Mingledorff RFP. Benefits Administration and Outsourcing Services

Transcription

1 Mingledorff RFP Systems and Technology a. Briefly describe the technology and/or software your company currently uses for servicing the needs of your clients including platform, web applications, carrier feeds, data accuracy, HIPAA compliance and back-up and recovery processes. In addition, describe any technology changes you are currently working on, when they will be completed, and what enhancements they will provide for your clients. For an additional fee, we can provide complete HR benefit solutions including benefits administration/outsourcing, billing administration, benefit technology, integrated wellness consulting and incentive management, as well as COBRA and Flexible Spending Account (FSA) administration. We ll help you maximize the investment in your benefits program, minimize your exposure to risk, engage your employees with our easy-to-use solution and full suite of communication vehicles, and empower them to use their benefits wisely and control their costs and yours. Benefits Administration and Outsourcing Services Enrollment and Eligibility Management We fill the role of benefits manager and staff for our clients. This includes handling day-to-day transactional work, special projects, supporting employees, managing vendors, and reporting activities. Consolidated Premium Billing and Reconciliation We create and present a single monthly consolidated invoice across carriers and vendors. We reconcile all monthly invoices and work with carriers to correct amounts incorrectly charged. We receive one payment from the employer and remit to all carriers and vendors. Benefit Call Center Using state-of-the art contact center applications and tools, we provide immediate benefits support for inquiries and issues from employees, retirees, and FSA and COBRA participants. This includes both phone and support. COBRA and FSA Administration We offer complete COBRA and FSA administration solutions, wherein we administer COBRA and FSA plans within full compliance of all laws and regulations, and offer both self-service and telephonic support for both participants and HR staff. Benefit Technology Services Customized Benefits Portal We create and manage customized online portals that provide clear and efficient communication of all benefits available for the employees. This includes documents and direct links to important benefit sites. Online Enrollment Services We offer a best-in-class online enrollment system that allows for employees to quickly, efficiently, and securely make and manage benefit elections. This system also provides extensive administrative capabilities and reporting. ACA Manager - The CarePlus ACA Manager helps employers maintain compliance with ACA full-time employee eligibility rules and avoid penalties for non-compliance. The ACA Manager includes employee eligibility tracking, ad-hoc monitoring and necessary regulatory reporting information. Data Management Services We manage electronic data exchange used to communicate benefit elections and changes with carriers, vendors, payroll and/or HRIS systems. We also have the capability to create custom interfaces to your specifications.

2 What Differentiates our Platform? BB&T s technology platform is different than other benefits administration outsourcing solutions due to our true single-source platform. BB&T utilizes a SaaS technology platform, built on a single code base which provides seamless data integration and rock-solid security between our system and other enterprise systems, vendors and carriers. Utilization of a single-source platform for technology and service delivery simplifies the entire process for your administrators and employees, as well as service from BB&T. All services are managed from the same web-based application, which allows the system to automate a significant number of processes that would otherwise require manual intervention. There are no lags in data transmittal between systems, because all services are being managed from the same system. Further, all administrators from both the client team and the technology team are leveraging the same system and looking at the same data there are no backend systems that typically create data integrity or transparency issues. Our single-source platform is true Software as a Service (SaaS) system. What this means to you is that you will always be on the latest and greatest version of the system. Not only does this make the up-front cost of implementing the system more cost-effective, but it also means that you do not need to invest in infrastructure or use your internal resources to maintain the system or implement upgrades. We believe in continuous improvement; therefore, there is ongoing development of the platform. Core input is provided by employees (based on input from clients and informed by commonly asked questions or confusion from our clients employees), market analysis (to identify gaps that need solutions), competitor review, and directly from current technology clients via monthly Product Council and Advisory Council meetings. Based on the insight gained through those and other avenues, the following five themes are foundational to the product roadmap: 1. Member Experience 2. Communication 3. Data and Analytics 4. Automation 5. Integration These five themes are core to the services we provide and we anticipate these areas will continue to drive the technology roadmap into the future. The product development roadmap includes: User interface enhancements for members, focused on empathy-driven design Continued evolvement of the depth and breadth of our available integrations Continued single sign on and web services integration with medical, wellness, and both group and individual life and disability providers Continued development of wellness tools including: wellness tracking, integration with fitness tools, tools to drive wellness campaigns Continued support for public and private exchanges Continued enhancement of our analytics to provide easy access to data both aggregate and individual for clients, partners and employees Evolution of our employee lifecycle (hire to retire) strategies to offer additional transition services, for pre hires, new hires, active employees, and retirees Continued development of functionality to support clients with healthcare reform Further, when developing new functionality, the focus is on a balanced mix of basic needs (integration, flexibility, price/value), performance needs, and finally, excitement needs.

