Texas, Austin, Round Rock, Group Individual Family Health, Dental, Life, Disability Insurance

Our Services set us apart in terms of the partnership, creativity and resourcefulness we offer.

Review of Current Status: Plans/Employees/Objectives
Benchmarking
Preliminary Plan Development and Modifications
Request for Proposal Process
Request for Proposal Response Review
Contract and/or Renewal Negotiations
Work with Benefit Administrator
Work to Resolve Claims and Benefit Issues
Work with Benefit Administrator/Controller to Resolve Billing Discrepancies
Call Center
On-Line Enrollment

There are many other services Spellings & Humphries, LLP offers that differentiate us from our competitors. Contact us to see why so many employers have Spellings & Humphries, LLP on their team.

Our Five-Step Account Management Plan

1. Analysis

We analyze the current benefit plan and financing. Our expertise with the various types of programs available lets us identify which program provides you the best control of benefits and cash flow, and we can tailor the program to meet your objectives.

2. Selection

We examine the marketplace to select carriers who best suit your objectives and negotiate favorable proposals. Although we can access hundreds of insurance carriers, we carefully select only those whom we trust to maintain the confidentiality of our clients' information, and past performance has been favorable. In a self-funded environment we request proposals for your group, both from stop-loss carriers, as well as the reinsurance/insurance markets a claim administrator may access. In other words, we do not rely on the claim administrator to research the marketplace for competitive pricing.

3. Presentation

We analyze the resulting proposals for you, "translate" them from insurance industry jargon, and present them in a format that identifies the true merits and costs of each option.

4. Implementation

Once a plan is chosen, we work with you to implement the program. This includes conducting employee enrollment and communication meetings. It has been our experience that when employees understand their benefits, the plan operates more efficiently and the employees are happier. Because they know what kind of coverage they have and how it works, they become better-informed consumers of medical care.

5. Plan Review

Throughout the year, we monitor the utilization of your program and keep you informed of trends that need your attention. At mid-year, we formally meet to review your plan and begin the renewal process. Because we've monitored the plan throughout the year, at renewal there are no surprises.

Enrollment Checklist

Handouts (provided by Spellings & Humphries)

þ Enrollment packets

þ Medical

þ Dental

þ Life

þ LTD

þ Voluntary Products

þ Schedule of Benefits to include summary of:

þ Medical

þ Dental

þ Life

þ LTD

þ Cost to Employees analysis

þ Claim Forms

þ Medical

þ Dental

þ Drug

þ Voluntary benefits - plus "replacement" forms if moving to new carrier

þ Directories

þ Preferred Provider directories - by location for employees and dependents

þ Pharmacy directories

þ Enrollment material to COBRA participants

þ Declaration of Good Health (DOGH) forms to add dependents not previously covered

(if needed) and/or HIPPA documentation.

þ Deductible and Out-of-Pocket Credit reports to new carrier if benefit year is different from

plan year - essential to ensure employees the least of concern with the change.

þ Conduct enrollment meetings, schedule meetings based on locations, shifts, etc.

þ After enrollment

þ coordinate implementation with selected carrier

þ review contracts for accuracy, obtain signatures

þ deliver Summary Plan Documents - "benefit booklets" for employees

þ be available for questions

o on-site as needed by group

o via telephone

þ Review monthly claim reports - keep group informed as to trends,

changes in the marketplace, legislation, etc.

þ Conduct a semi-annual review and evaluation of the program

þ request a renewal projection

þ review benefit structure

þ review funding of program

Our Philosophy and Commitment to Our Clients

We are professional employee benefits advisors. We have strong financial and professional incentives to give you a lifetime of quality products and service. We are not salaried employees of the insurance companies we represent; we are independent specialists who represent more than one insurance company. We are often compensated on a commission basis -- a percentage of the premiums you pay. In other cases we are compensated on a fee basis directly from employers. In each case, our loyalty and compensation rests with you, the consumer. Regardless of the method of compensation, we have strong incentives to place consumers with strong, financially stable carriers and provide superior service on an on-going basis. We believe that we are a vital link in the American health care system.

We are members of several professional trade associations which are a rich source of information regarding regulatory issues and changes affecting self-funded, conventionally insured and ERISA-compliant health benefits plans. Though we have extensive knowledge of partially self-funded plans, we also design and implement traditional, fully-insured plans. Our firm's principals are also active members of the National, Texas, and Austin Associations of Health Underwriters (NAHU, TAHU, AAHU) and the Texas Association of Businesses & Chambers of Commerce (TABCC), which both provide extensive information and continuing education to its members.

We realize that insurance is very confusing to most people outside the industry, so we believe it is important provide an extremely high level of on-going service. We remain involved after the decisions are made. We have found that the average person has little confidence in their own ability to resolve issues with insurance carriers, and we strive to lower their anxiety level by acting as an "advocate" for your employees and their dependents. Our nationwide 800 number and Internet e-mail capabilities allow your employees and dependents to reach us whether they are traveling on business, enjoying a vacation, or away at school. The typical response that our dedicated claims resolution staff hears is "Thank you! Thank you! It is so good to know that I have someone who understands this to help me!"

We are committed to serving the needs of our clients. Although we maintain an office staff and never underestimate its importance, we believe in personally answering to our clients. Your account will never be "passed on" to a service representative. We believe that by remaining personally involved with our accounts, our clients' concerns will be anticipated and quickly addressed.