1. 1. Ford Consulting A Customized Health Care Product & Services Solution for Customer 2015
2. 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. 3. FCS Solution An exclusive offering of Ford Consulting
4. 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. 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. 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. 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. 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. 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.