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ESC’s Staffing Specific Administrative Platform (SSAP)For over 10 years Essential StaffCARE has offered a Staffing Specific Administrative Platform (SSAP). The Affordable Care Act (ACA) hascaused staffing firms to look at their benefits and existing processes from a different reference point. SSAP allows a staffing firm to have an“Audit Log” for ACA, which specifically creates their processes and integration of systems appropriate for ACA. Employees also now haveACA responsibilities. SSAP can help with these processes as well. The overall Audit Log process can vary for each firm.ESC Experience11 years ago, we pioneered our “Staffing Specific Administrative Platform”which is the foundation for new tools such as the ACA Audit Log.1. ESCExperience2. ACA CostEvaluation Tools6. ACACompliantACA Products & EnrollmentHelps communicate approved ACA products and helps employeesenroll in their ACA approved plans.ESC’s Staffing SpecificAdministrative PlatformSSAP5. ACAAudit Log4. AdministrativeToolsACA Cost Evaluation ToolsACA decisions are not just based on numbers, SSAP has different evaluationtools to assist staffing firms in making a multi-year strategy for benefits.3. ACA Products& EnrollmentAdministrative ToolsOnce ACA decisions are made, you need optional tools to support your company.SSAP’s web-based tools are available to help integrate with your existing processes.ACA Audit LogHelps solve a staffing firm’s key ACA related issues that include: estimating cost strategies,consistent process for variable hour support, the look-back rule, and IRS reports.RESULT: ACA CompliantESC’s SSAP and Audit Log will support you with a consistent processthat can help you eliminate ACA penalties and save time.2
ESC’s Administrative PlatformIAG/Essential StaffCAREBlueCross BlueShield of SC (BCBSSC) Exclusive BCBSSC Staffing Industry PartnerEquifax Strategic Partner1500 Staffing ClientsInc 500/5000 America’s Fastest Growing Private Company for 5 yearsAward Winning Member of National Association of Health UnderwritersProduct Design, Implementation, & Communication Specialists1 of only 2 A.M. Best A (Superior) Rated in the US#2 IBM-Rated Data Center in the US (Top 2.5% in the world)48 Technology Acquisitions Across the USAdministers Various Back-Office Functions for 21 Blue PlansAcross the US TriCARE (US Military) & Medicare Part D Admin ContractsESC’s StaffingSpecificAdministrativePlatform (SSAP)PAI/Division of BCBSSCBCS BCS Financial is owned by all primary BlueCross andBlueShield licensees Over 60 years of experience in expanding protection BCS Insurance Company Rated A- (Excellent) by A.M. Best Licensed to provide insurance solutions in all 50 statesPremier Third Party Administrator (TPA)BCBS Major Accounts managementSAS-70 CertifiedAward winning customer service advocatesBest-in-class COBRA services3
Facts & Figures At-A-GlanceLeader In The Staffing Industry: Over 1,500 staffing companies offering ESCOver 2 million enrollment forms processed annually96% customer satisfaction rate98% client retention rate988% higher enrollment compared to all previous plansoffered by our staffing clients Up to 58% higher retention for employees enrolled inour medical plan New ACA related products for the staffing industrySuperior Plan Administration: 798,300 claims processed in 2014 95.8% of claims processed within 14 days 12 claims per 100 members, on average (demonstrateshigh usability of our plan) 99.23% financial accuracy 24 seconds is the average speed of call answer 100% more outpatient coverage on average, which isthe most utilized part of the plan by employees 2% of enrollees exceed the ESC outpatient limit 779,000 calls received per year 2.4% call abandonment rate 97.3% first call resolution (successfully handledemployee’s reason for calling) 100% of COBRA enrollments processed within 2 days 100% accuracy on COBRA payment processing4
Achievements and AwardsASA Corporate PartnerASA has multi-year corporate partnerships with: Essential StaffCARE, AkkenCloud, CareerBuilder, Inavero, Monster, People 2.0, andWorld Wide Specialty Programs. These partnerships go well beyond traditional sponsorships—they involve mutual commitments tolong-term working relationships focused on advancing the interests and meeting the needs of ASA members and the staffing industry.The National Association of Health UnderwritersENT PRTION & AFFORDCERTIFIEDARE AC TLE CPAT IECABOTThe National Association of Health Underwriters represents more than 100,000 licensed health insurance agents, brokers, consultants,and benefit professionals through more than 200 chapters across America. Members agree to abide by NAHU’s code of ethics, whichrequires them to always make health care coverage recommendations with the customer’s best interest in mind.NAHU ACA CertificationCertifies expertise in the provisions and implementation of health reform. ACA Certified NAHU members understand the key technicalcomponents of PPACA and are