Administration

Operational Review

Looking for a way to make your benefits administration more efficient and cost-effective? Segal can help.

We regularly assist public sector organizations in assessing the administration of their benefit programs. As part of these assessments, we analyze and evaluate strategic issues, administrative functions and supporting technology to identify key areas where efficiency and effectiveness can be improved.

How can you tell if your administrative office would benefit from an operational review?

  • Service issues, such as employee inquiries going unanswered, inconsistencies in responses to questions or backlogs in processing
  • Organizational issues, such as high staff turnover, a new administrator, key employees reaching retirement age, lack of accountability, unclear or undefined roles and responsibilities, inadequate staffing or lack of cross training
  • Financial and regulatory concerns, such as increasing administrative costs, compliance issues or inadequate internal controls or policies and procedures

Our operational assessments address the following key areas:

  • Operational: The operation of administrative tasks and functions and the efficiency of those efforts
  • Organizational: How the office is organized to achieve its mission, tasks and benefits delivery and service goals
  • Technology: How well the current level of technology supports the effective delivery of benefits and member service

Our consultants are well versed in the functional, technical, transactional and organizational aspects of benefits administration. Through our assessment process, we obtain a through understanding of your work processes, identifying problem areas and recommending short-and long-term solutions to address these issues.

As part of this process we will review all aspects of your organization including work processes, staffing, compensation, job descriptions, roles and responsibilities, organization and reporting structures, policies and procedures, performance management, staff training and development, benchmarking, compliance with legislative and regulatory mandates, technology tools, software, hardware, infrastructure, and technology support and maintenance.

Segal has worked with multiemployer funds, public sector entities, unions, VEBAs, training funds and TPAs to assist them with operational and organizational assessments. While we can review your entire organization, we can also focus on one functional area. Some of these areas may include:

  • Member Services/Call Center
  • Contribution Accounting Processing
  • Pension, Annuity/401k Administration
  • Health and Welfare Administration
  • Dues Administration
  • Information Technology

Feasibility Studies

Segal conducts feasibility studies to give public sector organizations an invaluable tool for making decisions about their benefits administration. Whether you are trying to decide whether to outsource certain administration processes, implement a new software system or provide a new benefit to employees, Segal can help.

Our feasibility studies focus on:

  • Cost comparisons — both capital outlay and ongoing expenses
  • Acquisition of hardware and software
  • Staff requirements and training
  • Quality and efficiency of service

With a realistic understanding of the risks and rewards of each option, our clients are able to make informed decisions based on real data.

With an increasing focus on administrative costs, many organizations are reviewing their internal and external costs related to administration. Segal can assist in reviewing your current method of administration and identify the most cost effective way of administering your benefit plan while maintaining a focus on the level of service provided to your employees.

Segal has worked with multiemployer funds, public sector entities, unions, VEBAs, training funds and TPAs to assist them in determining the most cost effective way to administer benefits while maintaining a high level of customer/employee satisfaction. Some of the areas of administration we have reviewed as part of our feasibility studies include:

  • Contributions Processing
  • Pension Administration
  • Health Claims Administration
  • Annuity/401k Administration
  • Vacation Fund Administration
  • Legal Fund Administration
  • Human Resources Administration
  • Customer Service

Third Party Administrators Searches and Implementation

Whether you are already using a third party administrator (TPA) or considering outsourcing your benefits administration operations or a single function, such as pension, claims, contribution processing, HRA, VEBA or 403(b) administration, for the first time, Segal can help you conduct a proper search and selection process.

While there are a wide variety of TPAs in the benefits administration market, not all of them have experience with public sector funds. And though many are experts at processing health claims, they may not also have experience with pension or savings plans, billing and collecting employer contributions, or maintenance of eligibility through hours banks or hourly contributions.

With our extensive knowledge of the TPA vendor market, pricing structure, services, technology and more, Segal can help you wade through the options and identify the best fit for your particular needs.

How can you tell if it's time to take a fresh look at the TPA marketplace?

