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Ø    Benefit Strategy Development
Ø    Plan Design
Ø    Funding Alternatives
Ø    Claims Analysis & Audit
Ø    Vendor Evaluation, Negotiation, and Management
Ø    Vendor Selection and Transition
Ø    Benefits Legal Compliance Oversight
Ø    Benefits Administration Outsourcing
Ø    Policies and Procedures
Ø    Benefits Communications
Ø    Employee Handbooks


1.      Benefits Strategy Development—A Benefits Strategy establishes key conceptual guides for the development and deployment of benefit plans, such as competitive benefits position, cost sharing with employees, funding mechanisms, the role of voluntary benefit plans, etc.

            A Benefit Strategy is usually developed in concert with a Compensation Strategy. 

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2.  Plan Design—Using our client’s Benefits Strategy, FBS either develops totally new benefit plans or changes to existing plans, so they are competitive, yet totally within realistic cost limits.  Section 125 plans are used to the maximum extent possible, to gain tax exemption for employee contributions.  We will also recommend and coordinate personal health risk assessment and behavior modification programs (health screenings, wellness fairs, lifestyle assessments, periodic health communications, etc.) to help reduce medical and disability plan expenses on a long-term basis.

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3.  Funding Alternatives—Self-funding may be desirable for some clients’ coverages, but not for other clients’.  Only a careful analysis can determine the best course of action.  FBS has several decades’ experience evaluating and installing self-funded, ASO, minimum premium (partially self-funded), and insured plans.

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4.  Claims Analysis & Audit—We analyze your quarterly claims for any looming problems.  Possible problems, which are brought to your attention, along with recommended actions.  We may then switch to more intensive monthly claim analysis/audit to resolve issues.  Some examples of our claim analysis and audit services are:

Ø      For insured plans, the analysis of carrier underwriting, reserve assumptions, and the careful archiving of claims data for future underwriting can reduce rate increases.  Also, careful monitoring of network provider usage and in-network claims can be used to your advantage.  Can some of these expenses be reduced?  Yes, with FBS’ technical experience.

Ø      Is there evidence of claim payment errors, fraud, or abuse?  Are benefit payments consistent with the plan terms?  Are employees accessing your plan for occupational injury claims?  FBS works with your vendor to quickly identify causes of delays and errors, shut them off, and recover overpayments.

Ø     Plan design analysis—Do plan provisions result in unnecessary costs or failure to meet our client’s Benefit Strategy?  Does the plan meet employees’ and dependents’ needs?  Is your plan competitive with other employers?

Ø      Managed care and provider network analysis—Is the correct strategy being used (PPO, HMO, EPO, POS)?  What about network penetration rates, procedure frequencies, specialist usage, preventive care usage, etc?  Are employees using their benefit plans in the most effective manner?

Ø      Administrative practices and procedures audit—Are the most efficient procedures being used for eligibility data maintenance and transfer to carriers, new hires, changes, and terminations, annual enrollment, timely COBRA notifications, HIPAA certificates, and employee problem resolution? Do some administrative procedures build in unnecessary costs and delays?  FBS can take over these annoying details for your staff. 

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5.  Vendor Evaluation, negotiation, and Management—Today’s world of benefits is complex and costly.  Poor vendor choice is critical.  Our clients pay for, and deserve, vendor efficiency, effectiveness, service, and integrity.  We have strategic relationships with the leading vendors in their fields, so change isn't always necessary.  FBS provides your company tangible help with:

Ø     Vendor service commitments and results analysis—Will your vendors commit to meaningful service guarantees?  Are their services valuable to your employees?

Ø      Vendor TechnologyAppropriate technology should take a burden off of your benefits team. Computer system linkages are critical to smooth, accurate “back of the house” functioning (eligibility, enrollment, claims payment, etc.) for your benefit plans.  At FBS, we have experience designing effective, efficient system linkages that are consistent with your company’s technological structure.