3 Backup and Recovery Processes for Our System Multiple Production Operating Datacenters (PODs) exist to maintain an active/active processing environment. Dedicated connections are utilized to synchronize production data between PODs. In addition to the multi-pod environment, each night the primary database is backed up to hard disk and transferred offsite. Physical backups are maintained in storage and retained for eight years. Web Applications A mobile-optimized layout of the platform is available for enhanced usability on any mobile browser. It was designed using Responsive Web Design, which allows users to perform the same enrollment functions across all devices without the need for a mobile application installed on the device. Data Management and Compliance We have extensive data management experience. Instead of simply doing Electronic Data Interchange (EDI) better, our superior data accuracy checks help to ensure that costly coverage errors will be eliminated, employees and administrators will save hours of time, and your concern about data integrity and enrollment accuracy will no longer cause you headaches. Our core services include: Key Data Management Activities Manage the monthly scheduled data transmissions with HRIS, payroll, and carriers/vendors Apply data validation filters on all files Review and resolve discrepancies identified on load error reports provided by carriers Manage system-programming updates due to changes in benefit plans, carriers, acquisitions, etc. Key Data Management Differentiators versus Other Vendors: Significantly better tools and processes on outbound files More all-inclusive handling and management of data (audits, etc.) Better online tools and visibility to files and schedules Better handling of exceptions (closed-loop processes) Key Data Management Differentiators versus Other Vendors: The system platform is currently used to interface with >200 different carriers, over 175 payroll feeds, and 25 payroll systems and growing. It has been preparing and transmitting HIPAA compliant files since late 2002, before mandatory compliance guidelines were being enforced. It has been designed and built in conjunction with EDI standards, to ensure compliance with published guidelines. The system was designed to support HIPAA compliance. Particularly in two core areas, we have strict compliance guidelines: Security Safeguards for security are in place to confirm client and employee data is being handled with the HIPAA compliance rules in place HIPAA EDI 834 (for our carrier partners) Fully compliant in exchange and handling of data through use of the EDI 834 layout We can also accommodate proprietary file feeds. Proprietary file feeds are generally comma delimited (.csv), fixed width, text (.txt), or XML. In addition to format variations, each vendor requires different data mapping (i.e., employee-only may need to be sent to vendor A as 1, vendor B as employee, or vendor C as EO, etc.). Project Management: After initial gathering of information, we establish a timeline with the carrier/vendor that will include test files, testing scenarios, file transfer protocol, and a live production schedule. Based on the needs and capabilities of the receiver, we offer daily, weekly, semi-monthly, and monthly files, although the vast

4 majority is handled on a weekly basis. We build a yearly schedule that is based on your unique payroll timing. Our Data Management team is responsible for confirming that all file feeds are sent in a timely manner and managing the error report handling with each of our clients. Ongoing Data Delivery Security Outlined below are the key areas of system and physical security in place to secure the platform. Data Encryption: We encrypt at the data transport layer using 128-bit SSL encryption. Remote administration is done using 128-bit AES encryption. Firewalls: We utilize a redundant Linux-based firewall. Access is allowed to the network only on services that should be publicly accessible (DNS, HTTP, HTTPS). Administration of the servers is disallowed from anywhere except the internal network. Intrusion Monitoring: We utilize Snort, an open source network intrusion detection system, for real-time application monitoring. The system and application are audited on an annual basis. The audit includes both a process component and a system intrusion component. Furthermore, the application is physically secured by a four-level access control at the Network Operations Center (NOC).

