Benefits Administration John Ykema, Director of Sales & Marketing.
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Transcript of Benefits Administration John Ykema, Director of Sales & Marketing.
Benefits Administration John Ykema, Director of Sales & Marketing
AgendaOverview
Plan Management
Benefits Underwriting & Quoting
Client & Employee Management
Process Management
OverviewLet's Get Started:
• What is your current Benefits Administration model?• Agents• Quoting & Underwriting• Claims Advocacy• Change Management Process
• What is your Benefits Plan structure?• Master Plans• Client Level Plans• Risk Tiers• Age Banding
• How will this impact your Payroll System?
• How will this be managed during Client / Plan renewal?
Plan Management
Master Benefits Plans
• Setup and Managed in Admin Workspace• Benefits Plan
Dataform• Assigned to
Prospect/Client as Offered Benefit Plans
Master Benefits Plans
• Plan Category• Status and Workflow• Premium vs True Cost• Base Plan• Comparison• Reconciliation
Model Benefits Plans
• Template Benefits Plans• Typically setup with
everything but rates filled in.
Client Level Benefits Plans
• Benefits Plans added directly to Client Workspace.
• Added from Scratch or Cloned from Model.
Risk Tiers
• Master Plan Tiers or• Client Level Bands• Supports Premium vs
True Cost
Benefits Underwriting & Quoting
Benefits Underwriting
• If Client Master, Health Benefits = Yes.• Then the Benefits
Underwriting record will be generated.
Benefits Pricing
• Benefits Tier Definition• Average Age & Percent
Male• Control Tier• Calculated Tier• Final Tier• PreSale Benefits Plans
Offered Benefit Plans
• How Benefit Plans are offered to the Client and in turn the Employees.• Offered Plan Workflow• Rate Grid• Contributions• HRA & HSA
Benefits Comparison
• Reports and Merges• Pulls data from :• PreSales Plans• Offered Plans
Example Excel Merge
Offered Plan Activation
Once the prospect has selected which benefits plans they would like. You should Activate the Offered Benefit Plans so that they can be associated with the enrolled employees.
Client & Employee Management
Company Benefits
• BOR/AOR Dates and Letters• Eligibility Tracking• Waiting Period by
Classification• Document
Management
Employee Benefits Management
• Enrollment Tracking• Employee Benefits
Renewal.• Used in Recon for
Data Validation.
Deduction Voucher Tracking
• Deduction History From Payroll system.• Many per Voucher.• Both Credits and Debits.• Used in Recon.
Process Management
Internal Administrative Process• Ensuring Client is matched up to the best plan for both them
and you.• Ensuring that Employee elections translate to smooth
Carrier enrollment and Payroll system setup.• Change Management. • Process Workflows.
Renewal Management
• Schedule Template Tasks or Cases• Process management
and enrollment auditing.• Historical Employee
Election Tracking
Relationship to Payroll System
• System of Record?• ClientSpace
• Largely disconnected, but there is hope.• HRP API in the works.• Data Imports are
available.
Relationship to Reconciliation
• It all builds toward the reconciliation tool.• Data Standards and
validation.• Less Exceptions