage, eligible benefits and payment history Immediate view-and-print access to your ID card Check your claim status 8 Omnitrade.ins@wellsfargo.com

12 Dental Plan Comparison This Dental Comparison of Plans is a brief summary of benefits. For exact details of coverage, including limitations and exclusions, please refer to the applicable contract or booklet. 9

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14 Vision Plan Comparison Benefit VSP Choice Network Plan B 12/12/24 VSP Choice Network Plan B 12/12/24 With Safety Glasses Rider #1 VSP Choice Network Plan B 12/12/24 With Safety Glasses Rider #2 Copay $25 copay every 12 months $25 copay every 12 months $25 copay every 12 months Single Vision 100% VSP $30 Other Provider 100% VSP $30 Other Provider 100% VSP $30 Other Provider Lined Bifocal 100% VSP $50 Other Provider 100% VSP $50 Other Provider 100% VSP $50 Other Provider Lined Trifocal 100% VSP $65 Other Provider 100% VSP $65 Other Provider 100% VSP $65 Other Provider Elective Contacts (Instead of glasses) Contacts $150 VSP $105 Other Provider Contacts $150 VSP $105 Other Provider Contacts $150 VSP $105 Other Provider Contact Lens Exam (Fitting & evaluation) Up to $60 copay Up to $60 copay Up to $60 copay Frames Frames $180 VSP 20% off the amount over the limit $70 Other Provider Frames $180 VSP 20% off the amount over the limit $70 Other Provider Frames $180 VSP 20% off the amount over the limit $70 Other Provider Limitations If you choose contact lenses you will be eligible for frames in 12 months. If you choose contact lenses you will be eligible for frames in 12 months. If you choose contact lenses you will be eligible for frames in 12 months. Exam $25 Copay, 100% VSP Provider $45 Other Provider $25 Copay, 100% VSP Provider $45 Other Provider $25 Copay, 100% VSP Provider $45 Other Provider Safety Glasses N/A $0 Copay Lenses* covered in full every 12 months (single, lined bifocal or lined trifocal). Frames covered up to $65 every 24 months 20% off the amount over the limit $10 Copay Lenses* covered in full every 12 months (single, lined bifocal or lined trifocal). Frames covered up to $65 every 24 months 20% off the amount over the limit *The lenses and frame provided under this plan are certified as safe for the work environment by meeting the necessary requirements set forth by ANSI (American National Standards Institute) (No coverage for other provider) This Vision Comparison of Plans is a brief summary of benefits. For exact details of coverage, including limitations and exclusions, please refer to the applicable contract or booklet. 11

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16 Basic, Voluntary Life, and AD&D Plan 1 Plan 2 Plan 3 Plan 4 Insurance Carrier Unum Unum Unum Unum Benefit Amount $10,000 $50,000 1 x Annual Salary to $100,000 1 x Annual Salary to $200,000 Guarantee Issue $10,000 $50,000 $100,000 $200,000 Minimum Group Size 2 Employees 10 Employees 10 Employees 10 Employees Voluntary Life and AD&D Employee Spouse Child(ren) Up to 5 times salary Not to exceed $500,000 in $10,000 increments *Guarantee Issue Amount: $180,000 for groups 10+ lives Up to 100% of employee coverage Not to exceed $500,000 in $5,000 increments *Guarantee Issue Amount: $25,000 for groups 10+ lives Up to 100% of employee coverage Not to exceed $10,000 in $2,000 increments *Guarantee Issue Amount: $10,000 for groups 10+ lives Premium Term life premium rates are age-banded and based on tobacco use. AD&D coverage is optional. This Life and AD&D Comparison of Plans is a brief summary of benefits. For exact details of coverage, including limitations and exclusions, please refer to the applicable contract or booklet. 13

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19 About the Administrative Platform Omnitrade Supporting Washington businesses to create a better community Omnitrade is an administrative platform that connects employers, vendors, third-party administrators, and professionals under one platform for all enrollment, fulfillment, compliance, insurance, and related resource requirements. An ever-changing marketplace requires tried and true partnerships, and Omnitrade s administrative efficiencies and flexibility enable us to deliver innovative products and services, while maintaining high retention and client satisfaction. Flexibility Omnitrade was designed to be robust enough to manage all aspects of administration while being flexible enough to meet the unique needs of participating companies. This critical feature provides scalable solutions for organizations of different sizes and sophistication, and allows us to integrate new technology, partnerships, and best practices for the betterment of our clients in a seamless and thoughtful manner. Our partners have come to rely on our proactive approach to expected challenges, while creating alternative solutions for unexpected marketplace changes. Innovation As a fully integrated platform, Omnitrade is a catalyst for innovation, setting new industry standards, sharing expertise, fostering collaboration, and delivering key business services. This ensures Washington State-based businesses are advancing not only their economic value, but their global impact. Service We understand our stakeholder s business needs require a 24/7 platform that can perform transactions and deliver solutions on demand. Providing web-based collateral and reference materials, access to online enrollment, and electronic premium payment options, allows Omnitrade resources to be available in real time. The ability to provide solutions without any lapse in support is concurrent with the service Omnitrade has become synonymous with. 16 Omnitrade.ins@wellsfargo.com

