Response to
Request for Proposal for Employee Benefits Insurance
July 16 th , 2024
Presented by:
6001 River Road, Suite 401 INSURANCE RISK MANAGEMENT
EMPLOYEE BENEFITS SURETY BONDS Columbus, Georgia 31904 706.571.0093
Introductory Statement
July 16 th , 2024
Carla Martin Human Resources Director Columbus Hospice Inc. 7020 Moon Road Columbus, Georgia 31909
Dear Carla:
We are extremely pleased to have the opportunity to discuss your insurance brokerage relationship and employee benefits insurance needs. The combination of market uncertainty and rising insurance costs concerns has driven many companies to review their options, and in many cases change brokers. 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: Our ownership structure, business model and culture are unique to the insurance brokerage business, which affords us a distinct and sustainable competitive advantage in our market. Consequently, we attract and retain the very best technical professionals in our business that are accountable, passionate, and committed to achieving the best results for our clients on a continuous basis. As a result, we have one of the industry’s leading client retention rates which is the ultimate measure of success in our business.
Dedicated, experienced professionals who understand your business operating in a unique, healthy, and energetic environment produce extraordinary results. We would very much like the opportunity to demonstrate our commitment to your company.
Throughout this document, we will illustrate the many value points and distinct
differences that make Yates a great partner for Columbus Hospice.
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Broker/Consultant Overview 1. Please describe the ownership structure of your firm.
• Yates LLC is 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. 2. Please share a mission statement or a similar statement of purpose that will help us better understand your firm. • Yates was founded on the basic principles of knowledge, service and tradition. We are committed to the highest standard of excellence in everything we do, and believe in growing and respecting the relationship with each client and carrier. Our firm believes strongly in sustaining a highly ethical, moral and caring culture. We strive to be the premier insurance agency in the market, and our goal each day is to do our best.
3. What is the total approximate number of employee benefits clients you serve? • Yates is proud to serve over 250 employee benefits clients of many different sizes in a wide variety of industries.
4. How many companies of similar size to our firm do you serve?
• We currently serve approximately 25 groups of similar size to Columbus Hospice.
5. How many companies in our industry (non-profit and for profit) do you serve?
• Yates currently partners with many different groups in the healthcare industry. We would be glad to provide references for some of these similar companies upon request.
6. Are there any financial or legal concerns with your firm we should be aware of?
• Yates has no financial or legal concerns to disclose. It is also important to note that our firm currently operates with no debt.
7. Please confirm you agree to full transparency of commissions and other payments from carriers.
• Our agency agrees to full transparency of commissions and to disclose any and all compensation received for services.
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8. Please list your E&O insurance carrier, coverage amount and policy termination date. • Carrier – Great American E&S Insurance Co. • Limit - $10M • Expiration Date – 3/1/2025 9. Are there any Carriers in our market(s) that you do not have access to? • No. Yates is not restricted in access to any carriers in the life and health insurance market. 10. Please name the carriers you currently have a relationship with. • We currently have relationships with many different medical and ancillary carriers. Below is a partial list of carriers that we have strong partnerships with and work closely together on a consistent basis: • Medical o Aetna | Anthem | Cigna | UnitedHealthcare | Allstate • Ancillary o MetLife | Principal | Guardian | Humana | SunLife | Aflac | Unum | Mutual of Omaha | Transamerica | The Hartford | Lincoln Financial | One America | The Standard
And others…
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Employer Service Model 11. Please provide an overview of your service model for customers of our size.
• Yates sits down with our clients to talk about their needs; how Yates’s capabilities can address each of these needs; then creates a written service plan, with the client at the table, which clearly lays out the service commitments and value added objectives. • We believe that the client should depend heavily on its insurance broker for advice, counsel, and service. This requires a close relationship based on continuity of people and familiarity with your needs. Columbus Hospice is extremely conscious of the cost of risk; therefore, the program should be structured in such a way to consistently achieve the best results.
