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I I I I I I I I I I I I 1 I I I I I I 1 I I I I I I I I I I I I Step 2- Review and Analyze (cont.) <)¡. Provider usage in versus out of network Inpatient surgery claims Outpatient surgery claims Emergency room visits Office visits Mental health usage Claims by major diagnostic category Lifestyle related claims Disease management and intervention opportunities Co-morbidity management and intervention opportunities Identify necessary areas for wellness education : 1. ~i\. ::\ <"l C :1. ,J,. ,,;¡. ;.~ , .,. ,ì Section 125 - Flexible Spending Account noting specifically, cè. Identify areas where plan can be utilized <.\. Analysis savings versus expense of implementation ~;~ Identify expected savings for City as well as employees ~ i~ Savings versus exposure to City to open plan to all areas versus premium only Step 3 - Analysis, Recommendations and Implementation ; :!l. Current administrative obligations/liabilities Contractual obligations/liabilities Opportunities for reduction in fixed costs Efficiencies of administration Vendor fees / commissions Compliance violations Claims utilization data report Benchmarking data Implement HR software site and train staff Plan of action to meet long range goals Recommended plan design changes Model plan design changes to provide cost differentials Section 125 recommendations, implementation and employee education Implement employee website and provide education materials and meetings Ongoing wellness and consumerism education to employees c .\. . , -.' ,~ '"" , '0 ,!.. .. ,... - , ,.... ~..l (~ ~1. ; 1 ;:1. c,:>' ',.. , ... " . . , ..-.-'-, '.ò . -.- -...... G~ (;RIZZAFFI DARny BeMli, Desit" and .\I""agt""'" ~P¿ ': *;i ;"t ~ ~~ Zf:' .:?"'.-iT."" ~ ~~:!~,~:s~~ ~~iã.~ !ë~ ,. ~ ~~~~ ~ ~~ ~ ~':"~'J':!\'!!~~r:r~~ ~~E':;2;.. J