Benefits Consulting Services

The vendor is required to provide benefits consulting services for include:
- Marketing research and benefit plan design
• Provide recommendations to hospitals with regard to current benefit programs based on extensive market trends and comprehensive financial analysis
• Review, analyze, re-design (if required) and negotiate annual renewals
- Annual review (benchmarking and reporting services)
• Notify hospitals of carrier renewals.
• Facilitate annual renewal process with carriers, working with data from year end and close on October 31st annually, ensuring rates are negotiated and agreed to by no later than January 1st.
• Prepare and present annual reports in format agreed to in advance and no later than three (3) months following this contract being awarded by both parties.
• Data requirements may include, but are not limited to, plan coverage details, financial analysis, network utilization, insurer cost structures and recommendations regarding changes, modifications and benefit enhancements.
• Reports are to be provided annually within three (3) months following the contract anniversary date.
• Facilitate client planning meeting to define objectives and service delivery timelines. Collaboratively develop agenda items a minimum of one (1) month prior to the meeting.
• Conduct sensitivity analysis to identify financial risk implications and tolerances.
• Analysis to include current funding arrangements and financial impacts.
• Track and evaluate benefit providers in terms of agreed upon performance measures and guarantees.
• Prepare senior executive briefing notes on each individual hospital plan performance.
• Provide individualized advice on cost containment of benefit premiums.
- Advisory services (ongoing support and guidance)
• On an ongoing basis, review and audit premiums and financial accounting of the benefit program.
• Track and evaluate benefit providers in terms of agreed upon performance measures and guarantees.
• Initial plan audit and then provide ad hoc spot checks following established criteria.
• Present and provide a written report with documentation to support completion of audit.
• At initiation of agreement conduct a comprehensive audit of program utilization against plan.
• Annual spot checks to occur for remainder of agreement working with the client to determine scope and approach.
• Ongoing, assist with managing program costs, cost containment strategies and cost reduction measures, legislative changes as they occur.
• Facilitate one regional cost containment session per year, provide specific recommendations as it relates to hospitals and implementation strategies.
• Ongoing, assist hospital HR staff in problem resolution and dispute resolution with benefit providers.
• Ongoing, attend and support hospitals in carrier meetings as requested by the hospitals.
• Proactively monitor and communicate relevant market and industry trends that may impact benefit eligibility, plan design, or administration throughout the plan year, identifying potential or confirmed impacts to plan experience.
• Escalated point of contact with hospital human resources to address employee questions or seek guidance.
• Reporting of relevant data, including but not limited to analyzing benefit usage, post-employment benefit valuation, responding to union disclosure request, etc.