BENEFITS 2025 CAPABILITIES
www.yatesins.com
Executive Summary Our Company Client Management Data Analytics Compliance and Legislation Employee Engagement Meet The Team
YATES STORY Dan Yates Jr. and Alan Yates Sr. formed Yates Insurance Agency in 1949. Yates LLC remains independently owned and has grown to become one of the largest independently owned agencies in the Southeast. All of the current stockholders of Yates are employees of the company, and there are no shares held by any outside investors. Today, our staff has grown to over 150 associates and is one of the largest privately held agencies in the Southeast. Yates represents the past, present, and future. It's all about relationships to us, because we believe those relationships are what build future opportunities. We're focused on our network and strong and quick response. Our commitment is unmatched. As our agency continues to grow and mature, we remain committed to the same principles shared by Dan & Alan Yates over 50 years ago: "We are going to look after our clients and prospects needs like they are our own, and our goal each day is to do our best."
Executive Summary
Tailored Solutions 1 Yates does not rely on standardized packages, we will take the time to understand your business’s unique needs and offer customized benefit solutions that align with your goals and budget. Yates has been extremely successful in establishing new client relationships in this turbulent environment given our unique value proposition. Our success comes from our ability to deliver the right combination of people, size, financial strength, expertise, marketing, and resources that add real value to our clients’ risk management processes. Our formula for success is straightforward: Personalized Attention You will work directly with decision-makers who prioritize your company. You won’t get passed from one department to another. Your broker is invested in your success and can be counted on for consistent, hands-on support. Deeper Client Relationships We strive for long-term partnerships. This translates to proactive service, ongoing support, and flexibility as your company evolves—not just during renewal periods but throughout the year. 2 3
Quick Response & Agility At Yates, we are more nimble and can quickly respond to changes in legislation, market conditions, or your workforce. You won’t need to wait for corporate protocols or red tape to address important matters. 4
Commitment to Your Business Every client counts. This means we are truly invested in your business’s well-being and in helping you attract and retain top talent through strategic benefit offerings. 5 Yates possesses the necessary expertise, wide range of services, track record of success, and innovative solutions to effectively manage your benefit programs. Throughout this presentation, we will provide you with a comprehensive understanding of our unique approach and resources. Our objective is to demonstrate why we are the ideal partner for you.
Client Services Structure
Account Management
Your Account Management team plays a critical role in fostering long-term relationships with clients, acting as the primary point of contact for all benefits-related needs. They provide consultative support by collaborating with their clients to better understand each client’s unique needs. The Yates team is dedicated to helping both the clients and their employees navigate claims and resolve any concerns that may arise. They will provide hands on support to resolve all claim or billing discrepancies.
Vendor Management
Vendor Management focuses on maintaining strong relationships with partner carriers to oversee the quality of services provided, ensuring that they deliver as promised to our clients. We work to negotiate the best possible terms and secure competitive rates, ensuring that clients get the highest value for their benefits investment.
Data Analytics and Reporting
Yates will gather and analyze data to provide valuable insights into employee usage patterns, claims, and overall plan effectiveness. By identifying trends, we will provide actionable recommendations to optimize benefits offerings while managing costs. Will also provide customized reports (more in reporting section).
Compliance and Regulatory
Yates will ensure that all benefit plans remain up-to-date with current laws and regulations such as the ACA, HIPAA, and ERISA. Your team will provide guidance on how to stay compliant, helping avoid costly penalties by proactively identifying changes in legislation that could impact their benefits offerings.
Enrollment and Communications Yates will assist in clear and concise communication during Open Enrollment and throughout the plan year. We will focus on benefit program education and will employ benefits technology to streamline the process.
Client Management Approach
Strategic Planning
Assessment Cost management Benchmarking
Financial Management
Financial analysis Health Program review Funding Alternatives Modeling
Competitive Bidding Implementation Management Vendor performance Vendor Management
7
Renewal Management
Vendor negotiations Plan design Modeling Contribution Strategies Budget Development
Client Management Approach
Phase 1
Phase 2
Strategic Planning
Current Program Analysis
Collect and review SPDs, contracts, employee communication materials, historical claims experience, utilization and other important information. Benchmark plan designs, employee contributions and total cost. Discuss cost analysis and financial forecasting for the current program Review wellness offerings, disease management and employee engagement
Understand current and desired employee benefit program intentions Determine how the benefit program objectives align with your corporate strategy Assist in designing a responsible benefit program to protect your employees Evaluate current market trends and incorporate all strategies into ta three-year action plan Create performance metrics to ensure success
Phase 3
Phase 4
Strategic Planning
Action Plan
Renewal pricing, analysis and negotiation Financial and plan design analysis Monthly/quarterly claims experience Plan benchmarking Quarterly program reviews Compliance and ACA guidance HR Assistance Service calendar Monthly newsletter
Vendor Management Employee/Employer communications
Claim assistance and resolution Eligibility management support Compliance Updates Employer/Employee Education Programs designed to provide resources for making wise healthcare choices Updates on benefit trends and product innovation
Marketing
We are confident in our process and will guarantee a seamless experience from strategy development through to open enrollment. Our approach will secure the best coverage for your needs, keep costs under control, and significantly enhance employee satisfaction.
