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Administrative Services

The West Suburban Health Group has contracted with Group Benefits Strategies (GBS) as its Central Benefit Administrator to provide the following services:

Group Benefits Strategies Services to the West Suburban Health Group

Central Benefits Administration
Enrollment processing for participating employers
Maintenance of master enrollment data base for all health & dental plans
Transmission of enrollment data to health & dental plans
Monthly billing to governmental employers (consolidated bill for all plans)
Review and processing invoices from vendors
Preparation of trust fund bills (on a warrant) for group’s Treasurer and liaison with Treasurer
Preparation and provision of data to group’s independent auditor

Claims Auditing
Auditing of monthly paid claims from claims data
Recovery – submission of disputed claims and COB to claims administrator(s)
Enrollment auditing

Independent Stop Loss Claims Tracking and Filing (if requested)
GBS provided this service to WSHG for a number of years, but the broker, American Stop Loss, took over this function

Consulting and Administrative Support to the Board and Committees

General Consulting Services:
o Preparation of Requests for Proposals
o Plan evaluation
o Benefit design analysis
o Underwriting/rate calculations for self-funded plans
o Health plan renewal evaluation
o Premium and fee negotiations
o Contract writing and negotiation
o Legislative information, updates, and advice on compliance (most recent HIPAA privacy)
o Preparation and presentation of briefing papers
o Review and evaluate health plan reports
o Draft policies

Administrative Support:
o Staff all meetings
o Preparation of meeting agendas
o Preparation of meeting minutes
o Communications – prepare and respond to correspondence
o Distribution of materials to member employers
o Maintenance of group records

Reporting:
o Annual cash flow projection
o Annual Report of activity
o Monthly reporting – Financial Update Report, Funding Rate Analysis, Balance Sheets (if requested – not done for WSHG), Stop Loss Reports, COBRA Administration Reports

COBRA Administration:
Provide all services required by COBRA

Invoice-Roster Service
Generates Excel file of Monthly Invoice & Health Plan Enrollment Roster

Other:
Organize/conduct information meetings for benefits administrators, if requested
Assist with wellness programs
Conduct workshops and seminars

Meet with employee committees as requested

Comparison Charts & Rates