5 b. How would your firm assist Mingledorff s in the use of technology in the communication, enrollment, self-service and administration of all benefit plans? What services are available from your firm including Human Resources applications? By employing CarePlus technology and administration, you will increase employee self-service and significantly reduce the time spent administering benefits, allowing the rededication of internal staff resources to support higher value company initiatives. The enhanced efficiency and reduction in time spent to access and manage benefits, plus the increased accuracy, simplifies your administration and further reduces your internal operational costs. BENEFITS OUTSOURCING: ENROLLMENT AND ELIGIBILITY MANAGEMENT ProView fills the role of benefits manager and staff for its clients. This includes handling day-today transactional work, special projects, supporting employees, managing vendors, and reporting on activities. The following are components of ProView s Enrollment and Eligibility Management Services: Monitor employee compliance with new hire requirements and policies. Default employee s coverage according to default rules. Collect Evidence of Insurability (EOI) forms as applicable and forward to carriers. Manage approvals/disapprovals of EOI forms by updating enrollment system records, payroll records, and notifying employees. Approve/disapprove Life Events/Qualified Status changes. Submit data to carriers; new hire and employee termination data required for administrative purposes (leveraging online enrollment system). Process enrollment data with carriers (leveraging online enrollment system). Manage over-age dependent process. Review and resolve data load issues (based on carrier load reports) as needed. Maintain electronic copies of employee correspondence and documents. Assist with escalated eligibility issues as needed with the account management team and the partnering carriers. Service Team ProView s Benefit Administration Department is organized into three-person teams. Each team has an Account Manager, Senior Benefit Administrator, and a Benefit Specialist and is an extension of your BB&T Insurance Services team. Team members come to ProView with experience in corporate HR departments and with insurance carriers. This makes them uniquely qualified to act as an extension of our clients HR departments, by successfully managing day-to-day tactical administrative tasks. Additionally, they hold certifications in COBRA and Benefits Administration. While the Benefit Administration team is the primary contact, they are supported by other departments (Customer Care Center, COBRA, Flexible Spending Account Administration, Billing and Reconciliation) who assist and support the delivery of service.

6 ProView has saved its clients hundreds of thousands of dollars in premiums over the years through its premium management and reconciliation audits. Typically, with each initial takeover, we find a 2-3% error rate on the monthly billing. BENEFITS OUTSOURCING: CUSTOMER CARE CENTER ProView s Customer Care Center consists of a team of experienced HR and benefits professionals. We respond to employee, retiree, and COBRA and FSA participant phone and inquiries. For example: Eligibility and coverage questions Benefit questions ( What is the difference between a co-payment and out-of-pocket? ) Enrollment verification Enrollment assistance Status changes Claim issues Reset online password Our hours of operation are 6:00am to 5:00pm PST. Expanded hours for peak periods are available. We offer toll-free telephone numbers for your convenience and customized phone scripts can be developed specific to [Mingledorff] needs. Multilingual Support We have internal bilingual agents available to assist callers. Our phone prompts offer a Spanish option and, when selected, route the call to an available Spanish-speaking agent. Additionally, we utilize the services of a phone translation service providing support in over 130 languages. ProView s robust Call Center technology platform consists of: Cisco Unified Communications Contact Center Cisco UCCX Historical Reporting Cisco Unified Interaction Manager Call Rex IP Call Recording and Monitoring Monthly Contact Metrics Reports and Trend Analysis Each telephone call and is logged into the system. Each contact is categorized by client, type of inquiry, and status. If a status is open, it is assigned a follow-up date and the open item is included on the daily work logs until it has been successfully closed. The Customer Care supervisor monitors the status of cases each week to ensure that resolutions are within the required service levels. Satisfaction Surveys Each participant who contacts the Customer Care Center receives a satisfaction survey via , consisting of a four-question rating scale and open-ended comments. We have an average response rate of 10%. Results are analyzed weekly by the ProView Supervisor Team and

7 reported monthly to the client. Any unsatisfied survey responses are reviewed thoroughly for quality. Areas for process improvement or training needs are acted upon immediately. Last year, we had 99% satisfaction levels among all participants surveyed. BENEFITS OUTSOURCING: CONSOLIDATED PREMIUM BILLING AND RECONCILIATION ProView s Premium Billing Administration and Reconciliation services provide clients with a comprehensive and efficient solution for managing insurance carrier premiums. Our clients receive one audited, accurate, and consolidated premium billing statement for payment on a monthly basis. ProView s Premium Billing Administration and Reconciliation solution includes: Reconciliation of monthly insurance carrier invoices to ensure consistency with enrollment information and premium rates Calculation of actual premium due based on enrollment information and adjustments Preparation of one Consolidated Invoice Statement for the client Monitoring of premium credits for retroactive adjustments Timely dissemination of payment to all insurance carriers Consolidated Invoice, Premium Disbursement, and Reporting Process: Step #1: Step #2: Step #3: Step #4: Step #5: Step #6: Step #7: Carriers are instructed to submit data electronically to ProView by the 1 st of each month. Between the 1 st and 10 th of the month, ProView prepares a Consolidated Invoice Statement. ProView compares list invoices against data maintained in the enrollment system. Discrepancies are logged into a custom tracking application, Rlog, and worked until resolved. Carriers are contacted to resolve each discrepancy identified as a variance between ProView data and carrier invoices. Near the 10 th of each month, a premium and reconciliation reporting package is prepared. It contains: A consolidated invoice that outlines the total premium due to each vendor on an aggregate and detailed basis. The invoice is forwarded to [Mingledorff] after being reviewed by a Benefit Specialist. As an optional service, a Premium Allocation Report that details premiums broken out by employee and location can be provided. Upon further discussion of format(s), we can advise on additional fees for this service, if any. [Mingledorff] wires funds to a designated depository account established by ProView. Other funding arrangements are also available. Premium checks are produced and distributed to carriers within 48 hours of receipt of funds.