Discovery & Strategy We will discuss and to understand your specific needs, goals, and budget for coverage options. Then we will analyze the current benefits package and identify areas for improvement or enhancement to align with client goals (e.g., cost savings, employee satisfaction, comprehensive care). Develop RFP & Vendor Negotiation Yates will develop a detailed Request for Proposal (RFP) outlining coverage requirements, goals, and key performance metrics. We will negotiate terms with carriers to secure competitive pricing, better benefits, and additional perks (e.g., wellness programs, telemedicine). Vendor & Plan Design Selections Yates will evaluate vendor proposals based on coverage options, pricing, service levels, and reputation and negotiate to secure competitive pricing, better benefits, and additional perks. We will then partner with our client to discuss and finalize vendor selection. Contract, Implementation & Communications Yates will review and analyze contracts to ensure all terms and conditions are favorable and clear. We will coordinate with vendors to ensure smooth implementation of the chosen benefits. We will provide employees with easy-to- understand information about their coverage options and changes for the upcoming year.
Discovery & Strategy
Develop RFPs & Vendor Negotiation
Vendor & Plan Design Selections
Contracts, Implementation & Communication
Open Enrollment
New Plan Year
Negotiating and Managing Contracts
When negotiating medical contracts, we take a strategic, data-driven approach that leverages both our financial modeling capabilities and underwriting experience. Our goal is to secure the best possible outcomes for our clients, balancing cost and plan integrity.
Yates will begin the renewal process with a financial analysis that will help us develop a financial projection and determine our targets. This is based on cost drivers and utilization.
Financial Analysis
Leverage Underwriting Experience
The Yates team’s carrier and underwriting experience plays a critical role in negotiating contracts that are financially sound and tailored to your unique needs. We draw on our experience working with insurance carriers to evaluate risk.
Using the insights gained from our financial models and underwriting expertise, we work with the with insurance carriers to negotiate your contracts based on our analysis helping us secure favorable renewals and the best possible deal for you. Our ability to understand the carrier’s underwriting practices allows us to negotiate in a way that gets us the best possible contract terms. As part of the negotiation process, we also focus on the overall plan design and how it impacts the cost. We will have up front discussions to determine whether plan design adjustments need to be made as a strategy to manage plan utilization or to reduce premiums. Additionally, we explore cost-containment strategies like wellness initiatives, care management programs, and disease management services. Rate caps or guarantees for Medical can be valuable in budgeting in planning for future years and create stability for employees. However, for pharmacy contracts we recommend a one-year contract. Pharmacy and drug trends are changing rapidly and a multi-year agreement may lock you into pricing or terms that no longer align with the current industry changes.
Negotiate
Evaluate Plan Design & Cost Containment Strategies
Durational Approach
5
Reporting
Effective employee benefits programs require regular reporting to ensure they remain aligned with organizational goals and employee needs.
Monthly
Monthly reporting typically focuses on key metrics Enrollment figures
Claims activity Plan utilization
These reports provide a snapshot of how the benefits are being used.
Quarterly
Quarterly reports offer deeper insights, including trends in claims costs, employee feedback, and any adjustments that may be needed to improve plan performance. These reports often include benchmarking data to compare the organization's benefits offering against industry standards.
Annual
These report serve as the foundation for any necessary adjustments to the program for the following year, such as plan design changes, cost-saving initiatives, or wellness program enhancements. Regular reporting at these intervals ensures continuous optimization and helps keep the benefits program efficient, cost- effective, and aligned with both employee needs and organizational goals.