Ø     Competitive pricing—You get what you pay for.  The best vendor is often not the cheapest; rather, it’s the best blend of price, services rendered, and commitment to your Benefits Strategy.  FBS’ staff has three decades of experience with vendors of all types, and will guide you in this key area.

Ø     Vendor administrative practices and procedures—Practices and procedures either build in efficiency or inefficiency.  FBS believes vendors must constantly improve, and that harmonious relationships are both desirable and achievable.  This means that vendors serve you.

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6.  Vendor Selection and Transition—Occasionally, vendor changes are unavoidable.  FBS can give you just the help you need for a turnkey project:

Ø      Preparation of the RFP

Ø      Solicitation of proposals from solid vendors

Ø      Evaluation of vendor proposals

Ø      Evaluation of vendor capabilities and reference checking

Ø      Preparation of side-by-side bid comparisons

Ø      Recommendation of vendor(s) for client selection

Ø      Managing the transition to a new vendor—If a change in vendor is necessary, a number of critical steps must occur, often in the correct sequence, for the transition to be successful.  FBS will work with your old and new vendors in your best interests.

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7.  Benefits Legal Compliance Oversight--With rapid, unceasing changes in HIPAA, COBRA, forms 5500, SPDs, etc., compliance is a full-time job.  While regulatory compliance is an unproductive expense, non-compliance can be very expensive.  FBS helps you comply with benefit laws and regulations in the most cost-effective manner, avoiding additions to your staff.

A new compliance concern is HIPAA privacy regulations.  These new regulations took effect on April 13, 2003 for large employers, with small employers to be covered on April 13, 2004.  Flatly speaking, they impose very significant privacy responsibilities on self-funded plans, with somewhat lesser responsibilities on insured plans.  In either case, compliance will result in new administrative methods and procedures for employers.  FBS will help you meet this new regulatory challenge.  Email us for help.

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8.  Benefits Administration Outsourcing—Increasingly, employers are outsourcing some or all of their benefits responsibilities and focusing their attention on “core” activities.  FBS will assist our clients by assuming administrative and communications responsibility for:

Ø      Annual enrollment

Ø      Normal employee enrollment, changes, and terminations

Ø      Mergers, acquisitions, and divestitures

Ø      Monthly billings to carriers and vendors

Ø      Management reports

Ø      COBRA and HIPAA administration

Ø      Flexible Spending Account (FSA), Dependent Care Spending Accounts (DCSA), and Transportation Reimbursement Account (TRA) administration

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9.  Policies and Procedures—Client benefits policies and procedures either build in efficient or inefficient plan administration; lower costs or higher costs.  They should result in streamlined, efficient, and equitable benefit programs.  Clerical and support operations should be minimized. 

FBS has 30 years of experience helping our clients design customized policies and procedures that reflect those customers’ benefits strategy and their technological realities.

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10. Benefit Communications—Effective communications are critical for a benefit plan to be understood and perceived favorably by participants.  Today’s realities of increasing benefit costs, tighter profit margins, and employees’ anxiety about benefits only increase the importance of benefits communication for our clients.   Without well-conceived, effective communications, employee morale can plummet and suspicion can rise.

Designing and delivering effective, multi-media communications is difficult and time-consuming if it’s not your regular business.

There are many barriers to effective benefits communication.  FBS overcomes these barriers for:

Ø      Annual enrollment

Ø      Benefit strategy communication

Ø      Plan changes, introductions, and terminations

Ø      Changes in contribution levels by employees or companies

Ø      Mergers, acquisitions, and divestitures

Ø      Retirement planning

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11. Employee handbooks—Handbooks are an important, but separate, part of benefit communication for both legal and practical reasons.  In addition to communicating HR policies, work rules, and benefits to employees, evolving regulatory requirements must be met, including “understandability” requirements, required notices of changes, etc.

FBS has the communications experience and technical software to produce highly customized, readable, understandable employee handbooks.  Let us help you.



© Flexible Benefit Systems, Inc., 2003. All rights reserved.