Strategy & Services

We handle all aspects of the renewal process. We compose and execute the RFP and manage the bidding process; negotiate rates with incumbent and prospective carriers; evaluate and select funding method; settle on a contribution strategy; determine carrier and plan design; implement and communicate; and review all contracts. We handle these tasks as follows:

• Determine with client what carriers will be included in the RFP, what plan designs we want to see in addition to matching the current plans, and outline any other goals and objectives
• Proposal intake, analysis, and evaluation
• Negotiations with carriers through competitive bids, technical analysis of claims and rate calculation, and carrier performance
• Funding method evaluation through claims analysis to determine the most appropriate and cost-effective approach to plan funding–self-insured, fully-insured, or in-between (such as minimum premium or retrospective refund)
• Determine carriers and plan design through a thorough comparison of network access, plan types and coverage features, financial impact, disease management and wellness capabilities, reporting and administration, and finalist meetings
• Settle on a contribution strategy by outlining financial goals and limitations, determining if the contributions should incentivize plan choice, and modeling various strategies 
• Implementation requires carrier meetings with the implementation manager present; we request a detailed timeline from the carrier with deliverables and establish the correct contacts early in the process, including IT for HRIS feeds 
• Communication support is delivered in any number of ways as determined collaboratively with our client and can include live presentations in various locations, live and recorded webinars, and written/electronic communications (see the Communications section of this RFP to learn more about our extensive communications capabilities)
• Contract review takes place throughout the process as contractual items are made available; in some cases new contracts are not available until after the renewal has passed but will always review all contractual language to ensure accuracy; we also outline and have approved any unusual or custom language in advance with the carrier and maintain detailed records

Throughout the entire renewal process we meet regularly and as-needed with our clients for status updates and in the event we need to change our approach.

The process of plan design and carrier selection starts with the client and their objectives. These can be reliant on factors outside of the normal realm of considerations, such as how much staff is needed to support a carrier transition and the impact on finance and payroll. When considering a change or evaluating the current program, we do the following to ensure no stone is left unturned:

• Readiness review—what is the client equipped to handle and what is out of the question based upon staffing requirements and culture
• Appropriateness review—based upon the clients’ culture and demographics we use benchmarking and other comparative analysis to determine the suitability of the current program and if there is a better, more efficient way of accomplishing their goals
• Plan design review—plan design is more than just the coverage provided by the plan; when coming to a decision on plan design we consider all of the following and weigh the relative importance of each to the client:
  • Number and combination of plans offered
  • Disease management 
  • Inclusion of health care accounts (such as an HRA or HSA)
  • Administration
  • Carve-out options (ex: Rx) and Domestic Tourism (ex: MRI’s)
  • Network coverage
  • Integration of wellness
• Carrier selection—the carrier(s) selected are typically determined by their offerings and flexibility with respect to the above in combination with the overall financial picture. Occasionally, due to reputation and perception a client will select the carrier first. While we are willing to work within this narrow framework, we will push our clients to consider other options that may work for them before making a decision.

“Strategy” is a broadly-defined term, often used to mean many different things. To us, strategy means executing thoughtful, comprehensive analysis in order to establish the most suitable plan for attaining a goal, be it short- or long-term. Our well-rounded, collaborative approach to benefits strategy includes:

• Meet regularly throughout the year on a “non-urgent” basis to tackle issues of the day; review marketplace trends and provide a general update; review/establish goals and objectives and identify any obstacles; and discuss the current corporate environment, which ultimately is the context for any decisions or recommendations made.
• Regularly review claims performance and other financials; the more frequently we review claims together the more customized the claims reporting and analysis becomes.
• Understand the culture, including the unique employee populations and demographics so as to properly evaluate the impact of any decisions.
• Ensure we are tuned-in to the decision-making environment and philosophical approach to benefits; know who ultimately makes decisions around benefits objectives, what the context is, and the ideal format for presenting recommendations.
• Utilize our tools and resources to meet objectives. We have invested in several strategic partnerships and developed in-house expertise with the aim of providing our clients with access to best-in-class consultation, services, and resources in specialty areas, such as wellness, HR services, HRIS evaluation, and communications.
• Customize our service model to meet the needs of our clients. We seek to provide our clients with the flexibility to utilize us in the ways that best suits their needs, be it the analysis we provide to the frequency and format in which we meet. We focus in on areas where they need or want the most help and will achieve their goals, with a focus on being nimble and ready to address their changing needs.