12. Tell us about the team that would serve our company. (Names/titles/tenure in industry/tenure with company/tenure in role and physical work location of each team member)
• Bill Woolfolk | Managing Partner; Columbus, GA Bill serves as the principal contact for the client. He manages all facets of service team activities and works directly with customers to ensure satisfactory results. Bill graduated from the University of Georgia in 1974 Cum Laude with a degree in business. He started his insurance career in 1974. • Charlie McDaniel | Client Executive – Employee Benefits; Columbus, GA Charlie has been in the employee benefits industry for 15 years. He initially started his career as an independent life & health insurance agent prior to joining Yates as a client executive on the employee benefits team in 2020. Charlie 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. • Billy Eissler | Client Executive - Employee Benefits; Atlanta, GA Billy’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. • Resa Carter | Senior Account Manager – Employee Benefits; Columbus, GA Resa has worked in the employee benefits industry for 20+ years bringing a wealth of knowledge and experience to her clients and their employees. Resa has established strong and long-standing relationships with her client’s human resources department – supplementing daily tasks of benefits administration, claims resolution and overall employee benefits-related support. Resa also manages each of her client’s annual renewal, marketing efforts, implementation of benefits and further employee education.
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• Leigh Drawdy | Senior Account Manager – Employee Benefits; Columbus, GA Leigh is a Senior Benefits Account Manager with Yates, LLC. She is an extremely detail-oriented, solutions-driven employee with 32 years of experience in the employee benefits industry. Leigh specializes in HR assistance and benefits administration with a primary focus on customer service and claims resolution. 13. Please provide a calendar or list of planned service interactions you recommend in the course of a year for a client of our size. • Yates provides clients with an implementation guide, as well as a 12-month compliance calendar to assist with necessary responsibilities and timelines. This information is provided upon initial engagement of the client. In addition, our clients will have access to monthly newsletters through Benefit Insights, which will provide an overview of any changes or updates in the employee benefits landscape. This includes helpful information on matters surrounding: o HR o Compliance o FMLA o COBRA o Affordability and ACA news o Etc. 14. What quality control processes or auditing do you perform to assure quality of your brokerage and consulting work? • Yates will conduct a comprehensive review of our clients overall performance and experience, and will collect surveys to help obtain important feedback. Quality control processes and assessment include: o Monitoring renewal outcomes o Ensuring renewals are received timely o Hosting annual meetings as necessary and on time o Open enrollment meetings o Employee surveys to determine overall satisfaction of employee benefits program
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Employee Service Model 15. What services do you handle on employees’ behalf vs requiring our company or carriers to handle? • Rather than refer employees directly to a carrier to address their needs, our team prefers to work directly with the member in order to ensure that their needs are met in an accurate and efficient manner. Yates takes a hands on approach, working with your employees to resolve all benefit related questions, such as coverage details, claims, EOB’s, benefit changes due to life events, etc. 16. Do you provide employees with claims assistance at initial claim? At appeal? • Our clients have dedicated claims advocates on staff that assist employees with all claim related items from the date a claim is initiated, all the way up until it is satisfied by the carrier. In the event of an appeal, we will continue to support all members during the process, acting on their behalf with the insurance company and provider to satisfy all issues surrounding an appeal. 17. Do you provide regular employee advocacy to include assisting employees with claims substantiation, RX claims support, medical claims support, dental and vision claims support, assistance with the employer sponsored life insurance and LTD claims? • Yes, Yates has an outstanding service team with many years of experience working with employers and individuals to properly support all matters in regards to claims for the lines of coverage mentioned. We work directly with our clients from the initial filing of the claim, through communications with the carrier, all the way up until claims are properly satisfied and paid. 18. Do you provide in-person employee advocacy? • Our agency will certainly provide in-person advocacy and assistance for any individual in need of personalized service for all insurance related matters. Yates local service team conducts many in- person meetings with clients on-site, as well ensuring our office is available to employees on an individual basis.
19. Do you offer any 800 phone line or other number for employees to contact you? What types of issues do you assist with?
