Employee benefits is a dynamic area for businesses that demands attention, industry expertise and a deep understanding of issues impacting coverage—plan cost management, talent acquisition, administrative efficiency and regulatory compliance. As an employer, you want to provide your people with attractive benefits and a wellness program that fits your culture rather than just accepting a cookie-cutter plan. Because the reality is, you’re shouldering a significant responsibility—employees and their loved ones depend on a company benefits and wellness plan to guard their health and livelihood. But, with the complex and everchanging healthcare and benefits environment, where do you start?
Entrust in The Fedeli Group. We understand how challenging it is to navigate the employee benefits landscape, which is why you need a partner with resources, a consultative mindset and clout in the insurance carrier market. We connect the dots for employers by creating employee benefits programs that align with your organization’s philosophy and structure.
Our Commercial Market team works with those clients over 100 employees where the options expand and our ability to leverage one-of-a-kind analytics capabilities provide historical insight and inform decisions for the future.
Our Emerging Market team works with clients ranging from 2-99 employees as the funding options are limited, but the programs and resources delivered to employers and employees alike are invaluable.
Our Public Sector team’s experience in working with dozens of municipalities enables us to understand the nuanced requirements of taxpayer funded decisions and unique labor discussions not found in other industries. We’ve also co-founded Ohio Government Benefit Cooperative (OGBC); a self-governed consortium designed to stabilize the overall cost of group health insurance plans.
Our No. 1 priority is protecting the health, wellness and future of your business, your people and their families. Here’s how we go about doing that…
Stewardship—Connecting the Dots. We maximize accountability with a protocol we refer to as our stewardship process. It involves procedures and best practices that encourage peer review to reduce errors. Every year, we produce a comprehensive stewardship report that reviews benefit plan results and activities, including financial results, clinical analysis, benchmarks, service documentation and the status of work plan objectives.
Attention to the Plan Details. We guide employers and benefit managers to write a simple benefits philosophy that addresses budget, culture and organizational objectives. From there, we can build a benefits plan that speaks to this philosophy—and we pay attention to every detail of your plan. That means carefully vetting contract provisions and running through all of the what-if scenarios. Due diligence prevents “spreadsheet decisions.” With alternatively funded health care plans, we advise on claims reserves, stop loss contract provisions and carrier requirements—common areas where employers can enter arrangements that aren’t beneficial for their organizations.
Backing Decisions with Data. We go beyond traditional reporting tools that are limited to basic claims information because transparency is what helps us make effective decisions for your employee benefits. The Fedeli Group uses a data warehouse that receives HIPAA-protected claim feeds from major medical insurers, pharmacy benefit managers, and third-party administrators. By using algorithms from OptumInsight, we can group claims by type of chronic condition and episodes of care. We can deliver data including: robust clinical information, accurate forecasts, reserve calculations and volatility risk. But, what makes this data truly powerful is our experienced, collaborative team—they provide the interpretation and recommendations to put this data to work for your organization.
Navigating Regulatory Complexities. We perform periodic regulatory compliance reviews to address areas including ACA, HIPAA, COBRA, ERISA, Medicare Part D, FMLA and non-discrimination rules. Our team has performed extensive consultations on the Affordable Care Act since 2010, and we tap into our internal experts and strategic partnerships with legal resources and administrative service companies to keep your employee benefits compliant, and to help you make decisions for your plan in a tough regulatory climate.
Building Wellness Programs that Work. Rather than promoting cookie-cutter wellness solutions, we focus on creating a best fit for your organization. That includes providing insight, facilitation, vendor assessment, coordination and planning—so you’re not on your own with building and running the wellness program. Plus, we can measure and track wellness results over time so you can evaluate program participation and effectiveness.
The Fedeli Group Difference. The health care industry is increasingly complex and highly regulated—and it’s a space we’re comfortable working in because of our expertise, access to data and outside resources, along with the protocols we have in place, which includes our stewardship process. For these reasons, we are clients’ trusted go-to for not just building and facilitating employee benefits plans—but planning for the future so they can keep their people and organizations healthy and strong.
Let’s Talk. Give your people the benefits they deserve while addressing regulatory complexities, cost and organizational goals. We’re here to help. Contact us.
Analytics
For more than 10 years, The Fedeli Group has been a leader in the industry, using powerful data comprehension to guide client engagements. We have invested greatly in tools and technology to support organizations' well-being program goals. By delivering superior insights and a personalized, easy-to-use wellbeing portal through this integrated platform, we can ultimately provide a holistic picture of your population’s health.
Delivering Meaningful Data. Our resources allow us to provide analytics that address:
- Premium rate calculations
- Initial and ongoing claims reserve calculations
- Annual funding projections
- Monthly claims reporting (including stop loss settlement)
- Cost forecasts
- A dashboard of executive-level reports
- Risk analysis modeling
- Claims analysis by chronic conditions, episodes of care, severity, co-morbidities, frequency and medical compliance
- Board-level reports and presentations
Fighting for Transparency. Information is the lens that allow us to see clearly through the regulatory complexities that are inherent in health care. Health care costs should not be a mystery—and our data helps uncover the true story. Our data services allow for informed decision-making and measuring results that satisfy executives, board members and operations managers.
