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REVISED 12/30/15
4│TRAINING: RESOURCES & SUPPORT
Actuarial Services
 IBNR Calculations (Self Funded Plans)
 Premium Equivalents
 Funding Development/Projection
 Employee Contribution Strategies & Calculations
 Benchmarking & Claims Analysis – Navmd
Pharmacy Benefit Consulting
 Carrier or PBM pharmacy contract review
 PBM (procurement)
 Plan design and benefit management
 Implementation oversight
 Market check (as allowed in current contract)
 Annual pharmacy experience review and clinical recommendations
 Vendor management
 Retiree-specific drug strategies, including Employer Group Waiver Plan (EGWP) and Retiree Drug
Subsidy (RDS) support
 Ad hoc projects (e.g., onsite pharmacy, 340B optimization, etc.)
Benefits Administration
Account Services
 Assist employees with claims questions and problems
 Assist with billing, enrollment issues, ID cards, etc.
 Develop and coordinate enrollment materials for new employees
 Prepare and conduct educational benefit seminars/health fairs
 Provide proactive benefit updates
 Electronically enroll paperless (w/out payroll, EMS) - EE Navigator
Voluntary Benefits
 Accident
 Cancer
 Critical Illness
 Disability
 Short-term (w)
 Gap
 Hospital Indemnity
 Identity Theft
 Legal
 Long-Term Care
 Pet Insurance