20 About the Managing General Agent Wells Fargo Insurance Services, National Wholesale Benefit Practice National Wholesale Benefit Practice 999 Third Ave., Suite 4100 Seattle, WA Wells Fargo Insurance Services, National Wholesale Benefit Practice manages several Association Health Plans, small group community-rated products, as well as large group products. The team is committed to offering innovative solutions and unparalleled service. Through various industry health trusts, the National Wholesale Benefit Practice provides accredited producers with access to a comprehensive array of affordable healthcare products and services designed to meet the specific needs of their clients. Driving National Wholesale Benefit Practice s success are two powerful and complementary components: technology and service. The Benefit Resource Hub (the HUB) is a web-based system uniquely designed for our wholesale model. Wells Fargo s significant investment in developing the HUB demonstrates an ongoing commitment to the small group market. The HUB not only provides efficient, one-stop electronic proposal submission capabilities, it also offers secure access to forms, benefit summaries and related resources specific to each trust. The team is committed to a two-day turnaround on the nearly 25,000 proposal requests received annually from more than 1,000 accredited producers across the state. The team not only delivers these proposals, but also handles the processing of all new business and renewals. National Wholesale Benefit Practice is a dedicated team which, with more than 50 years of combined trust management experience, is a dynamic group of professionals accustomed to the ever-changing health insurance environment. Your National Wholesale Benefit Practice team will assist with: Rate and product design assessment on behalf of employers and accredited producers Producer credentialing and training Marketplace benchmarking Value-driven strategies Employer presentations and enrollment meetings Marketing High-level claim and service issues General advocacy for accredited producers and companies Wells Fargo Insurance Services, National Wholesale Benefit Practice takes pride in its ability to thrive in a fast-paced environment. Combining a creative approach with a do-what-ittakes attitude is what differentiates this team from the competition. 17

21 About the Third Party Administrator Benefit Solutions, Inc. (BSI) The administration of employee benefits plans requires a commitment to service. Employers, employees, trustees, vendors, and advisors all require input and dedication from a Third Party Administrator. It is the administrator s responsibility to ensure that the flow of information to all parties is constant, timely, and accurate. The administrator must act as primary liaison between plan participants and all other ancillary participants of the Trust. Client Support BSI is known for establishing a new level of customer service. Our dedicated account teams deliver exceptional service, beginning with onboarding each employer. Your Account Manager will know you and your business, bringing together all the resources and expertise to support your day-to-day needs. What They Do Enrollment & Eligibility 834 Transmission Implement and process new groups and renewals, ongoing enrollment support and handle life event changes. All eligibility issues are addressed in accordance with rules based enrollment. BSI manages eligibility and sends data via HIPAA compliant 834 eligibility transmissions. Customer Service Experienced and dedicated Customer Service professionals work closely with producers, employers, employees, carriers and General Agent. There is a single point of contact for enrollment, eligibility, COBRA, commissions and billing. Consolidated Billing & Payment Consolidated billing allows for multiple carriers and coverages to be billed on a single invoice. BSI processes payment and ensures carriers and vendors are paid timely. Commission, Reporting, and Payment Commission reporting and payment services are fully integrated with our service offering. We have the ability to manage complex commission structures within a group, by coverage type, by carrier, and by broker status. COBRA Administration BSI provides full service COBRA administration with dedicated customer service and support. We send all required notices and communications. Monthly billing, customer support, annual renewal and plan set-up. We manage and process group and employee terminations and associated COBRA Services. 18 Omnitrade.ins@wellsfargo.com

22 About the Third Party Administrator, continued Benefit Solutions, Inc. (BSI) Compliance Services BSI provides compliance administration services in accordance with all federal and state regulatory requirements such as ERISA, HIPAA, COBRA and Health Care Reform. BSI also provides required notices to employers for distribution to their employees such as, Medicare Part D Creditable Coverage, CHIPRA, Summary Annual Report, and Summary of Benefits and Coverage. Online Services, Enrollment, Billing and Payment Simon provides a centralized location where an HR administrator can manage enrollment, billing and payments. This makes the entire process more manageable and results in streamlined processes and efficiencies gained. Consumer Directed Health Plan (CDHP) Administration Employers may offer Flexible Spending or other CDHP Plans. In each case, BSI conducts implementation, enrollment, debit card issuance, claim adjudication, participant reimbursements, and reporting to the plan sponsor and participants. BSI Technology The SIMON Employer Portal combines the best in breed features of both benefit administration systems and consolidated billing platforms. The uniquely designed platform is a SaaS solution meeting the special needs of both small to mid-size businesses and large employers by using a custom approach to each market segment. Group administrators can easily access and update enrollment and eligibility from one place, online, anytime. This makes the entire process more manageable and results in streamlined processes and efficiencies gained. 19

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24 Last Revised: 02/14/2017