Proprietary and Confidential ©Copyright 2013 Spring Consulting Group, LLC. All rights reserved CSCS Membership Spring Consulting Group, LLC June 6, 2013.
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Proprietary and Confidential©Copyright 2013 Spring Consulting Group, LLC. All rights reserved
CSCS Membership
Spring Consulting Group, LLC
June 6, 2013
What Spring Can Do For Your Business
With many CSCS employee benefit plans renewing in July, how can Spring Help?
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AgendaWhat Spring Can do for your Business
Spring Background How can Spring Help? What do I do now? Spring Differentiators Questions?
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Presenter OutlineGeorge W. Gonser, Jr. MBA CDHC, LIA – Spring― Partner and CEO – Spring
• Affiliated with MDS since 1998 – Employee/Business Partner
• Appointed by Mass Gov. Patrick in late 2011 to Commonwealth Health Insurance Connector Authority Board of Directors – represent individuals, businesses and brokers/consultants on Mass and National Health Care Reform
― 20 + Years in Employee Benefits / Health Care / Insurance / Consulting
• CEO - MDS Insurance Services Inc.
• Vice President• National Sales / Marketing / Client Service / Consulting
• Director of Information Technology• Development / Customer Support / Operations / Claims
• Underwriting / Benefit Analysis
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Spring Structure Nationwide Employee Benefits, Consultancy and Actuarial Firm
Spinoff of U.S. Watson Wyatt Insurance & Financial Services Consulting Group
Provides strategy consulting services to employers, insurance and financial service providers and captive owners
Offers subject matter expertise in retirement, life, healthcare (including retiree medical), disability, absence management, workers’ compensation, captive insurance and strategic risk management
Working as Employee Benefits and Financial Services Provider for CSCS members since 2012
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Key Practice Areas
Employee Benefits
& Risk Mgmt Consulting
Insurance & Financial Services
Consulting
Alternative Funding Strategies
(i.e. Captives, COLI, TOLI, BOLI)
Working with employers, insurers and financial service organizations provides unique insight regarding benefits & insurance cost reduction, streamlined
administration and improved employee satisfaction for employers
Employee Benefits and Financial Services
Brokerage Services
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Employee Benefits Brokerage Employee Benefits:
Strategy development Funding analyses and financial evaluations Program design, insurance placement and overall implementation
― Traditional medical, consumer directed plans, high deductible health plans, HSAs, HRAs
― Dental, vision― PTO, disability, LOA, FML, day one absences― Disease management, wellness, EAP/work life/concierge― Life insurance― Retirement services― Voluntary products
Contribution analysis Provider and vendor management Employee relations and communications Compliance support Ongoing plan and project management
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What Can Spring Do for your Employee Benefits Program?
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Partner with you as your trusted advisor to devise and implement the best, cost effective employee benefit
program for you and your employees
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More than ever, with budgets tighter and uncertainty of the 2014 insurance product
and service landscape due to PPACA, partnering with experienced, licensed and pro-active broker/consultant is essential.
Get the help you need!
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Strategy:
Set your goals and objectives for your employee benefit program around your corporate goals and short and
long budgetary realities
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What Spring Can Offer You:
Considerations:
Will you continue to offer benefits to employees – 30 hours or more?
Will you employ a Part Time Strategy to off load expense for employees under 30 hours?
What are the ramifications of the business and to staff – Recruitment and Retention?
Will you impose a buy up strategy via a quasi fixed contribution?
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Understand Your Budget:
With funding always an issue, you need to structure your employee benefit program to fit your budget. The key is balancing product and services selections with fiscal
restraints while allowing for increased employee engagement and choice.
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What Spring Can Offer You:
Considerations:
What will you set your contribution percentage to be? How much can the business and the employees
afford? Do you plan on adding staff during the year? What are the funding realities going forward?
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Insurance Product and Service Goals:
The company must set the insurance product and services goals around the realities of market prices and
product/network offerings
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What Spring Can Offer You:
Considerations:
Do you implement single or multi plan structure? What is the product mix – HMO/PPO/EPO/HSA? What is the employment mix What are your Network needs? Is out of area coverage necessary?
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Outlining Census:
The Census Process establishes the employee count, makeup and composition of the firm for quoting plan options and completing the analysis. For 2014, there
are many changes that will take effect in capturing data on new business and renewals alike.
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What Spring Can Offer You:
Considerations:
All Data Elements must be included to get an accurate depiction of the company and employees. (Provided in Excel Spreadsheet Format) Company Name Address City/State Zip Phone and Email SIC Code
Employee Last Name Dependent Last Name * First Name Gender Date of Birth Occupation * Annual Salary * Taking Health Insurance or Waiving Smoker – Non Smoker *
* New for 2013 and beyond
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What Spring Can Offer You:
Considerations Continued:
Are there employees either: Approaching Age 65 At or over Age 65
Do you offer 2 Tier or 4 Tier Structure Looking to 2014 – List Bill Consideration
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Creating an Analysis:
The analysis is a synthesis of data and strategic goals and objectives. The census is used to generate the plan
and carrier options while the analysis takes into account current plan year products and prices.