better prepared to counsel their clients on upcoming required healthcare changes and new options andrequirements for health plan.NAHU Soaring Eagle AwardThe highest honor given by the Leading Producers Round Table to recognize National Association of Health Underwriters members whohave “achieved the greatest success in demonstrating exceptional professional knowledge and outstanding client services.”NAHU Golden Eagle AwardThe National Association of Health Underwriters has presented the Golden Eagle Award, which acknowledges outstanding leadership inthe health insurance industry.MDRT Top of the Table MemberMDRT, The Premier Association of Financial Professionals, is an international, independent association of more than 38,000 of theworld’s leading life insurance and financial services professionals from more than 450 companies in 74 countries. MDRT membersdemonstrate exceptional professional knowledge, strict ethical conduct and outstanding client service. MDRT’s Top of the Table is anexclusive forum for the world’s most successful life insurance and financial services professionals.Inc. MagazineInc. Magazine announced its 34th annual Inc. 500/5000 ranking of the fastest growing private companies in the United States withInsurance Applications Group Inc., the developer and exclusive marketer of ESC, as the leading health insurance and benefits programfor the staffing industry. This is the sixth year Insurance Applications Group Inc. has been recognized by Inc. Magazine.5
Staffing Companies Offering ESC6
Support of Staffing AssociationsEssential StaffCARE is one of only seven corporate partners of the American Staffing Association. This is the highest level of financialsupport to benefit the association, its members, and the staffing industry. Essential StaffCARE is a member and supporter of numerousregional staffing industry associations and trade organizations. American Staffing Association (ASA) – Corporate PartnerVirginia Staffing Association (VSA)South Carolina Staffing Association (SCSA)Wisconsin Association of Staffing Services (WASS)Ohio Staffing and Search Association (OSSA)Minnesota Recruiting and Staffing Association (MNRSA)California Staffing Professionals (CSP)Colorado Staffing Association (CSA)Georgia Staffing Association (GSA)Nevada Staffing Association (NSA)AnserteamTempNetIllinois Search & Staffing Association (ISSA)Florida Staffing Association (FSA)Mid Atlantic Staffing Association (MASA)Texas Association of Staffing (TAS)Capital Area Staffing Association (CASA)Tennessee Staffing Association (TSA)North Carolina Association of Staffing Professionals (NCASP)Executive Forum7
Integrated PartnershipsOur Partners are companies who have been fully integrated with Essential StaffCARE’s proprietary file feed process. If you are using one ofthe listed companies for your payroll processing or back-office software, you can get started with Essential StaffCARE’s ACA Compliant andVoluntary Plans for your temporary employees today. AdvanceCOATsAviontéTricom FundingSterling National BankBridgewareBondTempworks SoftwareSkilMatchEfficient HireApplied Systems TechnologyCarvin SoftwareAkken CloudEquifaxEfficiency Improvement Platform8
What They’re Saying – Staffing AssociationsAmerican Staffing Association “Essential StaffCARE has established itself over many years as an important partner, supporter, and advocate of theAmerican Staffing Association, its members, and the millions of temporary and contract workers they employ each year.”– Richard Wahlquist, President of ASANorth Carolina Association of Staffing Professionals “We have enjoyed a long ongoing relationship with Essential StaffCARE and they continue to raise the bar on newproducts, market intelligence, customer service and training and development webinars. We appreciate our relationshipwith the Essential StaffCARE team and we highly recommend them to handle your health benefit needs!”– Mary Mallett, CPC, NCASP Board of DirectorsWhat They’re Saying – Integrated PartnershipsCOATs “The staff has been amazing and it has been a complete pleasure partnering with Essential StaffCARE.”– Tom Sarach, Founder COATsAvionté Staffing Software “Avionté has been partnering with Essential StaffCARE for several years and we really couldn’t have made a betterdecision. Their team understands the industry, believes in building strong partnerships with its clients and worksamazingly hard to deliver outstanding service.”– John Long, CEO Avionté Staffing SoftwareAdvance “Essential StaffCARE and Advance were a perfect fit from the start, with our shared values and the commitment toproviding exceptional client service.”– Adam Stern, President Advance9