  • Service issues, such as inquiries going unanswered, processing errors and/or backlogs, lack of service innovation, or a sense that your TPA is not keeping up with the times
  • Financial and regulatory concerns, including large fee increases, frequent "pass-through" charges for special programming or regulatory compliance, or slow and/or inadequate compliance efforts
  • Reporting and technology issues, such as mistakes and inaccuracies in reports, delays in providing actuarial data, inability to create ad hoc reports, reliance on manual processes and other technology limitations

Our Approach

A TPA search by Segal consists of the following steps:

  • Documenting Administrative Requirements: Identifying the general and unique administrative requirements of your plans. Our RFPs go beyond the typical questions about price and performance to inquire about quality-of-service measures, financial status, experience, technology, staffing levels and training, audit controls, regulatory compliance and ability to deliver self-service, web-based applications.
  • Developing the Request for Proposal (RFP): Drafting the RFP, identifying potential TPAs based on size, geography, experience, etc., and distributing the RFP to a select group of TPAs
  • Vendor Selection: Analyzing vendor responses and facilitating the finalist interview and due diligence process
  • Contract Negotiations: Using our industry knowledge to assist with price and performance guarantee negotiations and technical contract analysis
  • Implementation: Resolving disputes and monitoring progress to ensure a timely and successful implementation
  • Project Management: Assisting with planning and managing all phases of the TPA search process

Third Party Administrators Services

Many of the benefits administration and technology services that Segal provides to public sector organizations can also be performed for third-party administrators (TPAs). Segal's expertise in the field can help you provide better service to your customers while minimizing costs.

Specifically, Segal can help you with:

  • Technology Acquisition and Implementation
  • Information Systems/Technology Reviews
  • Operational and Organizational Assessments
  • Web Site Development
  • Feasibility Studies
  • HIPAA Compliance Reviews
  • Recruiting

Vendor Performance Monitoring

We have the staff, resources and knowledge to assist our clients in improving the service levels received from its vendor partners. As your consulting partner, we serve as your advocate in proactively managing vendor partners on a day-to-day basis to ensure performance expectations are clear and measurable. If service issues arise, we directly access the proper individuals at the insurance carriers and vendors to facilitate immediate resolution. As a core ongoing service to our clients, Segal assesses vendor performance guarantees and financial penalties. Our extensive experience in the local and national marketplace provides a solid foundation to continue to “stretch” the carriers for continuously improving performance metrics.

We ensure that all carriers have standard sets of performance guarantees that they will offer based on our clients’ size and type of plan. We have negotiated implementation, account management, customer service and claims management standards with vendors and can help you design overall satisfaction standards where the “pass or fail” determination is based only on your opinion, not the vendors.

Operational Review

Segal can help make your benefits administration more efficient and cost-effective.

We regularly assist multiemployer organizations in assessing the administration of their benefit programs. As part of these assessments, we analyze and evaluate strategic issues, administrative functions and supporting technology to identify key areas where efficiency and effectiveness can be improved.

How can you tell if your administrative office would benefit from an operational review?

  • Service issues, such as participant inquiries going unanswered, inconsistencies in responses to questions or backlogs in processing
  • Organizational issues, such as high staff turnover, a new administrator, key employees reaching retirement age, lack of accountability, unclear or undefined roles and responsibilities, inadequate staffing or lack of cross training
  • Financial and regulatory concerns, such as increasing administrative costs, compliance issues or inadequate internal controls, policies and procedures

Our operational assessments address the following key areas:

  • Operational: The operation of administrative tasks and functions and the efficiency of those efforts
  • Organizational: How the office is organized to achieve its mission, tasks and benefits delivery, and service goals
  • Technology: How well the current level of technology supports the effective delivery of benefits and member service

Our consultants are well versed in the functional, technical, transactional and organizational aspects of benefits administration. Through our assessment process, we obtain a thorough understanding of your work processes, identifying problem areas and recommending short- and long-term solutions to address these issues.

As part of this process we will review all aspects of your organization including work processes, staffing, compensation, job descriptions, roles and responsibilities, organization and reporting structures, policies and procedures, performance management, staff training and development, benchmarking, compliance with legislative and regulatory mandates, technology tools, software, hardware, infrastructure, and technology support and maintenance.

Segal has worked with multiemployer funds, public sector entities, unions, VEBAs, training funds and TPAs to assist them with operational and organizational assessments. While we can review your entire organization, we can also focus on one functional area. Some of these areas may include:

  • Member Services/Call Center
  • Contribution Accounting Processing
  • Pension, Annuity/401k Administration
  • Health and Welfare Administration
  • Dues Administration
  • Information Technology

Feasibility Studies

Segal conducts feasibility studies to give multiemployer funds an invaluable tool for making decisions about their benefits administration. Whether you are trying to decide whether to outsource certain administration processes, implement a new software system or provide a new benefit to participants, Segal can help.

Our feasibility studies focus on:

  • Cost comparisons, both capital outlay and ongoing expenses
  • Acquisition of hardware and software
  • Staff requirements and training
  • Quality and efficiency of service

With a realistic understanding of the risks and rewards of each option, our clients are able to make informed decisions based on real data.

With an increasing focus on administrative costs, many organizations are reviewing their internal and external costs related to administration. Segal can assist in reviewing your current method of administration and identify the most cost effective way of administering your benefit plan while maintaining a focus on the level of service provided to your membership. 