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What Spring Can Offer You:
Considerations:
Spring provides analysis to CSCS Member entity Does the analysis have options that fall within budget Do you need to reconsider contribution strategy or
revisit the strategic direction based on the analysis? The business will drill down to a few options at this
point in the process
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Looking beyond the Numbers:
The analysis, while crucial to the employee benefit program, is not the only component. The company
and the broker/consultant need to look at the numbers and what they represent and the other factors that can influence what the analysis really
represents.
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What Spring Can Offer You:
Considerations:
Low price doesn’t always equal best value What is the risk of the plan to the overall operations
and flow of the business Employee benefits represent the 2nd highest corporate
expense after salaries… How will this plan impact the lives of the employees –
does this really matter to you?
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
PPACA Effects:
All insurance product and services decisions MUST keep an eye on whats coming in 2014. While plans
renewing in 2013 will have a reprieve in the PPACA effects until renewal in 2014, changes and cost increases must be factored into decisions now
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What Spring Can Offer You:
Considerations:
Metallic Tiers coming in 2014 Will my product selections be compliant in 2014? What is the cost implications for my plans based on
estimations for 2014 including: PPACA Taxes and Fees Essential Health Benefit requirements and limits New Bill structure
9.5 Percent rule Small Business Tax Credits
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What Spring Can Offer You:
Essential Health Benefits Brief Overview:
Starting in January 2014, the Affordable Care Act will require all new individual and small group health plans (for people who don’t have traditional job-based coverage) to cover important health benefits like maternity, mental health, preventive, and pediatric dental care. These benefits, considered “essential” by the Department of Health and Human Services fall into 10 categories:
1. Ambulatory patient services (outpatient services)2. Emergency services3. Hospitalization4. Maternity and newborn care5. Mental health and substance use disorder services, including behavioral health treatment6. Prescription drugs7. Rehabilitative and habilitative services (those that help patients acquire, maintain, or
improve skills necessary for daily functioning) and devices8. Laboratory services9. Preventive and wellness services and chronic disease management10. Pediatric services, including oral and vision care
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Plan Selection and Funding:
The plan selection and funding phase is now at the forefront. Should you think of having less dollar one coverage for savings and setting up a funding vehicle
to pay or pay a portion of the deductibles?
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What Spring Can Offer You:
Considerations:
First Dollar vs. Deductible Management of Funding Vehicles – FSA, HRA, HSA – tax implications Payroll Deducted vs. post tax dollars
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Managing the Implementation:
Implementing the plan includes applications, network verification, education and verification all done in a
timely fashion to meet submission deadlines set by the various carriers
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What Spring Can Offer You:
Considerations:
Is training a factor with the staff? Outline Network access electronically is the best
avenue Transition timelines Application requirements
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Customer Service and Compliance:
Post implementation involves ongoing Customer Services functions and Compliance Guidance
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What Spring Can Offer You:
Considerations:
PPACA – always in play Fulfillment and ID Cards Customer Services – billing and claims On-going compliance support
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What Spring Can Offer You:
Helping to Set Your Strategy Understanding Your Budget
Establishing Your Insurance Product and Services Goals Outlining The Census Process
Creating An Analysis Looking beyond the numbers
Planning around the Long and Short Term effects of PPACA Assisting the Plan Selection and Outlining Funding Mechanisms
Managing the Implementation Providing Customer Service and Compliance Investigating Other Products and Services
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What Spring Can Offer You:
Other Products and Services:
There are many other products and services that round out the employee benefit portfolio. Some are
employee funded and others are purely voluntary/employee paid.
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What Spring Can Offer You:
Considerations:
What products Dental STD/LTD/Life Financial Services –Individual and Corporate Many others
Is there an appetite on behalf of the client and their employees?
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What do I do now?
• Work only with a pro-active, licensed, broker/consultant• Be compliant• Become better benefit, insurance and health care consumers
Get the “right” help
• Create a long term plan for ALL of your employee benefits• Re-evaluate annually based on updated corporate goals and
objectives• Be Ready to Pay More – taxes, fees, rating changes, administration
Long-term
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Spring’s Team Differentiators Experienced and innovative
Objective and independent
Transparent remuneration
Knowledge of competitive landscape
locally, nationally and globally, bringing the latest
ideas to employer and vendor clients
Flexible to customize products and services to meet corporate
objectives
Reliable in delivering strategy through to implementation
Focused on client services and quality assurance
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Questions
George W. Gonser Jr. MBA, CDHC, LIAPartner - CEO
Spring Insurance Group LLC
george.gonser@springgroup.comPhone: 617-589-0930; ext 106
Toll Free: 800-821-6033
Toll Free - (800) 821- 6033 www.springgroup.com
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