• Yates has a dedicated and direct line for employees and their families to assist with any general/specific questions or issues that may arise. Our experienced and knowledgeable team is willing to advise on all aspects of your companies insurance program, including but not limited to: o Enrollment Assistance o Claims o Benefits and Coverage Questions o Access to Care
o Rx and Pharmacy o EOB Assistance o Network and Provider Access o HSA/HRA/FSA Support o COBRA Facilitation
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o Benefits and Coverage Questions o Medicare Guidance o And more…
20. What ongoing education and communication for employees do you offer during the course of the year? • Effective and consistent employee communication is a key aspect of our role as a broker, and significantly important to the employees of any company. Lack of communication can create confusion and disinterest in the benefits available to them as a member of your organization. With all of the tools available for communication today, there are endless opportunities to provide employees with timely and accurate information regarding their benefits program. Our team will work with you to educate employees regularly on:
o Benefits covered under their health plan o Wellness initiatives and engagement o Cost-sharing requirements and reimbursement arrangements o Provider networks and physician access o Cost of services and how to reduce their health care spend o Calculation of benefits and employee responsibility o HSA/HRA education • Types of communication include: o Email
o Videos o Intranet o Newsletter/Bulletin board postings o Town hall meetings o Company-wide meetings o One-on-one meetings with employees
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Compliance 21. Does your company have a compliance officer or other compliance leader?
• Chris Purvis is the compliance officer for Yates LLC. Contact information may be provided upon request.
22. What specific compliance resources will our company have access to? • Our firm provides hands-on consulting and guidance for all compliance and HR matters. In addition, we provide every client direct access to our Zywave Client Cloud at no cost. The Zywave Client Cloud offers all the tools and content needed to solve unique pain points, along with the day-to- day concerns of HR and Compliance. We also have a preferred partnership with iSolved Benefit Services to integrate and simplify all items associated with ERISA, COBRA, FMLA and Cafeteria Plans. 23. What is your process for helping us ensure we are compliant with all state (GA and AL) and federal regulations? • Yates currently has employees on staff with ACA certifications to assist with all matters related to ensuring your compliance with state and federal regulations. In addition, we have relationships with many TPA’s that assist us in compliance regulations and mandates. All clients of Yates will also be provided with a 12 month compliance calendar based off of their renewal date. We also have an ERISA attorney on retainer.
24. Will your team prepare and file the annual Form 5500? If so, is there an additional cost to Columbus Hospice associated with this service?
• Yes, all of our clients over 100 employees will have access to the guidance and assistance from Yates in preparation of their annual 5500 filing. All schedule A’s will be collected and reported in a timely manner by the date they are due based on the effective date of benefits. Yates currently provides this service at no cost to our clients.
25. Will your team assist with annual ACA filings and compliance, PCORI and RxDC reporting? If so, is there an additional cost to Columbus Hospice associated with this service?
• Yates will work together with your administrative team to ensure that all of these items are properly addressed and satisfied prior to carrier and government deadlines. Whether it be primary aspects of ACA standards and compliance, PCORI fees and form 720 filing, or RxDC reporting annually for carriers submitting information to CMS on behalf of the group, our team will work with you directly at no additional cost or direct billed fee for service.
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Enrollment and Communication 26. Describe your Enrollment and Communication approach.
• Yates understands the importance of being proactive and timely in regards to open enrollment, new hire enrollment, and having well established methods of communication. Our team works closely with our clients to accommodate their preferences and timeline for assisting employees with enrollment requirements, plan communications, plan changes and updates when applicable, etc. We also will provide a complete and detailed benefit guide for all eligible employees with the necessary plan details and carrier information, along with employee advocacy contacts and required legal notices. Our benefits team always makes themselves available for in-person meetings for a hands on approach, giving employees peace of mind and the ease of decision making with complete support from our organization. • It’s important to balance technological channels with in-person communication. While being available for in-person meetings are always a priority, the use of technology in enrollments creates many efficiencies in gathering election and required carrier data, as well as housing a library of resources for employees to access 24/7. Our agency holds its own license with Employee Navigator, an advanced but user-friendly benefit administration system that has a great deal of communication resources within its software. Utilizing the communication preferences in your company/employee’s profile, we can easily share all necessary enrollment and plan communications as needed. This streamlined technology service greatly assists in our ability to communicate directly with your employees either individually or as a whole. 27. Will you present multiple in-person, on-site Open Enrollment sessions? If so, what are your limitations on number of sessions and times of sessions – (are you open to presenting sessions outside of the normal 8:00 – 5:00 work day – i.e. starting at 7:00 am or having meetings that extend to 7:00 pm)? • Our team is committed to making themselves available for in-person meetings during open enrollment with no limitations. We would work closely with your group to attend sessions during the dates/times that will best accommodate Columbus Hospice.