8 A consideration for the services below and applicable fees are to be determined: Individual monthly billing services for retirees. Coordination with possible trust, grant and/or banking arrangements. Collection and remittance to insurance carriers. BENEFITS TECHNOLOGY: BENEFITS PORTAL The portal is a secure, online application that provides a single point of access to employee benefit information and online services for our clients and their employees. All of the content across the site can be customized to the specific needs of the client. The portal can connect to various online enrollment and health tool partners using secure single sign-on technology. Single sign-on offers the convenience of a one-time registration process that then allows registrationfree access to multiple applications that may otherwise require the user to log in multiple times. Additional content features include: downloadable forms and documents; announcements; event calendars; eligibility groups for targeted content distribution; site search; online surveys; custom Web forms; secure content; and content management delegation. Benefit Portal Includes: Integration with enrollment system via secure single sign-on (SSO)* Integration with health management tools, including healthy living program, webinar replays, slideshows, health promotion program details Direction to core programs, such as NurseLine, maternity programs, etc. Monthly health promotion updates We follow an iterative development cycle that allows us to rapidly adapt to client needs. We are continually analyzing and prioritizing client recommendations for inclusion into the next release cycle. Our software is built upon an ASP.NET-based open-source portal framework. The Web servers run Microsoft IIS and the database is Microsoft SQL. *All SSO connections are done securely. Employee tokens are encrypted with public/private keypairs along with a time stamp, and then sent over the client browser via SSL. We take great care to ensure that no sensitive information is ever transmitted unencrypted, unsigned, or stored in the Web browser cache. BENEFITS TECHNOLOGY: ONLINE ENROLLMENT Our online solution automates employers' insurance benefits enrollment by consolidating benefit vendors into one location and customizing the process specifically to match their enrollment requirements. By working with us, we become the single interface between your company, your employees, your HR team, and your benefit vendors. We provide you the power to reallocate resources, save time and money, and focus on more strategic HR initiatives. Our system empowers your employees and HR professionals with the tools to self-serve, enabling your company to streamline and automate existing ineffective and manual processes. Online benefit management creates cost-saving efficiencies and frees up resources which directly benefits your bottom line.

9 With Our Online Enrollment Website, Your HR Professionals Can: View current and historical eligibility and enrollment information Manage and monitor annual, new hire, and ongoing enrollment Download billing and other benefit files Access real-time data anytime Create and post messages for effective employee communication Generate real-time reports With Our Online Enrollment Website, Your Employees Can: Access current benefits information, including elections and confirmation statements Review, download, and print benefit overviews View payroll deductions Find and print benefits-relevant forms Access and print current Benefit Summary Security Outlined below are the key areas of system and physical security in place to secure the platform. Data Encryption: We encrypt at the data transport layer using 128-bit SSL encryption. Remote administration is done using 128-bit AES encryption. Firewalls: We utilize a redundant Linux-based firewall. Access is allowed to the network only on services that should be publicly accessible (DNS, HTTP, HTTPS). Administration of the servers is disallowed from anywhere except the internal network. Intrusion Monitoring: We utilize Snort, an open source network intrusion detection system, for real-time application monitoring. The system and application are audited on an annual basis. The audit includes both a process component and a system intrusion component. Furthermore, the application is physically secured by a four-level access control at the Network Operations Center (NOC). System Capacity Planning: We track our system capacity by monitoring our daily usage logs, page response times, and server load averages. Based on projected increases in usage and member enrollment, we determine if our system capacity needs to be increased. If additional capacity is deemed necessary, we introduce additional resources into our balanced Web/application server array. Periodic stress testing is performed using JMeter. The results of the tests are used to determine system constraints. Past results have helped us manage database server upgrades/migration, application efficiency changes, as well as when to introduce additional Web/application servers. Password Management: The system requires password-level security for each employee, manager, and administrative user. Each user receives access only to data and files within his or her hierarchical security rights. The initial log-in page features a link for first-time users. By clicking on this link and providing the system s three unique identifiers (SSN, date of birth, and company key), the employee is prompted to create his or her username and password.