Industry Leaders in Health Care ReformEssential StaffCARE led the way from the moment the Affordable Care Act (ACA) was passed into law in 2010, and we continue to leadthe way for the staffing industry today. We have provided “Reality Checks” to the nation on health care reform by offering free webinarsexplaining the implications of health reform annually since 2010. Uncovered previously hidden dangers and unintended consequences Thought-creatively and pro-actively while others panicked Established thought leader on effective healthcare reform solutionsDevelopment of the New ESC PlansThe graphic on the following page illustrates our methodical approach in dealing with the complexities of the constantly changing ACAhealth care reform law. This includes the establishment of the ESC ACA task force, consisting of ERISA attorneys, actuaries, underwriters,IT specialists, and communication specialists from BlueCross BlueShield, BCS Insurance Company, and Insurance Applications Group. Thishealth care reform task force ensures the compliance and ongoing viability of the ESC plans beyond 2014.ESC Products Offered: Fixed Indemnity -- Supplemental Coverage for Variable Hour and Full Time Employees Minimum Essential Coverage -- ESC MEC Wellness / Preventive ESC Bronze -- Minimum Value Major Medical Bronze Level10
ESC Framework For ACA StrategyESC’s ACA Strategy is to offer our suite of products and services to find the best coverage options and lowest net cost for Staffing Firmand your employees to solve ACA issues. Our integrated ACA strategy provides multiple products offerings including Fixed Indemnity,MEC, Bronze or Exchange plans to employees in order to minimize employer tax issues. Combined with ESC’s Fixed Indemnity Plan, thissolution provides ACA compliance while helping offset these high deductible plans with first dollar claims coverage.Bronze With Employer ContributionFixedIndemnity Plan(FIP)MEC Wellness/PreventivePlanESCBronze60%Minimizes theemployee’s out ofpocket expensesand high deductiblesinherent in bothBronze and ExchangePlans.ACA-Compliantplan offered to allemployees with zerocost to Staffing Firm;eliminates (A) Tax.If enrolled, coversemployee individualmandate.Offer ACA-Compliant60% Major Medicalplan to FT employees.No participationrequirements & FullyInsuredWhich Option?Offer ACA Compliant Plan to FT Employees No (A) or (B) TaxEliminates Option of Subsidy for EmployeeConfirmed “Offer” by MailCovers Individual Mandate, If EnrolledLow Employee EnrollmentEmployee Pays 9.5% of SalaryBronze With NO Employer ContributionOffer ACA Compliant Plan ALL Employees No (A) Tax, But (B) Tax Needs To Be Managed Employees Can Still Access Subsidies atExchanges Covers Individual Mandate, If Enrolled Lower Employee Enrollment All Premium is Paid By Employee11
Importance of Fixed Indemnity PlansAccording to the Department of Labor (DOL): “Fixed indemnity coverage under a group health plan meeting the conditions outlined inthe Departments’ regulations is an excepted benefit under PHS Act section 2791(c)(3)(B), ERISA section 733(c)(3)(B), and Code section9832(c)(3)(B). As such, it is exempt from the health coverage requirements of title XXVII of the PHS Act, part 7 of ERISA, and chapter 100of the Code.”ESC Fixed Indemnity Plans Help Employees Who Need Help The Most: Those who cannot afford the high premiums, deductibles and co-pays that accompany traditional“Major Medical” health insurance plans either offered by an employer or obtained from an exchange. Covers 84% to 95% of the average employee’s annual medical expenses.* No deductible, no co-pay, first day coverage, includes one of the largest national PPO networks.More Importantly, Our Fixed Indemnity Plans: Are “excepted” benefits and therefore protected from constantly changing and disruptive ACA policies. Do not interfere with an employee’s ability to receive valuable ACA subsidies. Provide first dollar benefits that cover the majority of an employee’s day-to-day medical needs.ESC Fixed Indemnity is the foundation for all our product offerings to employees.*Source: Milliman Distribution of Health Care Expenses Brief (brief commissioned by IAG for Essential StaffCARE)12
Our Indemnity PlansHow Our Plans Were Created: Used sophisticated claims modeling software for the Staffing Industry.Analyzed 50,000 ESC claims from 29,000 temporary employees.Offers improved coverage across many key areas, including doctor visits, surgeries, etc.Compared 23 different indemnity plans on the market, ensuring Essential StaffCARE remains the mostcompetitive. Our Preferred Risk Pool offers substantial rate discounts and benefit enhancements. Pool includesover 1,000 staffing companies representing approximately 1.5 million temporary employees.What We Included: NO DeductiblesNO Co-PaysNO Pre-Existing Limitation ClauseNO Waiting Period for Medical BenefitsBenefits for Doctor Office VisitsInpatient Surgery BenefitOutpatient Surgery BenefitDaily Room and Board Benefit13
