International Benefits Administrators Managing Healthcare Cost

Transcription

1 International Benefits Administrators Managing Healthcare Cost Garden City Plaza, Suite 102 Garden City, NY

2 Introduction Founded in 1972, International Benefits Administrators (IBA) is a Third Party Administrator that specializes in self funded solutions, with an emphasis on personalized service and efficient plan management. IBA s approach ensures Plan flexibility Consultation and innovative plan design Quality healthcare access Personalized customer service Employee satisfaction In addition to these cores services, IBA provides our clients with time tested strategies that reduce claim costs. This coupled with over forty years in business, allow IBA to provide the largest claim discounts, lowest fixed costs and most competitive stop loss rates for our clients. 2

3 Cost Management Focus on Networks & Medical Management International Benefits Administrators has developed long standing relationships with some of the largest and best known national PPO networks. These relationships provide flexibility for your clients as well as ensure them the deepest claim discounts. IBA uses a state of the art precertification system which controls cost through the effective evaluation of impending medical care. In addition, this service ensures the medical management of ongoing treatment. IBA provides all of our clients access to an outside claims review service. This independent service Renegotiates all large claims Checks all claims for fraud, daily Evaluates the necessity of a member s treatment Provides out of network claims negotiation 3

4 Cost Management Focus on Stop Loss & Pharmacy Management International Benefits Administrators maintains solid business partnerships with some of the largest and best known stop loss carriers. This allows our clients to obtain the most competitive stop loss rates in the marketplace. IBA provides cost effective pharmacy solutions for your members as well. This often overlooked health plan cost is one that must be managed correctly. We can assist our clients by helping them select a solution that maximizes their cost savings. Some of these methods include: Network discounts Generic utilization programs Mail order pharmacy services Custom retail programs Formulary drug program and management Detailed reporting 4

5 Integrated Benefit Program IBA provides it s clients with an integrated benefit program designed to streamline medical, dental and vision administration. This program will reduce claim costs, enhance member wellness, and offer 24 hour customer service and support. Our program will include: Claims Administration : Plan Administration: Customer Service: Medical, Dental & Vision, Claims review and Renegotiation Medical Management Manage Eligibility, Enrollment & Cobra for all plans 24/7 & 365 days/yr, Online Claim Access, Dedicated number 5

6 Medical Administration The cornerstone of IBA is medical administration. Our claim payment systems are specific to each plan we administer. This allows our clients to offer a wide array of customized benefit plans. Our system allows for IBA to administer all levels of fee schedules and PPO plan configurations. In addition, our benefit coding allows us to track deductibles, out-of-pockets maximums and plan maximums. Electronic submission, auto adjudication, and our expertly trained staff assure the accuracy and timeliness of all claim payments. Our staff will be especially trained to know all aspects of a client s benefit plan. Note: on average each staff member has over twenty years experience. 6

7 Claims and Administration Capabilities IBA utilizes a state of the art, claims processing system. This system allows for claims to be paid within 30 days of being submitted, well below the industry average of 60 days. Furthermore, we provide our clients with many different reporting options and the ability to administer multiple plans including: Life / Accidental death & dismemberment plans Dental plans Vision plans Disability programs High deductible health plans Cost sharing plans Retiree plans Limited medical plans Association plans Taft Hartley 7

8 Customer Service and Benefit Solutions As a full service third party administrator, IBA will provide our clients with a comprehensive benefit and administrative solution. Some of the many services this solution will provide are: Managing plan eligibility and enrollment HIPAA compliance & HIPAA compliant cobra administration Member communication, and online access for your members to check claim status and payment An exclusive number for customer service for each client Premium billing and collection services Printing of summary plan design booklets and ID cards Open enrollment meetings Large claim management and medical management Access to wellness programs and initiatives 5500 Filling 8

9 Online Access for your Members Through our online web portal, IBA members have real time access to verify eligibility, check claim status, and view benefit plan information. 9

10 Focus on Wellness for Local 456 All IBA members have access to IBA s Health X wellness program. Through this program members can access the following services and programs. Health and Productivity Assessment Online Healthy Living Programs Comprehensive Health Content Health Tools and Trackers Incentive Tracker Personal Health Record Standard Participation Report Online Library of Medical Information 10

11 Focus on Wellness for Local 456 Health & Productivity Assessment Validated by Dr. Dee Edington (Univ. of Michigan) and Dr. Ron Kessler (Harvard) Recommends top three Healthy Living Programs based on risk factors and readiness to change Identifies health risk factors, readiness to change, and productivity impact Provides personalized information about behavioral and medical risks Questionnaires and personal reports are available online and in print in Spanish 11

12 Focus on Wellness for Local 456 Online Healthy Living Program IBA members will have access to interactive tools which keep them engaged and track progress over time. Each program is tailored to the user s preferences, risks and readiness to change. There are thirteen programs available to our members. Weight Loss Healthy Heart Smoke-Free Diabetes-Fighting Healthy Seniors Healthy Kids Your Healthy Living Program Healthier Diet` Get In Shape Stress Relief Healthy Aging Easy Start Cancer-Fighting 12

13 Our Partners Long standing business partnerships and over thirty years of experience are the foundation of IBA s industry relationships. Some of these partners include: 13