28. What technology or technologies do you use to communicate with and enroll employees?
• For Benefits Administration, we implement Employee Navigator at no cost. This system integrates with all carriers and will automatically feed demographic information, enrollment elections, and terminations to each carrier. This creates efficiencies and accuracies for the employer and employee, all while streamlining the process. It will service as the primary system of record for the group, where open enrollment, new hire enrollment, qualifying life event management, etc. will be administered. As mentioned previously, we also implement Zywave and prefer iSolved Benefit Services to further the data integration.
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29. Describe what role your team will assume in coordinating with the Paycom (HRIS) system in planning, programing, and premium changes.
• Our benefits organization has years of experience coordinating services and working directly with payroll vendors on behalf of our clients to ensure the accuracy of election and premium data as changes occur. We are committed to open lines of communication with these administrators to help with all deduction information, data file requirements, vendor specific form or file completion, and integration services if desired or applicable.
30. Will your company build and print the Benefit Guide for annual open enrollment? If so, is there an additional fee to Columbus Hospice for this product?
• Yates has a Benefits Technical Coordinator on staff that builds both digital and PDF versions of our client’s annual open enrollment benefit guides. We customize all of these guides to our clients’ specifications, and will provide high quality printed guides upon request. These services would be available to Columbus Hospice at no cost. 31. What enrollment and communication services does your firm handle and what do you outsource to carriers or other vendors? • Our firm believes that communication during enrollment and throughout the year is key in the maintenance and service of all of our clients. For enrollment and related items, we rely heavily on the use of our license with Employee Navigator and our internal team to communicate: o Onboarding information o New hire enrollments
o Enrollment windows/deadlines o Carrier forms/ID card distribution o Evidence of insurability requirements and status of open requests o Life event changes outside of the renewal period o Class/structure updates o Premium changes o Etc. • We partner with vendors and work with your employees to administer: o COBRA related notices and requirements o HSA administration o HRA submissions/reimbursements o FSA/Dependent care FSA o POP/ERISA wrap documents 32. How do you handle employee on-site meetings?
• Our team will work closely with you to develop an understanding of the scheduling, processes, and time required to reach all employees either as a group or on a one-on-one basis. During on-site meetings, we make sure to provide employees with all of the necessary benefit and plan information needed for them to make informed benefit decisions, while also being conscious of their time as a professional with your organization.
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33. Do you help employees with one on one decision support at time of enrollment?
• Yes, at Yates we believe very strongly in employee assistance and recommendation of plan options that best meet the needs of each individual person and their families. We also understand that in the ever-changing industry of health insurance, employees look to their benefits advisors now more than ever for advice. We acknowledge that each employees needs are different and will vary greatly from person to person, and we take great pride in our ability to work alongside employees to help them make the best coverage decisions based on their personal needs and individual situation.
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Health Plan Cost Management 34. Describe your experience assessing and implementing self-insured options.
• For any clients that have at least 100 eligible employees, Yates will conduct a feasibility study to determine if self-insured options are appropriate. The results of this study and collection of data. This will apply to any employees currently in or seeking a self-insured option or captive arrangement. This includes the collection and assessment of the prior 36 months: o Claims data (medical and Rx) o Prior renewals o Enrollment and plan participation • Additional items to explore in regards to implementation or assessment of a self-insured program include: o Actuarial risk assessment o Premiums vs. claims o Incurred but not reported o PBM management o Etc.