10 This password can be reset by either the employee or the administrator. In addition, the client is provided with best practices materials to support and guide the employees through this process. BENEFITS TECHNOLOGY: ACA MANAGER (TRACKING AND REPORTING) The CarePlus ACA Manager helps employers maintain compliance with ACA full-time employee eligibility rules and avoid penalties for non-compliance. The ACA Manager includes employee eligibility tracking, ad-hoc monitoring and necessary regulatory reporting information. Employer is adding this capability to the services offered by ProView. Key features: 1. Variable-hour employee hours worked are monitored to provide the employer with advanced notice of any employees at risk of being classified full-time 2. Full-time employee eligibility notifications are automatically sent to those who s hours qualify 3. Easy dashboard visibility of administrative period rules and hours worked 4. Processing of employee loss of eligibility 5. Reporting including gathering and sending annual IRS forms and form information 6. Integrated with secured online enrollment platform REPORTING All reports are available 24/7/365 to administrators with the appropriate administrative access. The system features ad hoc customization features on many reports, allowing the administrator to select the fields they would like to pull in their report. All reports can be customized by Structure Group and Report Format (HTML, Excel View, and Excel Download). In addition, once a report has been customized, the Reports Profile feature allows you to create custom template reports that can be requested on an ongoing basis. The system includes a standard report library including, but not limited to, the following: Address Change Audit Report Demographic Change Dependent Census Benefit EEO-1 Employee Census Employee Census Benefit Employee Directory Employee Termination Evidence of Insurability New Hires Open Enrollment Status Payroll Deduction Audit Payroll Deduction Change Submitted Changes ADDITIONAL HUMAN RESOURCE SUPPORT Our team also provides Compliance and HR resources to support general questions related to ERISA, the Affordable Care Act, Wellness programs, FMLA, FLSA, COBRA, LTD and Leave of Absence. We provide weekly communications on employee benefit industry news, regulatory updates, and legislative alerts. We utilize a variety of industry leading resources such as EBIA, SHRM, Zywave, and HR360.

11 Additionally, BB&T has on-staff ERISA attorneys for guidance and offers a series of complimentary seminar and webinar on a variety of benefit related topics.

12 Other HR resources such as employee handbooks, policy manuals, position descriptions, performance evaluations, and salary benchmarking are available for an additional fee. c. Describe how you coordinate with your clients that utilize ADP Workforce Now for payroll and HRMS services. We are happy to share our expertise in the area of Benefits Administration as it relates to connectivity with Payroll & HRIS Systems. We have a number of clients that utilize ADP and we have the ability and experience to integrate with ADP systems. Below are what we consider to be advanced functionality in the marketplace; both rules based functionality and/or data integration for improved operational efficiency. Calculations you should expect from a Payroll/HRIS System: Table I for Life Amounts over $50k Domestic Partner Imputed Income Incentives for Healthy Behavior Completion a. Negative deduction (credit) back to payroll Pro-rated & retro deductions (many clients decide to waive for all employees) Pre & post-tax fields for the appropriate benefit deductions (i.e., medical is pre; LTD is post; offers employee the choice for all, etc.) ACA capabilities: a. Hours tracking b. Metric reporting c. Administrator alerts d. Employee status per pay period e Employee Reporting f & 6056 Employer Filing g. IRS Employer filing transmission The chart below provides a high level list of employer reporting needs and the likely system of origin.

13 Payroll / HRIS Partners We are connecting with over 25 payroll/hris vendors across the platform today; and this number is growing rapidly. Your unique setup with ADP Workforce Now (i.e., deduction codes, UDF fields, etc.) will be taken into consideration when we build our interface files. We ve designed the chart below as an example of where our clients may sit in the wide spectrum of capabilities that we support. ~ Not One Box Fits All Clients ~ Our clients range in connection capability is at their discretion according to their growth patterns. Our goal is to help each client evolve to a completely automated hands-free file exchange state, should they desire. Our exchange of data is always performed in a secure environment as regulated under HIPAA HighTech regulations.