1. Ford Consulting A Customized Health Care Product &
Services Solution for Customer 2015
2. The Health Care Industry Yes, the health care industry is a
mess. And it is likely to remain that way for some time to come.
But, in that confusion, FCS Solution was formed to take care of the
most important component of the health care equation The Employee.
And in the process, companies get an elegant, low maintenance
solution with significant savings.
3. FCS Solution An exclusive offering of Ford Consulting
4. Ford Consulting & Customer 1. Review Existing Customer
plan 2. Describe Customer new FCS Solution Plan and Value
Proposition 3. Describe how new plan will work once in place 4. How
to get started and associated timeline
5. New Customer FCS Solution Plan The analysis compared current
employee withholding plan with a recommended schedule of
withholding for management to consider. The complete comparison
between existing and proposed plan is in the detailed excel
spreadsheet included as a part of this analysis and feasibility
study.
6. How the FCS Solution Plan works -Customer retains
Professional Benefits Administrators PBA West as plan
administrator. -PBA West provides an ACA qualified plan document
that becomes the new group benefit. -This benefit is mostly funded
by high deductible Bronze Level policies. -Customer self insures
the difference between the plan document and the bronze level
policies on a pay as you go basis. -One benefit equals two cards
for each employee.
7. How the FCS Solution Plan works Employer -PBA West relieves
Human Resources department of most of the administration work
becoming almost like an extension of that department. They become
the employees advocate. -Customer pays PBA West the plan costs each
month and PBA West then pays the individual policies, claims and
fees. -PBA provides all Cobra administration as well.
8. How the FCS Solution Plan works Employee -Two cards equal
one benefit. The employee receives an insurance card from the
individual carrier and a secondary card for the self-insured
component underneath the primary policy. The employee presents both
at the point of service and the provider collects the deductible
and the co-pay, then files the remaining portion of the claim with
PBA and the insurance company. -PBA makes certain that the
insurance company pays what it should and the balance is paid by
the employer via the second card.
9. How to get started ? 1. PBA West prepares a Claims
Administration Agreement for Customer. 2. Ford Consultingthen
provides a contract for customers signature. 3. Enrollment for each
employee consists of two steps. The first is enrollment with PBA
West for the secondary card. The second step is enrollment for the
primary insurance card. 4. PBA West prepares the compliant Plan
Document and Summary of Benefits. 5. This process takes 60-75 days
to complete.