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Executive Summary

GBS is an insurance claim technology organization headquartered in Springfield, Missouri; and is one of the most respected providers of employee benefit management services in the region. We have a variety of resources to provide a premier quality of employee benefit services helping to deliver what plans want most – improved savings, optimal quality, and positive member experience.

Our focus is to assist Plan Sponsors in developing employee benefit programs that yield very specific achievable goals. During the process of developing a benefit program, we also design an administrative package around the Plan Sponsor, leveraging our technology and other resources to save your Plan time, effort, and liability, all of which result in substantial savings to the Plan and greater member experience.

We assemble a team of experienced staff specifically for your project. Our company has outlined below some of the key points to consider when moving towards positive clinical and financial outcomes through an ongoing evolution of your program. It is also imperative that you know we are here to assist your organization and employees to meet the challenges ahead.

1. Improved Savings

GBS understands that making the right plan choices for employee benefits can significantly reduce plan spending while maintaining high quality of care. For this reason, we incorporate a Policy Performance Strategy (PPS), which covers many facets of your organization’s employee benefit program including plan design, contractual nuances, disease management, drug spend, reporting practices of the affiliated carriers, and measuring your program with others alike around the U.S. to ensure your plan is competitive and meets the needs of your company. Further, our flexible suite of administrative solutions allows our clients to incorporate unique programs and strategies that suit their specific objectives and needs of their members.

2. Progressive Plan Design Options

GBS has experience and expertise in plan design development and management for diverse clients, which gives our company the flexibility to design and administer numerous employee benefit management programs and services to meet any organization’s unique needs while supporting the development of a strong and long-term relationship.

Our progressive plan design could help your organization uniquely respond to the ongoing economically challenging times. We can develop new and effective approaches by:

1) lowering the amount of potentially large claims,
2) helping employees make good clinical and financial decisions,
3) reducing overall health care costs, and
4) building a complete administrative package to streamline your entire processes.


The following are some “key” points in designing your employee benefit program:


Medical:

Þ High Performance Medical Plan Design – strongly incentivizes the users of lower cost alternatives by providing access to high quality medical outreach and educational programs through URAC accredited informed care programs along with life saving and cost-effective disease management that monitors plan members with a potential of high cost events including the number of persons presently on your high dollar listing.

Þ Multi-Option Plan Offerings – offer a variety of options for the plan members to choose from in order to meet their specific needs, and assists them in maintaining and/or lowering overall plan costs.

Þ Health Savings Account (HSA) Programs – introducing this type of plan as a viable option for employees give them the opportunity to further educate themselves and make good healthcare choices.

Þ Funding Options – provide a variety of funding options for better cash flow results based on your group size, and tools available from a variety of sources to increase financial outcomes and lower costs.

Þ Healthcare Reform – plan review can assist your organization in determining what laws are affecting you, and how to structure the employee benefit plan and administration in order to meet critical compliance deadlines.


Pharmacy Benefit Management:

Þ High Performance Formulary Design – strongly incentivizes the use of lower cost generics and preferred brands.

Þ Generous Generics Design – strongly incentivizes the use of more cost-effective generics.

Þ Evidence-Based Plan Design or Valued-Based Plan Design – a condition management strategy that removes cost barriers to care for medications proven to provide better health outcomes.

Þ Preferred Pharmacy Choice Design – directs members to mail services and retail pharmacies that can save them and your plan more money.


Utilization Management:

Utilization Management strategy focuses on three (3) fundamental elements: Treatment, Medication Safety and Appropriateness, and Chronic Condition Management.

Þ Medication and Treatment Safety – GBS believes in a comprehensive approach to medication and treatment safety over the entire course of members’ treatment and drug therapy. For instance, Utilization or Disease Management Plan provides members access to the best treatments and facilities for positive resolution and proper maintenance of their conditions as well as yielding savings to your medical and drug plans.

Þ Medication Appropriateness – GBS directly works with the Utilization Management and Prescription Benefit Plan (PBM) firms to ensure the right treatment is prescribed at the right dose and at the right time—reducing unnecessary drug cost and waste, while empowering your members to better manage their chronic conditions.

Þ Chronic Condition Management – GBS directly works with the Utilization Management and PBM to ensure chronic and potential chronic users of the plan make sound decisions towards proper condition management, which includes good drug therapy.


Adherence:

GBS understands that adherence to appropriate therapy is a primary factor in managing members’ health and reducing long-term costs, and we make medication adherence a cornerstone of our plan member educational programs.

