How to Compare and Bid Plans
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SAMPLE BID QUESTIONS
- Years in business
- References from current clients
- References of past clients
- Average ID turnaround
- Average claim turnaround
- Provide examples of communications, such as explanation of benefits & denials letter
- Language skills of customer service
- What type of training do customer service undergo to prepare them for dealing with international exchange participants
- Location of customer service operation
- Name and availability of direct customer service contact
- Availability of firm’s primary service representative
- Hours of service
- Sample brochure
- Assistance with orientation materials
- Financial Stability of the carrier (Best Rating)
- Licensing of carrier/broker
- If contract is with broker (not carrier) how long has carrier been on book? If short period, what is history with prior carriers?
- Will broker guarantee in writing that replacement carriers will have the appropriate rating?
- Please provide examples of reports
- Refund guidelines
- Late enrollment guidelines
- Availability of weekly or daily rate?
- How will renewal rates and fees be calculated?
- Obtain a brief explanation of the experience rating methodology you propose for this group. Is the Pricing pooled or experience rated?
- If pooled, outline rate history
- If experienced, what is claims/premium ratio?
- Is there a PPO element? If so, obtain details.
- How does claims administrator determine reasonable & customary?
- What is the current level of medical trend used for a nationwide account such as this group?
- When will you be able to present a renewal position for the 09-10 plan year?
- Please illustrate any rate guarantees or capitations available for 2009 & 2010
Pricing Factors/Questions for Larger Plans
- How are PPO fees paid and please identify average charges
- Will you be able to use the completion factors from the current administrator in renewal calculations?
- If not, how will you project runout?
- How does your actuarial and underwriter measure trend?
- Please illustrate a proposed dividend arrangement should the experience be below projected
- What are enrollment arrangements?
- What are billing arrangements?
- Detail administrator services (enrollment, plan management)
- Detail student services (claims, IDís, etc)
- Web content
Compass Benefits is the endorsed North American Broker for IASIS, the non-profit insurance & Educational Travel Confederation.
THE BASICS - COMPARING PLANS1.Establish selection criteria and relative importance, i.e.
- Financial stability
- Program stability
- Claims processing capabilities
- Other service arrangements (ID’s, orientation development, etc)
- Web content/capabilities
- Others significant to your organization