Annual reporting is a comprehensive review of the entire benefits program, analyzing: Cost trends Utilization Chronic disease management Plan performance Compliance with regulations Employee satisfaction
In medical benchmarking, the ongoing metrics shared with clients to keep them informed can vary based on the specific focus of the benchmarking initiative (e.g., clinical outcomes, operational efficiency, patient satisfaction). However, the following are some common categories of metrics that are typically tracked and reported to clients: Benchmarking
Benchmark Data Our benchmarking approach combines data from our in-house clients, who voluntarily provide information about their health plans, with a variety of national benchmarking data. The health analytics platform we utilize also provides robust benchmarking in real time. We place a strong emphasis on national benchmarking studies, as this enables us to offer more comprehensive and detailed metrics to our clients across the country. Benchmark Timing Benchmarking can be provided on either a quarterly or annual basis. However, depending on the metrics being evaluated, it is often more meaningful to review certain items annually, as those metrics are typically updated on an annual basis. While
Benchmarking Metrix
Cost Trends
Analyze the cost of premiums and out of pocket expenses. Compare costs to similar sized employer groups Quarterly or Annually
Cost per Employee
Track total cost per employee Contribution arrangements HSA funding Quarterly or Annually
quarterly data can be useful, the full value of some benchmarks is realized with an annual review.
Enrollment/Participation Trends Enrollments by plan and benefit Monthly or Quarterly
Claims Data
Compare Medical and Rx claims month to month Overall spend and the split between Medical/Pharmacy Monthly, Quarterly and Annually
Health & Wellness Programs
Review Gaps in Care, Preventive Care, Chronic Disease Management Quarterly
Compliance & Legislation From compliance to communication, we will provide a full spectrum of solutions for our clients. We understand the challenges today’s employers face, and we know you’re asked to take on more than ever before. We offer attorney-reviewed resources to help you stay in compliance. We also partner with trusted outside counsel to address legal issues, which allows us to bring in specialized expertise and diverse perspectives on complex matters. This approach ensures we have access to a broader range of legal insights and up-to-date industry knowledge, providing you with the most comprehensive and effective solutions for your employee benefits needs.
COMPLIANCE BULLETINS
The Compliance Bulletins provide timely, essential information on the latest legal updates. These newsletters cover a variety of legislative topics, including health care law and federal agency health and safety standards.
NEWSLETTERS
Remaining informed on a variety of legislation and trending industry topics is easy with our regular newsletters. These newsletters feature concise summaries of rule changes and other topics to help you catch up with the latest information.
EMPLOYER EDUCATION
We offer thousands of employer-facing materials to help you navigate a wide range of topics. Our resources include deadlines, training and comprehensive HR compliance overviews. These tools are designed to help you stay informed and ensure your benefits program remains compliant with the latest requirements.
We provide a variety of trackers and checklists to help you stay on top of compliance requirements. The goal is to simplify the process, ensuring that you meet all necessary deadlines and regulatory standards, from plan design to reporting and documentation. COMPLIANCE TOOLS
Compliance & Legislation
HEALTH CARE REFORM
Health care legislation is a primary concern for employers. We offer a wide range of resources to help navigate the ACA regulations and requirements such as the Employer Mandate, reporting obligations, and coverage standards. We will keep you up to date with the constantly evolving regulatory landscape and ensure your benefits programs remain compliant.
FMLA COMPLIANCE
Complying with the Family Medical Leave Act (FMLA) is an important responsibility for HR and benefit managers. We have easy-to-understand informational materials and forms you need to administer FMLA within the law.
COBRA COMPLIANCE
Administering the Consolidated Omnibus Budget Reconciliation Act (COBRA) is another vital HR responsibility. Access numerous employer- and employee-facing educational pieces, as well as model forms and notices to help you remain compliant. Over the past few years, the Department of Labor (DOL) has ramped up its enforcement of federal laws, such as the Fair Labor Standards Act (FLSA). Attorney-created resources can help you learn about DOL compliance obligations and make sure you are following all of the rules. DOL COMPLIANCE
HIPAA COMPLIANCE
Plan sponsors know the importance of complying with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and HIPAA Privacy and Security regulations, but sometimes the implications of those laws on a business can be unclear. We can help you understand HIPAA laws and stay current with updates, as well as make administration easier with notices and forms.
Benefits Technology
Technology Evaluation and Selection 1 Assist clients in assessing their current systems and ensuring the best partner for benefits administration software is in place based on their business needs, size, and budget. Yates plays a crucial role in helping you navigate the complexities of benefits administration technology. With our expertise, we will ensure your business selects, implements, and optimizes the right technology to streamline processes, ensure compliance, and improve the overall benefits experience for both the HR teams and employees.
Implementation Support
2
We assist clients from initial setup and integration with other HR systems, as well as help customize your current technology platform to ensure the plans align with your organizational objectives.