35. Please provide examples of how you have helped your customers manage and/or reduce healthcare costs.
• Cost management strategies will vary depending on their size and resources. Yates works with each client directly to ensure appropriate measures are taken to manage and reduce spend. Traditionally, we
will analyze and explore changes/updates to: o Deductibles/reimbursement arrangements o OOP o Copays o Co-insurance
• For larger employers (over 100 eligible), options to reduce spend can include strategies to address: o Disease management o Wellness programs o Network accessibility o Direct primary care o Rx spend and assistance programs
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36. What is your approach to the process for managing prescription drug costs? • Managing prescription drug cost is significantly dependent on your current funding arrangement. o Fully insured While there are many positives to being fully insured you are ultimately at the mercy of the insurance carriers in regards to your contracts and Rx spend. Typically, drug formularies that are offered by the BUCA’s (BlueCross, United, Cigna, and Aetna) are significantly limited. • Rarely do you see RX claims denied unless it is experimental or specialty. o In the event a drug is denied we will work with the carrier to get the medication approved. • How does this happen? o Providing proper documentation form the provider that the Rx is medically necessary. o Documentation that a generic or brand name does not provide the same medical effectiveness. o Self-insured If you are self-insured (not level-funded) you will be working directly with a PBM who will manage your formulary and provide details in regards to your Rx spend. Under this platform the broker and client would take on a larger responsibility to manage the RX cost.
• Rebates • AWP’s • Carve outs • Outsourcing • Copay assistance
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Wellness 37. Describe how you incorporate wellness initiatives into your overall plan designs.
• There are many different ways to incorporate wellness into your company’s benefits program and plan designs. Our team will help determine appropriate plan alterations by either making small adjustments to cater to employee specific needs, or in some cases implementing an entirely new program. Some of the items that we use and study to create wellness initiatives include: o Monitoring employee needs and interest o Conducting screening events o Health education and promotion activities
o Health risk assessments o On-site medical clinics o Measuring and managing employee fatigue o Activities to relieve employee stress 38. What resources does your company have to assist with wellness initiatives?
• Yates partners with many third party wellness companies, whether it be directly with a carrier or a third party administrator that we implement for our clients. Working with these groups gives us access to the following resources: o Wellness coordinators o On-site screenings o Health fairs o Reward programs 39. What steps do you take to help a company assess potential for implementation of wellness initiatives? • We encourage the use of surveys, focus groups and health risk assessments to learn more about the health status and interest areas of your employees. We work with our clients to determine the areas of interest and level of anticipated engagement from your employees to help decide the different forms of wellness programs and initiatives best suited for their company. • Areas of focus include disease prevention, fitness, smoking cessation, alcohol and substance abuse counseling, nutrition education, weight loss and stress management, etc. To encourage employee engagement, your program must fit what they perceive to be a need in order to address their willingness to participate.
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40. What other educational seminars related to benefits, Medicare planning, and/or Social Security planning are you prepared to offer? • As a full-service brokerage firm, we are capable of offering custom tailored educational information to all types of employees and industry. Some of the resources we utilize to promote these programs include: o Open enrollment meetings o Brainshark – AI educational videos on current benefit offerings o Mid-year benefits review – Host virtual or in-person meetings to discuss any issues, roadblocks or pain points that employees are facing with their current benefit plans. • Yates has designated Medicare specialists on hand to assist employees and their families in navigating the complexities of Medicare and the transition from private insurance into Medicare eligibility. Some of the pieces of Medicare our team can assist with include: o Providing guidance on types of Medicare and their specific coverages o Supplemental/gap plan options o Part D prescription drug coverage questions o Questionnaire assistance o Coordination of coverage with other insurance/primary vs. secondary payer
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Why Choose Your Firm? 41. Please provide a brief summary of why we should choose your firm.
Yates history of providing personalized and innovative service to our clients spans over 100 years. In July 2006, two of Georgia's oldest insurance agencies, The Yates Agency (established in 1949) and The Woolfolk Agency (established in 1896) merged based on a shared principle of offering custom programs managed by world-class talent. Today, our staff has grown to over 150 associates and is one of the largest privately held agencies in the Southeast.
Yates was founded on the basic principles of knowledge, service and tradition:
We are committed to the highest standard of excellence in everything we do. We believe in fostering and respecting the relationship with each client and carrier, and we promise to make a recognizable difference to our clients' businesses through innovative insurance solutions. We believe in sustaining a highly ethical, moral and caring culture. We strive to be the premier insurance brokerage firm in the markets we serve. Our philosophy for offering first-class client service begins with recruiting, attracting, and investing in the best and brightest talent. We believe in empowering our employees with the abilities to exercise their skills, and we are committed both to being a great place to work and to offering unmatched client service. As a privately held firm, our principals and the executives handling your account have a vested interest in developing and maintaining long-term relationships with clients such as Columbus Hospice. 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.”
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