Employee Benefit Strategic Partnership Healthcare Services Employee - - PowerPoint PPT Presentation

Wallstreet Group Randy Lueckenotte, Co-Owner, RHU, LUTCF 1530 Rax Court Jefferson City, MO 65101 (800) 769-5994 - www.wallstreetins.com Vizient Insurance Services David Smith, Dir. of Sales & Marketing 7415 W 130th Street, Suite 200 Overland Park, KS 66213 (913) 319-6202 – www.vizientinc.com Healthcare Services Group Joe Moody, President & CEO 4700 Country Club Drive Jefferson City, MO 65109 (573) 893-5300 – www.hsg-group.com

Employee Benefit Strategic Partnership

Healthcare Services Employee Benefits Consortium (HSEBC)

Creating a best-in-class employee benefits group purchasing

• rganization to serve our members.

Wallstreet Group is one of the top producing agencies in Missouri with full-service Group Benefits and Property and Casualty

• Departments. Formed in 1987, Wallstreet Group is an independent agency, representing numerous companies. This allows us to

do the shopping for you and enables us to provide the best insurance products at the most competitive rates. We specialize working with Employee Benefit Group Purchasing Organizations. (GPO’s)

Advisor Expertise & Service

Over the past several years we have partnered with VHA, now known as Vizient, to serve acute hospital clients. With recent mergers and acquisitions described below. We have combined our acute and non acute advisor and insurance GPO programs

• together. This has created the largest nationwide Employee Benefit GPO available to our clients.

Breaking News – Vizient, Inc. Purchases MedAssets

2015 VHA merges with University Healthcare Consortium VHA and UHC signed an agreement to combine into a single organization that will be the largest member-owned healthcare company in the country. 2016 VHA & University Healthcare Consortium become Vizient, Inc. Vizient, Inc. acquires MedAssets VHA and MedAssets is now Vizient, the largest member-owned health care company in the country representing almost $100 billion in annual purchasing volume. Vizient’s unprecedented size, national scale, and market leverage allows Vizient Insurance Services to create and manage employee benefits and property & casualty pooled programs designed to spread risk and deliver savings. By purchasing insurance coverages as a group, we dramatically increase our leverage with insurance carriers to obtain better pricing, stable rates, and enhanced policies for our members. Over 250 hospitals representing nearly $300 million in paid premium are currently participating in Vizient Insurance Services.

MEDICAL

• Direct Terciary Agreement with significant deeper discounts than Traditional PPO Network

Discounts.

• Reference-based reimbursement as a percentage of Medicare; obvious concern over

member disruption and balanced billing.

• Air Ambulance/Medical Transport Rates/Plan Document Language/Process “Medically

Necessary”/ Prior Authorization Process for Hospital-to-Hospital Transport

Developing Provider Network Trends

PHARMACY Through our relationship with Vizient we provide an Independent Team of Pharmacy Advisors, who specialize in a marketplace review and benchmarking of the current Pharmacy Benefit Management pricing. We typically see savings of 10% to 15% through reviewing administrative fees, manufacture rebates, and clinical utilization savings programs. This can also include coordination with a 340-B program and maximizing the hospital client’s own retail pharmacy.

Current PBM A PBM B Ingredient Cost $402,072 $357,997 $354,039 Dispensing Fees $7,060 $6,304 $5,043 Prescription Expense Total $409,132 $364,301 $359,082 Administration Fees $983 $0 $0 Manufacturing Rebates $28,080 $34,410 $59,990 Net PBM Expense $382,035 $329,891 $299,092 Base Annual Savings Over Current $52,144 $82,943 Clinical & Utilization Savings $26,144 $26,483 Proposed Net Annual PBM Expense $303,747 $272,609 Total Annual Savings Over Current $78,288 $109,426

Note: claims repriced include the 12 months between 8/1/2015 and 7/31/2016

Total estimated annualized savings opportunity ranges from $52,000 and $109,000

Vizient’s PBM pricing model yields significant savings.

How Our Advisor & Insurance Services Can Help You

With 250+ healthcare facilities, our partnership provides enormous purchasing strength in the

• marketplace. With over 100,000 insured employee lives and millions of dollars of premium volume, we

continually save healthcare providers cost and improve benefits within our exclusive programs. Our pooled programs are well-established with a proven track record for rate stability.

• Dental and Vision Insurance – 10% Average Savings
• Life Insurance – 25% average savings
• Disability Insurance – 15% average savings
• Specific Stop Loss Arrangement with built-in protections such as no-laser, and cancer carve-out
• Renewals have been below trend with two of the last five years at 0%
• Over $20 million in preventable lasers from on going catastrophic claims
• Pharmacy utilization and contract analysis – 15% average savings

Healthcare Facilities retain their independence and choice, including:

• Freedom to choose Fully Insured or Partial Self Funded Insurance Programs
• Freedom to choose TPA, PBM, & provider network
• Freedom to chose plan designs & funding structure
• Freedom to choose which products to implement

A wide offering of customized solutions for your hospital including:

• Communication & Education
• Enrollment
• Administration
• ACA & ERISA Compliance

Administrative Services  Custom Medical Network Design  Third Party Administration  FSA, HSA & HRA Administration  COBRA & FMLA  Section 125  Paperless Enrollment System  Disease & Wellness Management Voluntary Benefits  Cancer, Critical Illness, Accident  Permanent Life  Long Term Care  Limited Medical Plans “MEC”  Voluntary Legal and Identity Theft  Customized Benefit Communication  Employee Assistance Program Benchmarking Focused on Your Industry  Plan Design Comparison  Expense/Premium Comparison  Cost-Utilization Comparison  Pharmacy Claim Management  Medical Claim Management  Network Management  Retirement Plan Benchmarking Core Group Benefits  Health Insurance  Stop Loss Insurance  Pharmacy Benefit Management  Basic/Supplement Life & AD&D  Short- & Long-Term Disability  Dental Insurance  Vision Insurance

Product Portfolio

Choice & Flexibility