2. ESP Benefit Design Background
• Staff with over 60 years employee benefits experience
• Worked with over 1,500 employers of all sizes with 100 years customer
service experience implementing plans to over 6,000 employers analyzing
their benefits.
• MBA from Franklin University with a health care major, Certified Employee
Benefit Specialist, Author of over 40 articles in:
• Customer-focused to ensure best value for services provided
as a result of our experience and background,
ESP Benefit Design provides:
• Provide full service management of accounts from the initial sales process, in-
force servicing of account to include claims, billing, subrogation, continuation
of coverage and every other facet of service requirements for employee
benefits
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4. ESP Benefit Design
offers:
Employer
Human Resources: Industry Service
Employee Handbooks Experience:
Self-Service Portal UnitedHealthcare
Online Resources Prudential
Vacation Policy New York Life
Benefits Communications:
Administration: Memos templates
Section 125 HR Portal
COBRA Open Enrollment
HIPAA
CDH:
HSA
Technology:
HRA
Share Point
Legal
Health Risk Assessments
Self Service Portal
Resources:
Wellness Plans
Seminars
HIPAA
Fitness Plans
COBRA
Medicare
State Laws
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5. COBRA Administration
Applications for terminations and new hires sent to our office for processing which then are
input for COBRA notifications to employee
Online processing for record keeping to ensure compliance is maintained for COBRA services,
if not done properly employers face significant penalties
Monthly report to Dynamix Engineering for review to ensure all COBRA recipients and those in
corridor period are accounted for their election
ESP Benefit Design sends out initial notifications to all new hires and all terminated employees.
Terminated employees receive Termination Notification via “proof of mailing” so that
a record exists for potential audits.
Full legal resources available to research any COBRA situation and ensure company is compliant
with COBRA ever changing requirements
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6. Human Resources Portal
• Online tools for HR self service
• Medical research tools
• All HR forms can be attached
• Links to any site
• No additional cost for service
• All plans and contribution levels
• Custom design to suit your company needs
• HRA administration attached to site
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8. Human Resources Services
HR Hotline
Human Safety &
Resources: Health Services
Employee Handbooks Inspections
Self-Service Portal Program Assistance
Online Resources Training
Vacation Policy Safety Audits
Employer Surveys:
Compensation:
Wage & Tax
Job Evaluation
Policies & Practices
Performance Management
Employee Benefits
Variable Pay
Employee Opinions
Executive Compensation
Customer Satisfaction
Sales Compensation
Bonus Plans
Training & Affirmative
Development:
Action Plans:
Public Programs
Plan Language
On-site Custom
Workforce Analysis
One-on-one
Adverse Impact Analysis
Training Needs Analysis
Comp Analysis
Legal Briefings
EO Survey
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9. Day-to-day Servicing
• 24 hour turnaround time on phone calls
• Timely servicing of claims, enrollment,
continuation and billing issues
• Courteous knowledgeable staff to handle all
concerns
• Supply fulfillment center via email and electronic
order forms
• Share Point procurement software
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12. Monthly Check-up Via Phone With Customers
• Phone call to each customer monthly to ensure
that all issues are handled
• If issues are unresolved, phone calls and
necessary communication with vendor
• Any notable market developments are provided
at the time of monthly checkup
• Monthly e-newsletter to employer representative
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13. Annual Review in Person With Customer to
Review Policy and Marketplace
• Analysis of current and renewal information
from vendors (comprehensive financial, network
and benefit analysis)
• Analysis of risk composition of group
• Analysis of marketability of group
• Prescreening process to test waters and analyze
risk composition
• Application process if appropriate conditions
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15. Financial and Actuarial Analysis
• Assess claims reporting to ensure pricing
accurately relates to paid claims
• Evaluate claims reporting to work with carriers
to identify candidates for disease management
programs and generic prescription substitution
• Confirm accuracy of billing and claims
• Annual market review of products
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19. Bid Specifications Development and
Management
• Customize a formal bid specification process Distribute
RFP to vendors
• Analyze and collect proposals
• Help assess vendor information to inform of most
suited vendor
• Conduct interviews with vendors
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20. Benefit Statement
• The Hidden Paycheck will show employees what
their employer pays for in benefits
• Provides employees perspective of the intangible
costs that are hard costs for employers
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22. Start-up or Transition Meetings
• Meeting with group to discuss any changes in benefits
or vendors
• Meeting(s) with group administrator to ensure billing,
claims and overall operation of benefits is working
adequately
• Individual meeting following group meeting to discuss
problems and lay groundwork for fixing problems as
well as new hire orientation
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23. Consumer Advocacy
• Health Care Advocate assisting employees:
troubleshoot claims, eligibility and provider network problems
to ensure timely delivery of care;
coordinate and interface with multiple parties, including health
plans, hospitals, medical groups, provider’s offices, and
collection agencies to resolve billing disputes;
educate employees about their benefit plans, and the
appropriate ways of accessing those benefits;
support employees with information and resources on various
health conditions and diseases.
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24. Service Commitment
ESP Benefit Design
ESP Benefit Design provides the following commitments to ensure that your policy is running efficiently:
• Group enrollment meetings to begin the policy with accuracy to all enrollees.
• Post enrollment check-up to verify all applications are entered correctly so that the first billing cycle is correct.
• Weekly phone call updates to address any service issues that exist.
• Billing statement review to verify accuracy on coverage and participation.
• Monthly meetings in person to discuss relevant topics and to offer creative suggestions about the usage of product
offering.
• Quarterly review of product offerings by way of survey to employees and those that administer the benefits
offerings at your company.
• Market analysis annually that provides a price, product and network assessment for your company.
• Ongoing commitment to return calls within 24 hours and to offer solutions to any related service issues.
• Legal expertise to help research any specific issues concerning your employee benefits.
• Group administrator training for your company so that those administering the plan(s) can fully learn about the
offerings.
• Employee Assistance Program services and programs designed to specifically address your company needs.
• Supply request requisition forms to allow for efficient and timely ordering of materials needed to administer
enrollment for new hires and changes and to get provider directories to those who need these materials.
• Technology update to give your company the fullest understanding of how to deal with claims, enrollment,
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changes and any other pertinent concern.