Our company develops a program to provide adherence support wherever members choose to access different levels of the healthcare program that we will work with you to create.

Þ Research-based – develop messaging methods for more effective communications through extensive consumer and industry responses.

Þ Multi-channel Accessibility – reaches out with adherence counseling whenever a member enters the system with a new prescription and/or through different access points of healthcare by employing Utilization Management strategies at various points of healthcare.

Þ Coordinated – connects to various touch points for members to receive consistent messaging to help modify their behaviors, improve health outcomes, and save money through unique consumer engagement.

Þ Continual Adherence – members receive refill reminders (letters, IVR, Web) and non-adherent prompts (letters and phone calls) as well as invitations to implement automatic refills and prescription renewals.

Þ Prescriber-inclusive – Pharmacy Benefit Manager (PBM) alerts prescribers whose patients dropped off their therapy or who have gaps in medical care.


3.
Comprehensive Specialty Drug Management

Specialty pharmacy costs now exceed 10 percent of total pharmacy spend, and this trend continues to grow. In this economy, your organization can control drug spend by utilizing the expertise and innovative solutions we provide through the PBM. A comprehensive specialty guideline management program can help prevent off-guideline utilization, reduce waste, and ensure therapy effectiveness by using exclusive networks, which include pick-up specialty pharmaceuticals at certain pharmacies or directly at members’ home. In addition, it provides patients courtesy call prior to shipment of specialty pharmaceuticals to ascertain the quality of drugs the patients have on hand, which also helps to avoid waste. A solid specialty drug strategy can largely improve your savings in specific drug categories by reducing waste and inappropriate drug treatment strategies.


4.
Enhancing the Member Experience

Customer Care

Þ GBS is proud to have the ability to provide the best possible experiences for members, and our Customer Care Representatives (CCRs) are not only trained to do much more than answer phones and respond to inquiries but also empowered to function as member advocates by promoting healthy choices and helping members identify appropriate cost-savings options. They act as liaisons for each member to various components of the employee benefit program.

Þ Our CCRs further provide our clients with industry-leading support for all member inquiries via telephone, e-mail, Web, and written correspondence. They have online access to the information they need to service all inquiries regarding claims, utilization review assistance, and access to case managers for medical and pharmacy services as well as assistance in finding various networks locations to use in your program.


Delivering Quality Service to Our Valued Clients

Þ Account Management

Your GBS account team will provide the right combination of capabilities and expertise to help achieve the lowest overall costs and assist your organization gain the most engaged members. From efficient implementation through on-going plan support, our company can help reduce your costs and improve members’ health outcomes. Our consultative services play a major role in the support of your strategic objectives for managing your employee benefit trends. Our expertise and experienced business partner professionals in health care research, benefits consulting, and information technology will work directly with your organization to establish a specific strategy based on benefit priorities.

Moreover, your account team will be responsible for developing, implementing, and maintaining a strategic business plan; overseeing performance, managing the implementation of new products and/or groups; and providing various consultation services to review the overall effectiveness of the program. They will also be accountable for your organization complete satisfaction with our services.


The GBS Difference

GBS has built the infrastructure to provide a fully integrated range of solutions to the employee benefit management problems faced by employers today, and we can tailor our programs and services according to your company’s specific needs and expectations.

Our goal is to provide not only an excellent service to our clients, but also achieve the best cost-saving programs the employers need for their plan members. Our programs and services aim to empower you and your members by designing the best plan possible for your group size and provide the tools you need to join us in making smarter and more economical health care decisions.

GBS customizes employee benefit programs based on the organizations’ specific needs, which gives us the opportunity to offer variety of plan solutions for any group size. We are proud to be one of the most respected providers of employee benefit management services in the region, as well as having numerous resources to ensure we give you a premier quality of services. We have a team of experienced staff for specific projects to meet the healthcare challenges today.

Our customized plan programs not only help your organization lower the amount of potentially large claims, help employees make good clinical and financial decisions, and reduce overall health care costs but also give you a complete administrative package to streamline your entire processes.

GBS looks forward to helping your organization secure the industry’s best practices and adapt to a rapidly changing medical and pharmaceutical landscape. We can provide the significant difference that you seek in an employee benefits Third Party Administrator, and we would be honored to work with your organizational needs. Simply click on the following link to allow us to prepare a detailed proposal for your orgnaization. "Request for Proposal"

 

 

 

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