Longfellow takes a thorough and technical approach to claims management. We regularly provide in-depth claims performance analysis that includes a variety of metrics and analytics. To the extent possible and reasonable, we do what we can do tailor reporting to address the needs of the specific client. Essentially, we take the “raw” and often overly-complex carrier data and transform it into a cohesive, actionable story upon which our clients can base future initiatives and build toward their short- and long-term goals.

For our experience-rated-fully-insured and self-insured clients we regularly review claims performance on a rolling 12 or 24 month basis, depending upon plan type:

• Incurred or Paid vs. premium 
• Incurred or Paid vs. expected (self-insured only)
• Tracking of high-cost claims
• Lag reporting 

Upon renewal, we breakdown and analyze the rate calculation including a retention cost analysis, to identify technical points of leverage for negotiations. We will also ask the carrier(s) to present occasionally on cost drivers, disease management, and large loss activity, analysis that can also track to wellness initiatives.

For self-insured plans we work with the carrier/administrator to set claims projections and working rates. We also handle the stop-loss bidding process and guide clients in selecting the appropriate stop-loss contract types and levels.

Financial Reporting and Modeling
We take a thorough and technical approach to financial analysis. Supported by the expertise of underwriters, our team of consultants is well-versed in funding method evaluation and transitioning between the different methods, claims performance reporting and metrics, plan design and contribution modeling, and rate calculation analysis.

We model plan design changes and cost impact at renewal and also in pre-renewal projections. We setup our documents so we can engage in real-time modeling of plan design and contribution scenarios.

Through turnkey online meeting software, we also have the ability to meet with clients in an online, interactive environment to review financials and engage in collaborative financial modeling from anywhere at anytime. This capability allows us to meet instantly when the need arises and frees up time and resources for us and our clients.

Benchmarking
We utilize various benchmarking sources to provide our clients with detailed, on-demand benchmarking by industry, size, and location(s), such as:

• HighRoads
• HealthLeaders InterStudy
• M Financial (M provides us with one-stop access to various industry benchmarking sources)
• A.D.A.M. Online Benefits
• Other industry sources, such as Milliman and Kaiser Family Foundation
• Carriers, as needed and appropriate
• Our own client base

The benefits world is legislatively complex and heavily regulated. We help you keep up with the regulatory environment surrounding employee benefits by keeping a close, detailed eye on all legislation, industry trends and best practices. When changes arise, we notify clients in a variety of ways depending upon the nature of the change. Some require a global Client Bulletin, which is sent out via e-mail. Other updates may require a more personal approach, whereby clients receive communication directly from their Longfellow consultant. In addition, we host regular webinars and seminars and are frequently published on topical matters (visit our Newsroom  for access to articles and releases). Our expectation is that our clients will hear from us first with the information and guidance they need.

In addition, we review compliance calendars with our clients and notify them of upcoming filing and notification deadlines. We provide model language and templates for notices, and through our communications group  we are able to offer support in the distribution of materials.

Compliance Audit
When necessary, we perform a comprehensive Compliance Audit that dives deep into the following areas:

• Notices, filings, and distribution requirements
• State and federal regulations
• Contracts and plan summaries
• Plan documents, SPDs, and 5500 filings
• HIPAA and COBRA
• Discrimination rules and testing
• Onsite posters
• Statutory disability
• More

Once the audit findings are available, we then work with the client to bring them into compliance in any areas where gaps were uncovered.

We have developed a comprehensive suite of services and solutions designed to meet the unique needs of employers today. These solutions were implemented in direct response to client demands in specialty areas such as HR, HRIS, and International Benefits.

We want to provide clients with best-in-class support and expertise in these areas. For some, we cultivated the expertise in-house such as with wellness and communications. For others, we looked externally for partners who offer best-in-class expertise and share Longfellow’s vision and approach to service and strategy. We have fully integrated these solutions into our service model so the experience is seamless to the client.  To learn more about these solutions, visit our Strategic Solutions page.