Benefits Consulting
Health Benefits Consulting Services
Jack T. Mann offers a full range of consulting services for health plan sponsors, including:
• Health Plan Design Jack T. Mann's health consultants have extensive experience in the design and redesign of all health benefit plans for employees and retirees, such as medical, dental, prescription drug, vision, behavioral health, short- and long-term disability, life, accidental death and dismemberment and flexible benefits.
• Vendor Selection Jack T. Mann creates custom requests for proposals (RFPs) for fully insured and/or self-funded plans. We create and analyze vendor/bidder responses from the full array of managed care organizations (MCOs): health maintenance organizations (HMOs), preferred provider organization (PPOs) and point-of-service (POS) plans. Our analysis covers vendors' fee projections. Jack T. Mann also negotiates with vendors and helps clients coordinate vendor management.
• Projection and Forecasting of Benefit Plan Costs Jack T. Mann's consulting services include projecting claims, setting contribution and COBRA rates, determining reserve requirements, performing incurred-but-not-reported (IBNR) calculations required for retiree health accounting, analyzing the impact of proposed plan design changes, underwriting and funding methodology, creating budget and renewal projections, preparing annual health benefits reports, determining pricing for flexible benefits, conducting merger studies and analyzing the development of health care purchasing coalitions.
• Evaluation and Formulation of Provider Reimbursement Methodology Evaluation and formulation of provider reimbursement methodology includes per diems, diagnostic-related groups (DRGs), outliers, discounts, capitation and physician services and procedures.
• Health Care Quality Assessment (Q-ValSM) For more information on this unique service, click here.
• Collection and Analysis of Cost Utilization Data Collection and analysis of cost utilization data includes monthly claim experience, health care trends and cost savings.
• Medical Claims Auditing Jack T. Mann's claims auditors review medical, dental and/or prescription drug plans for fully insured and self-funded administrative-service-only claims administrators to assure financial and procedural accuracy in claims processing. We can benchmark results for clients to industry norms.
• Reviews of Pharmacy Benefit Managers (PBMs) Rapidly rising prescription drug costs are driving overall increases in the cost of health coverage. Jack T. Mann's health consultants conduct PBM reviews that yield information that can be used to manage the cost of prescription drug coverage.
• Design and Implementation of Prevention and Medical Management Features Jack T. Mann designs and implements health promotion/wellness programs, employee assistance programs (EAPs), managed disability programs, disease management programs, centers of excellence programs, 24-hour, telephone-based nurse "triage" programs, executive physical exam benefits and long-term care coverage.
• Health Compliance Updates and Research Jack T. Mann keeps clients informed about health compliance news through publications, including the Web-based Capital Checkup, a periodic electronic newsletter summarizing activity in Washington with respect to health care and related subjects. Jack T. Mann's health compliance consultants can be retained to research plan sponsors' specific questions about compliance issues, update or create plan documents, create amendments and investigate vendor compliance with state and federal laws (e.g., ERISA, HIPAA and COBRA).
• Participant Communications Jack T. Mann's communications consultants write and design general or personalized participant communications, including summary plan descriptions (SPD), participant communications required by state and federal laws, announcements about plan amendments, brochures highlighting plan features. In addition, Jack T. Mann publishes Health Report, a quarterly subscription newsletter for plan participants that is devoted to wellness and promotion of a healthy lifestyle.
• Design and Tabulation of Participant Surveys Participant satisfaction with their benefits contributes to a content workforce, and content workers are less likely to seek alternative employment. Jack T. Mann can draft, conduct and tabulate custom surveys to assess participant satisfaction annually or periodically. Our communications consultants can draft and design summaries of survey results for distribution to participants.
• Complete Analysis of Claims Based on Carrier Discounts By utilizing proprietary software we can research, develop, and implement the analysis of claims. We can show the client how much the discounts would have been with various carriers on various lines of coverage.
• Corporate Benefit Surveys As clients wish to know where they stand when compared to other employers we can provide surveys and reports which grade other employers based on the benefits package offered.
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