Payroll Deduction and COBRAEssential StaffCARE is a payroll-deducted benefit plan that uses a series of weekly payroll reports to administer. Using these reports, weare able to outsource most of the administration for you. This process takes the work off of your HR and Payroll departments. To ensureprivacy, the files are transmitted through a secure HIPAA compliant process that only your company has access to. File #1: You send us a basic payroll report showing all employees who worked that specific pay period. File #2: We send you a list of employee premium deductions to load into your payroll system, based onthe enrollments, changes, and terminations that occurred that week.If an employee misses six (6) consecutive weeks of premiums, their coverage will automatically terminate and a COBRA package will bemailed to their home address. PAI handles the COBRA administration for all enrolled employees. The premium rates for COBRA coveragewill be approximately 2% higher than the original premium.In And Out Of Benefits StatusAn employee who is off assignment and is no longer receiving a paycheck, can miss a premium payment without having their benefitsenrollment canceled. If an employee comes back to work between one (1) and six (6) weeks, payroll deductions will automatically resumeand be applied on a going-forward basis (no back premiums need to be paid unless there has been a claim). If, while off assignment, anemployee files a claim then all missed premiums (up to 6 weeks) will need to be paid before the claim can be processed.14
Our Medical NetworkESC utilizes First Health Network, one of the largest and most respected networks. ESC pays the provider, and the providers, in turn, fileyour employees’ claims so employees don’t have to wait on a claim check!Our Medical Network Also Provides Access To: Over 1 million health care professional locationsOver 90,000 ancillary facilitiesMore than 5,000 hospitalsNetwork doctors who are carefully screened and selectedID Cards clearly identifying employees as a participating memberFirst Health does not outsource any of their provider contracts. They hold direct contracts and strong relationships with their providers.Visit firsthealth.coventryhealthcare.com (then click “Locate a Provider”)Enter your city into the websiteShows resultsThe First Health Networkcovers over 98% of the U.S.population who are within10 miles of a participatingnetwork physician and within20 miles of a participatingnetwork hospital.15
Sample PlansSTANDARD RX PLANSLight Industrial and Clerical Employees90% of our clients choose one of thesethree plansProfessional and TechnicalEmployeesBENEFITValue PlanPlan 1Plan 2Plan 3Plan 4Medical NetworkFirst HealthFirst HealthFirst HealthFirst HealthFirst HealthCaremarkPrescription NetworkCaremarkCaremarkCaremarkCaremarkNetwork Provider Must Accept PlanYesYesYesYesYesWellness Care (once per year) 75 100 100 100 100 2,000 2,000 3,000 4,000 5,000 400 400 600 800 1,000N/A 250 250 500 500Standard Care (per day) 300 300 500 700 800Intensive Care (per day) (paid in addition to standard care benefit) 400 400 600 800 900Skilled Nursing (per day) (for stays in a skilled nursing facility after a hospital stay) 100 100 100 100 100 2,000 2,000 2,000 2,250 3,000Physician Office Visit (per day) 55 100 100 100 100Diagnostic (Lab) (per day) 75 75 75 75 75Inpatient Hospital Benefit (require 24 hour minimum stay)Surgery (per day)Anesthesiology (per day)First Hospital Admission (1 per year)Outpatient Medical Benefit Maximum (All outpatient benefits are subject to outpatient maximum)Diagnostic (X-Ray) (per day) 150 200 200 200 200Ambulance Services (per day) 300 300 300 300 300Emergency Room Benefit - Sickness (per day) 100 200 200 200 200Emergency Room Benefit - Accident (per day) (covers treatment for off the job accidents only) 300 500 500 1,000 1,000Surgery (per day) 500 500 500 1,000 1,000Anesthesiology (per day) 200 200 200 400 400 50 50 50 50 50 600Physical Therapy, Speech Therapy, Occupational Therapy (per day)Prescription Drugs 1 (REIMBURSEMENT) (Not subject to the outpatient maximum, payable via the reimbursement method)Annual Maximum 600 600 600 600Generic Coinsurance/Co-Pay70%70%70%70%70%Brand Coinsurance/Co-Pay50%50%50%50%50% 15.98 19.98 20.91 28.50 35.78Employee Plus Child(ren) 26.54 37.96 39.73 54.15 67.98Employee Plus Spouse 30.36 33.17 34.71 47.31 59.39Employee Plus Family 40.44 50.55 52.90 72.11 90.52Weekly RatesEmployee Only1If company is sitused in CA, CO, CT, FL, ID, IN, LA, MD, MN, MO, NV, OH, RI, or UT, RX plans pays a flat 20 per day for any type of prescription drug.
ENHANCED RX PLANSLight Industrial and Clerical Employees90% of our clients choose one of thesethree plansProfessional and TechnicalEmployeesBENEFITValue PlanPlan 1Plan 2Plan 3Plan 4Medical NetworkFirst HealthFirst HealthFirst HealthFirst HealthFirst HealthCaremarkPrescription NetworkCaremarkCaremarkCaremarkCaremarkNetwork Provider Must Accept PlanYesYesYesYesYesWellness Care (once per year) 75 100 100 100 100 2,000 2,000 3,000 4,000 5,000 400 400 600 800 1,000N/A 250 250 500 500Standard Care (per day) 300 300 500 700 800Intensive Care (per day) (paid in addition to standard care benefit)
COATs Avionté . – John Long, CEO Avionté Staffing Software Advance “Essential StaffCARE and Advance were a perfect fit from the start, with our shared values and the
