Consulting Services - Health Benefits

     
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The primary objective of The BPA Financial Group of Companies' consulting services is to ensure that clients receive the best professional advice possible for decision making so that their duties and fiduciary responsibilities can be properly discharged. All of BPA's consulting services are supervised by its fully qualified in-house staff. The Account Executives will provide the direct personal consulting services.

The following is an outline of the various consulting functions available from BPA:

          At the Inception of the Health Benefit Plans
  • Develop a projected budget to determine availability of funds for plan benefits and necessary reserves;
  • Design plan benefits to suit the budget as well as the specific needs of plan Members;
  • Report on plan cost projections and methods of furnishing benefits;
  • Report on eligibility rules and alternatives with financial costing;
  • Prepare and submit specifications for competitive bids to providers of benefits (i.e. insurance carriers), and report on proposals with recommendations;
  • Review insurance contracts and negotiate contract terms with insurance carriers;
  • Co-ordinate insurance carrier's installation procedures with the plan's administration procedures;
  • Draft documents outlining eligibility, benefits and limitations for distribution to plan Members;
  • Assist accountants and attorneys in the preparation of tax and legal documents, if required; and
  • Assist in the design and implementation of administration procedures, if required.

    On a Day-to-Day Basis
     
  • Act as the intermediary between the trustees, auditor, investment counsellor, legal advisor and insurance carrier;
  • Review and advise on the plan's administration procedures;
  • Handle claims appeals, negotiate with insurance carriers at the instruction of the trustees on special claims;
  • Initiate and review cost containment procedures; and
  • Periodic reports to the trustees on emerging claims experience, abuses, special situations and other matters.

    On an Annual Basis

     
  • Review insurance carrier's operation reports;
  • Report to the trustees on the plan's claims experience, year-end deficit/surplus, premium adjustments, reserve requirements;
  • Report on plan's year-end financial summary;
  • Report to the trustees on benefits adequacy and upcoming trends in benefits provision; and
  • Advise the trustees on the insurer's competitiveness, product availability, benefit expansion, cost containment, new programs and concepts.

         Special Reports

  • Periodic competitive bids to investigate benefit costs;
  • Report financial effects on the plan under different eligibility rules;
  • Report new underwriting practices, funding media and cost containment procedures which may reduce plan costs;
  • Report regarding revision of collection methods and banking contracts; and
  • Report benefit costs to assist the trustees in collective bargaining or during arbitration proceedings and carry out litigation procedures in matters involving the trustees on their behalf.

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