Segal has worked with multiemployer funds, public sector entities, unions, VEBAs, training funds and TPAs to assist them in determining the most cost effective way to administer benefits while maintaining a high level of customer/member satisfaction. Some of the areas of administration we have reviewed as part of our feasibility studies include:

  • Contributions Processing
  • Pension Administration
  • Health Claims Administration
  • Annuity/401k Administration
  • Vacation Fund Administration
  • Legal Fund Administration
  • Human Resources Administration
  • Customer Service

Third Party Administrators Searches and Implementation

Whether you are already using a third party administrator (TPA) or considering outsourcing your benefits administration operations or a single function, such as pension, claims, contribution processing, HRA, VEBA or 403(b) administration, for the first time, Segal can help you conduct a proper search and selection process.

While there are a wide variety of TPAs in the benefits administration market, not all of them have experience with multiemployer funds. And though many are experts at processing health claims, they may not also have experience with pension or savings plans, billing and collecting employer contributions, or maintenance of eligibility through hours banks or hourly contributions.

With our extensive knowledge of the TPA vendor market, pricing structure, services, technology and more, Segal can help you wade through the options and identify the best fit for your particular needs.

How can you tell if it's time to take a fresh look at the TPA marketplace?

  • Service issues, such as inquiries going unanswered, processing errors and/or backlogs, lack of service innovation, or a sense that your TPA is not keeping up with the times
  • Financial and regulatory concerns, including large fee increases, frequent "pass-through" charges for special programming or regulatory compliance, or slow and/or inadequate compliance efforts
  • Reporting and technology issues, such as mistakes and inaccuracies in reports, delays in providing actuarial data, inability to create ad hoc reports, reliance on manual processes and other technology limitations

Our Approach

A TPA search by Segal consists of the following steps:

  • Documenting Administrative Requirements: Identifying the general and unique administrative requirements of your plans. Our RFPs go beyond the typical questions about price and performance to inquire about quality-of-service measures, financial status, experience, technology, staffing levels and training, audit controls, regulatory compliance and ability to deliver self-service, web-based applications.
  • Developing the Request for Proposal (RFP): Drafting the RFP, identifying potential TPAs based on size, geography, experience, etc., and distributing the RFP to a select group of TPAs
  • Vendor Selection: Analyzing vendor responses and facilitating the finalist interview and due diligence process
  • Contract Negotiations: Using our industry knowledge to assist with price and performance guarantee negotiations and technical contract analysis
  • Implementation: Resolving disputes and monitoring progress to ensure a timely and successful implementation
  • Project Management: Assisting with planning and managing all phases of the TPA search process

Third Party Administrators Services

Many of the benefits administration and technology services that Segal provides to multiemployer and public sector organizations can also be performed for third-party administrators (TPAs). Segal's expertise in the field can help you provide better service to your customers while minimizing costs.

Specifically, Segal can help you with:

  • Technology Acquisition and Implementation
  • Information Systems/Technology Reviews
  • Operational and Organizational Assessments
  • Web Site Development
  • Feasibility Studies
  • HIPAA Compliance Reviews
  • Recruiting

Vendor Performance Monitoring

We have the staff, resources and knowledge to assist our clients in improving the service levels received from its vendor partners. As your consulting partner, we serve as your advocate in proactively managing vendor partners on a day-to-day basis to ensure performance expectations are clear and measurable. If service issues arise, we directly access the proper individuals at the insurance carriers and vendors to facilitate immediate resolution. As a core ongoing service to our clients, Segal assesses vendor performance guarantees and financial penalties. Our extensive experience in the local and national marketplace provides a solid foundation to continue to “stretch” the carriers for continuously improving performance metrics.

We ensure that all carriers have standard sets of performance guarantees that they will offer based on our clients’ size and type of plan. We have negotiated implementation, account management, customer service and claims management standards with vendors and can help you design overall satisfaction standards where the “pass or fail” determination is based only on your opinion, not the vendors.

Overall, there are several guiding principles we employ in creating performance guarantees:

  • Be wary of the vendors' standard performance guarantees, they are typically easy for them to attain
  • Understand if the standards are measured based on your business or an overall book-of-business. For example, many vendors will offer you claim office or call center guarantees based on the overall office performance, not your plan. All performance guarantees should be specific to your plan’s performance.
  • Review the guarantees offered every year at renewal, and make sure they are still relevant to your needs. Vendors will rarely update these without prompting, and you should make sure that any at-risk money are in areas that are most important to your plan based on the prior year's performance and issues that you are facing now, not years ago when the plan was put in place.