Review and Analysis Reveals Need for Change

The Issue

A large group prospect had revealed their disappointment in the level of service and results they were receiving from their current employee benefits consultant. The company, with just under 300 employees, was pressured by the escalating cost of healthcare coverage, managing the enrollment of their dependent population and accuracy issues from their third-party administrator (TPA) and felt the consulting firm was not doing enough to resolve their issues.

Our Solution

We responded to their Request for Proposal (RFP) and after several discussions with their management team, were ultimately awarded with a consulting contract. We immediately poured through the company’s claim utilization data and employee demographic information, then conducted an analysis of their HR and benefit administration technology and enrollment process. [Broker Agency Name] determined that the strategy going forward should focus on four components:

  • A marketing analysis of alternates for TPA replacement
  • Implementation of a new benefit administration system
  • Modification of benefit approval processes for new hires and life status changes A full-scale dependent audit

The Result

Due to a lower administrative fee structure, the new TPA produced a first year savings of $128,000 and an updated benefit administration system is scheduled to be installed the beginning of next year. With the new TPA’s modified provider network, employees were unexpectedly able to decrease their out-of-pocket costs, while the completion of the dependent audit revealed a large number of ineligibles that when removed yielded an immediate annual decrease of $65,000 in premium and stopped any forward bleeding. All new hire and life changes processes were revamped to assure accuracy and, along with the new benefit administration system safeguards, costly enrollment mistakes going forward should be eliminated.

Our skilled and highly technical consultation and underwriting team can help your company refine tools, processes and plan structure to maximize efficiency and savings.