Optimization and Process Improvement Analyze the system’s performance and recommend process improvements, automation, and optimizations to enhance efficiency and reduce administrative burden. 3
Vendor Management Manage vendor relationships to ensure their technology systems are integrated with your benefits providers. Advise on and facilitate integrations between the benefits platform such as payroll to streamline data flow and reduce manual data entry. Employee Engagement & Communication Help implement features within the technology that improve employee engagement, such as self-service portals, mobile access, and personalized benefits communication tools. 5 4
Open Enrollment
We prioritize client support during Open Enrollment. We will help you make sure employees have all the details they need to make the best benefits choices. Before enrollment starts, we create customized communication materials that take into account the unique needs of your employees. We are flexible and add a personal touch because we know how important open enrollment is for everyone involved.
Effective pre-enrollment communication sets the foundation for a successful open enrollment period. The flyers, videos and brochures help ensure employees are aware of upcoming deadlines and help them make informed decisions. Customized Pre-Enrollment Communications:
Face-to-Face Meetings
Face-to-face meetings create a unified platform where employees can engage in discussions, receive clear explanations, direct access to answer any benefits question and address any concerns in real-time. Employees feel more confident in making informed decisions and understanding of the benefits available to them. Personalized email campaigns, brochures, and digital content designed to inform employees about upcoming changes, benefits options, and key deadlines. Education & Communications Ensuring each client receives dedicated, responsive support throughout the entire enrollment period, with your team readily available to address questions or concerns in real time. Focused Attention
Employee Communication
QR CODE FLYERS
BENEFIT GUIDES
CUSTOMIZED VIDEOS for consistent messaging
POSTCARDS
Supporting our Clients
Yates will support employees by offering guidance and advocacy, and involve the carrier when the situation requires their direct intervention or when there are complexities that need carrier-specific resolution. Our goal is to ensure a smooth and positive experience for employees while minimizing the burden on your internal team. All of the support for HR and your employees are handled by your local support team.
Initial Support If an employee has a claim issue, our team will assist them in understanding the benefits process, review their claim details, and help identify where the issue may have occurred (e.g., billing errors, eligibility concerns, missing information). We would correct the issue or provide guidance on how to file an appeal or resolve any issues internally.
Escalation & Education
Tracking & Follow-up
If the issue cannot be resolved or if further intervention is needed (e.g., a claim denial, incorrect payment, or delays), we would escalate the matter to the carrier on behalf of the employee. We will see this situation through until claim is resolved. We will provide the member with additional updates throughout the process and final education if needed based on the situation.
We track and report back all open and closed claim issues with the HR team. We monitor claim issues to see if there are trends with a specific vendor or if additional member education is needed for the entire membership.
Employee Education & Engagement through the Plan Year
Effective communication and engagement around medical benefits are critical not just during open enrollment to ensure employees fully understand and appreciate their healthcare benefits. The complexity of medical benefits can often overwhelm employees, leading to confusion or disengagement, which can impact their overall satisfaction and healthcare outcomes. We promote employee engagement and education by providing clear, client specific communication strategies that help employees navigate their benefits with confidence. By sending ongoing education throughout the year, the goal is to drive better health outcomes, optimize plan utilization, and ultimately enhance both employee well-being and plan success.
We collaborate with our clients s to design wellness programs that aligns with the culture of their workforce. This can include on-site health screenings, fitness challenges, mental health resources, and access to health coaching. We ensure these programs are seamlessly integrated with the overall benefits plan to encourage participation and engagement. Wellness
Customized Wellness Programs
We will work with you to design a wellness program that meets the culture of your workforces. All programs are seamless and integrated.
Mental Health
Mental Health is a critical component of wellbeing. We can incorporate EAPs, counseling service and stress management.
Point Solutions
Through data, we can help you identify condition specific solutions, such as diabetes, hypertension or musculoskeletal.
Preventive Services
Educating and promoting preventive services reduce the need for costly interventions later.
Rewards | Incentives
Wellness incentives such as discounts on premiums or account contributions for completing health goals help drive engagement and participation.
Tools and Resources
We can help you integrate tools and apps to promote healthy lifestyle choices. These can be paired with other services.
Employee Education & Advocacy
Employee Communications
Provide your employees with all the tools they need to succeed during open enrollment season, including benefits elections forms, flyers, presentations and emails.
Customized Videos
Our advanced Flipping Book technology enhances the capabilities of PDFs. With this technology, we can transform enrollment materials, analytics, and other PDF content into an interactive HTML5 flipbook. This flipbook can be easily shared across various media platforms, such as email, website embedding, and social media. This valuable service is accessible on any device and provides an engaging experience for employees.
