Financial Perspective:
A Client-Perspective Case Study
We asked John Gause to
review our medical plan claims report as we had questions regarding the
information provided by our TPA. In the course of this review, John
discovered an aggregate claim reimbursement from the previous plan year
that had not been paid to us. This over due reimbursement was in excess
of $90,000, which our current agent and third party administrator had
not reported. Subsequently, we approached our TPA to request this
reimbursement from our reinsurer on our behalf.
Also, we had a
partially self funded plan and a separate HMO plan . We were
experiencing significant PPO problems as well as service issues with
our administrator. Apex was able to provide a financially competitive
solution to bring the plans together under one administrator and one
national network. Apex was able to move us to a dual option PPO plan
which benefited our employees and the implementation of the new carrier
and PPO provided deeper network discounts and easier administration
that directly impact our bottom line."
"Apex was able to help us benchmark our benefits and employee cost against our peer group to make sure we were competitive. We were able to revamp our plan to fit our business strategy rather than react to the marketplace. Not only was Apex able to provide a competitive solution, they directed the implementation process to insure success of our plan. With our company's growth initiatives, providing a cost-effective competitive benefit program is critical to attracting and retaining employees."
Mike Stout
Chief Administrative Officer
HH Gregg