Regulatory Compliance
When’s the last time your employee benefits plan received a regulatory review? Do you have a team of professionals—attorneys, CPAs, healthcare industry experts—to advise on your benefits plan? And, what about data to back tough decisions? These are the resources that The Fedeli Group brings to your organization as an employee benefits partner. Our regulatory reviews identify areas of concern and deficiencies. We also confirm areas that do meet standards so you have a full audit of your benefits. Through the process, our experienced consultants guide you through the process—we’re your advocate.
Our regulatory compliance activities include:
- Plan Documents
- Notices
- Form 5500
- COBRA
- HIPAA Privacy
- Affordable Care Act
- Fees, Taxes and Filings
- Regulatory Compliance Review
Learn more about how The Fedeli Group’s regulatory compliance satisfies Department of Labor health plan audits while identifying gaps in your plan—and solutions to ensure your plan satisfies regulatory demands.
Wellness
Promote a healthy, vibrant workplace where employees are present, productive and living strong in and out of the work environment. As an employer, you can provide access to benefits and wellness programs that can make a positive impact on your people. The Fedeli Group can help you craft a wellness strategy to accomplish those goals through culturally-driven design. Here’s how we do that…
Developing Wellness Strategies. We work closely with you to create a wellness program that aligns with your organizational goals, values and mission. We discuss demographics, geography, educational levels, identified disease states—issues that impact wellness. Your organization is unique, and your wellness plan should reflect who you are as a workplace.
Promoting Preventive Health. Disease prevention is critical for controlling healthcare costs over the long-term. That’s why we are firm believers in preventive health—and we encourage developing personal relationships with primary care physicians.
Managing Stress. It’s the silent killer, and unmanaged stress leads to absenteeism, lost productivity and employee turnover. By offering stress management tools, we can encourage employees to own their health and wellbeing.
Offering Resources. It’s not easy to commit to improving long-term health. That’s why we provide a range of resources to support, supplement and facilitate your wellness initiatives. We share best practices and ideas with professionals in the corporate wellness field, so we can bring fresh concepts to your wellness program. Let’s work together to build healthier workplaces. We’re your partner.
Voluntary Benefits
No one expects accidents to happen, or critical illness to occur. But we do need to plan for these events because they can be financially damaging for families. Voluntary benefits allow individuals and families to manage the cost of unpredictable health events—accidents, illness, disability, death—and to access information about the benefits in a convenient way.
Why Voluntary Benefits? For employers, voluntary benefits can reduce absenteeism, improve the way your people understand and appreciate their benefits, and provide linkage to other benefit coverages. For employees, these benefits provide access to high-quality financial counselors, cost-effective financial protection and an ability to avoid financial hardship.
Taking Fear Out of the Process. Purchasing financial protection products can be daunting—but we’re here to make the process seamless. An employer-sponsored voluntary benefits program can provide vetted products that serve employees’ interests. We create a program based on workplace demographics and a range of variables—the purpose is to tailor the plan to your organization’s people and their potential needs.
Providing Resources. We can supplement voluntary benefits with benefit counselors, online platforms, group meetings and more. With upfront planning, we can help ensure the initial and long-term success of your voluntary benefits program.
Let’s design a voluntary benefits plan that suits your organization’s needs today—and in the future.
Insurance Placement
When you partner with The Fedeli Group, you gain access to leading health, disability, life, dental and voluntary coverage insurers. We engage you in a discovery process to identify the appropriate plan design for your organization—and we ensure that plan is compliant. Part of our insurer selection process includes understanding contract provisions, financial ratings, claims payment reputation and service standards. Our focus is pairing you with the best carrier for your needs.
Matching Long-Term Partners. We take the carrier selection process seriously—and that often means presenting you with finalist presentations. This can set expectations, drive accountability and play an important role in building long-term relationships.
Let’s Talk. Employee benefits is a complex arena, and The Fedeli Group has the resources, expertise, tools and access to reputable carriers to build a program that addresses your organization’s needs today and into the future. Let’s start a conversation.
What is the OGBC?
The OGBC stands for the Ohio Government Benefit Cooperative.
The OGBC was established in 2018 by The Fedeli Group and Medical Mutual of Ohio with the consulting expertise of The Fedeli Group. The OGBC is a consortium designed to stabilize the overall cost of group health insurance plans. The consortium was formed and is governed by a member of each public entity.
What are the benefits of OGBC?
Consortiums are designed to benefit employers by sharing in claims pooling.
The benefit of being an OGBC member differs from other consortiums. As a member you experience lower administrative costs, avoid paying state insurance taxes, build consistency and reserves, mitigate medical trend and receive pharmacy rebates.
Difference between the OGBC and other Consortiums
The OGBC is self-governed by a Board of Directors and operated by the members of the consortium, not by a consultant. Each entity in the consortium has a representative on the Board of the OGBC.
You have plan design flexibility in the OGBC. This allows each employer to continue the current plan(s).
OGBC members are NOT locked into a multi-year contract. Employers can exit the consortium without financial penalty or incurring reserve costs.
The difference in the OGBC program is the renewal process. Each entity is underwritten based on their own performance, not the utilization of the entire consortium. This eliminates employers incurring a higher increase to offset another employers poor utilization.
Who can be an OGBC Member?
To be a Member of the OGBC you must be one of the following:
- A City
- A Township
- A County
- A Political Subdivision
The Consortium is designed for health insurance programs that are both fully-funded and self-funded. The OGBC allows large and small government entities with 50+ eligible employees into the program.
Interested in becoming a part of the OGBC? Let's Talk.