Advocate Services
Addressing claim problems or locating network providers may transform your HR team into a medical concierge service. Yates provides a solution with their Health Advocate Service. By authorizing Health Advocate through a single call, they can assist your employees in resolving issues with providers and insurance companies. They serve as a valuable resource in navigating healthcare decisions and ensuring accurate claim payments Advocate
Employee Retention & Enagagement
In today’s competitive job market, providing the right mix of benefits can impact employee satisfaction and engagement. We are working with our clients to find the right mix of benefit offerings to personalize their benefit package based on employee needs and demographics. There are a variety of solutions that we have packaged for our clients.
Flexible Benefit Packages
Offering flexible benefits packages can cater to the diverse needs of employees. For example, allowing employees to choose from a variety of benefits (e.g., wellness programs, pet insurance, child care assistance, or educational stipends) gives them more control over what matters most to them, which can improve loyalty. Mental health is a growing concern, and offering comprehensive mental health support—such as counseling services, stress management programs, and access to meditation apps—can significantly improve employee retention. A holistic wellness program that includes physical, mental, and financial wellness resources can show employees that you care about their overall well-being. Wellness and Mental Health Support Providing personalized recommendations based on employee demographics or life stages (e.g., new parents, retirees) can make employees feel like their benefits are directly aligned with their needs, enhancing their connection to the company. Personalized Benefits
Below are some creative strategies that can tie into your overall benefits package, wellness program or an incentive program.
Lifestyle Reimbursement Account
Work Clothes Account
Student Loan Reimbursement
Giving Savings Account
Pet Care
Allows employers to give money to employers for wellness and wellbeing expenses determined by the employer.
A Pet Care Reimbursement Accounts allows employees to be reimbursed for a variety of expenses related to caring for pets.
Allows employers to reimburse for work clothes expenses incurred by employees. Limited
Reimburses employees for student loan debt payments.
A Giving Savings Account allows employees to set aside funds for their favorite charities.
to clothes for employment.
Mergers & Acquisitions Support We support our clients through mergers and acquisitions (M&A) by helping navigate the complexities of integrating employee benefits programs.
Plan Harmonization Yates will work with our client to determine if there is a harmonization strategy. If that is the intent, we will review the steps to align the benefit programs. We will provide customized recommendations to align the programs from a plan design and financial offering. We have worked with clients to complete this in one year or through a three-year initiative. Due Diligence Yates will evaluate the benefits programs of both companies involved in the merger or acquisition to identify coverage variances, potential risk, gaps or coverage redundancies. We will analyze the benefits structure and financial implications for both employer and employees.
Communications An important part of the transition is communication and managing expectations. The Yates team will act as a liaison to address questions and concerns about the health plan changes. We will produce communications to educate on the new offerings. Compliance Yates will work with both entities to address compliance concerns that may come up ensuring a smooth transition.
Sample harmonization report from our due diligence process.
Meet the Team
“We are going to look after our clients and prospects needs like they are our own, and our goal each day is to do our best”
Bill Eissler Client Executive
AJ Cassidy
Client Executive
Bill’s primary objective is to work with his team to establish and maintain a relationship with our clients to best meet their needs. He has been in the insurance industry for the past 10 years and provides constant evaluation of current benefit offerings to control cost and risk while maintaining an industry leading benefits program. His focus is to present innovative strategies to meet the needs of our clients in an ever changing employee benefits environment.
AJ has been in the employee benefits industry for 4 years. AJ focuses on developing long-term relationships with his clients with an emphasis on exceptional service and consistent communication. His experience in the industry allows him to best advise his clients on how to properly administer their benefits program and manage employer costs, while also delivering value and competitive product offerings to their employees.
Brandie Andermann
Paige Duckworth
Senior Account Executive
Account Manager
Brandie brings 19 years of experience to the team with an extensive background in Employee Benefits program management. She is known for her strategic thinking and ability to build strong, lasting relationships based on exceptional service, results, and follow-through. Brandie has experience working on the broker side, as well as, in group medical sales, but her true passion is working directly with clients. She loves helping them create and implement strategies that are tailored to their unique needs. Her strengths include self-funded arrangements, data analytics, benchmarking, and employee engagement.
Paige started her career in the healthcare sector, focusing on medical coverage, before transitioning to the brokerage side to broaden her expertise and gain a deeper understanding of employee benefits. Over the past 6 years, she has developed a strong passion for advocating on behalf of clients. Paige finds great fulfillment in helping both employers and employees navigate the complexities of benefits, ensuring they receive the support and guidance necessary for success.
“We are going to look after our clients and prospects needs like they are our own, and our goal each day is to do our best” Thank You Contact Information
404.486.2239
BEissler@YatesIns.com
www.YatesIns.com
2800 Century Parkway NE Suite 300 Atlanta, GA 30345
Yates. All rights reserved
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