Service Administration Management

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					FMLA Administration, Disability Claims Management,
  Return to Work & Premier HR Service Offerings

 "During our 2008 renewal, our organization was pleased to gain a 60% savings on our basic life insurance
 rates. As well, we were able to save 12% on our long term disability coverage. This savings provided us
 dollars to outsource our FMLA processing and use those internal resources to better serve our employees."

                                           Presented by
                            Premier Insurance Management Services, Inc.
                                           July 30, 2008

Today’s Objectives

 • Understand the risks of FMLA Administration

 • Learn the value of outsourcing FMLA Administration

 • Discover why Disability Claims Management is critical for Return to
   Work success

 • Find out how you can connect with your peers and take advantage of
   HR purchasing contracts through Premier

                  FMLA Outsourcing


             Why Outsource FMLA?
             Benefits of Outsourcing & What’s the “ROI?”
             Expectations of Outsourcing
             Integrate FML administration with STD
             A Success Story


                              Why Outsource FMLA?
                 Employers biggest regulatory headaches   Complex to administer
                               9%                         Prevent abuse
                          8%                              Improve accuracy
                      8%                                  Reduce risk
                       ADA                        FMLA    Streamline reporting &
                        9%                        51%
                       Affirmative                        Integrate FML
                                                          administration with
             Source: HRNext
                                                          Disability Program


                              Benefits of Outsourcing


               Expectations of Outsourcing
                 The Carrier’s Responsibilities
             Monitor federal/state leaves
             Develop tailored, consultative implementation plan
             Explain the FML certification & approval process to the employee
             Outline the employees responsibilities, set expectations and answer any
             Review the required certified documentation, determine eligibility & calculate
             leave allotment
             Issue the required leave tracking and approval notices within timeframes
             Integrate FML & STD
             Track leave time & report
             Keep the employer and employee informed of leave status
             Verify return to work status
             Notify the employee & employer if the employee has exhausted available FML
             time or received an extension


               Expectations of Outsourcing
              The Employer’s Responsibilities
             Post notices & include in Employee handbook
             Notify employee of requirements for maintaining benefits & protection
             Advise the employee to notify The Hartford when the need for leave arises
             Determine HR & payroll process implications
             Return employee to their former position upon return from leave
             Make appeal employment decisions
             Retain fiduciary responsibility


                          A Success Story
             Clients Major Issues/Concerns Prior to Outsourcing
                Cost & time spent by supervisors, HR and legal counsel to report, track
                & administer leaves
                Out of compliance
                Granted more time than required
             Positive Results of Outsourcing
                Centralized approach to administering FMLA
                Integrated STD & FML
                Appropriate use of company resources
                Improved company’s compliance
                Reduced risks
                Consistent administration
                Dependable reporting


                              Group Benefits from The Hartford

               Disability Claims Management

            Timely Decisions
  • Claims entered into system instantaneously

           Average STD turnaround time
              • One business day with complete information
              • 85% within 10 days from initial claim report

                                Average LTD turnaround time
                                    • 5 business days

                                                 Average Speed to Answer
                                                    • 22 Seconds

                                                               Call abandonment rate
                                                                   • Less than 3%

   Initial STD Claim Workflow

             Initial LTD Claim Workflow

   Receive LTD                                        Complete
                                                                                                         Approval Letter
     Notice of                                          Claim
    Application                                      Investigation                Approval          Calculate & Pay Benefits

                                       Eligibility               Restrictions                      Periodic Review Guidelines
 Claim Components
                                      Verification               & Limitations
   Apply ERISA/                       Functionality            Essential Duties
    State Laws                          Analysis                  Analysis        Make Initial
   Policy / Plan                       Claimant                      Financial     Decision
     Analysis                          Interview                     Analysis
                                      Information             Documentation &
    DCS Input                                                                                    Team Leader / Specialist Review
                                       Requests                   Letters
    Claim File                                                                    Denial                 Denial Letter
                                  Pending the Claim          Resource Referrals
                                                                                                     Advise Appeal Rights

         Vocational Rehabilitation Case
Specialized knowledge. Specialized support.

                                          • Discusses return-to-work options and assesses
                                            employee readiness
                                          • Works collaboratively with provider, employer
                                            and employee to develop a customized return-to-
                                            work plan
                                          • Coordinates accommodations, education,
                                            training and other support including local
                                            resources and counseling to achieve Return-to-
     Vocational Rehabilitation Case         Work plan

              Premier Human Resources
                  Service Offerings

HR Product and Service Offerings

• Human Resources Networking Opportunities
   – HRConnect - Listserv
   – Annual Breakthroughs Conference

• Group Purchasing Contracts
   – Human Resources Committee
   – Human Resources Contracts
   – Other Premier contracts of interest to HR

• Premier Labor Management Offerings

• Premier Consulting Services - Partnering with healthcare
  organizations to deliver innovative solutions that make a difference in
  the communities they serve.


                             Human Resources Networking
                                and Knowledge Share

 • Join HRConnect, Premier’s Human Resources listserv, to instantly
   connect with your Premier Human Resources peers and share best
 • HRConnect is an open forum for Premier's HR members to network
   with each other - this is a free service to you as a member of the
   Premier health alliance. There are over 500 current, active members
   with daily email interaction.
 • Please send an e-mail with your name and e-mail address to to join.

Annual Breakthroughs Conference
                         Human Resources Networking and Knowledge Share

 2009 Breakthroughs Conference – June 16 – 19, 2008.
 Convention Center, Anaheim, CA. As always, no attendance fee
 A look back at the 2008 Breakthroughs Conference- Workforce Excellence Track
 Over 3000 attendees and more than 400 contracted suppliers June 10 -13 at Gaylord Opryland Resort,
     Nashville, Tennessee.
 •   Choose from nearly 83 concurrent sessions (including a Workforce Excellence track), as well as 19
     breakfast sessions and plenary sessions with Premier executives and distinguished special guests.
     The 2008 HR keynote speaker was Tom Olivo, author of Impending Crisis.

 A sampling of 2008 Human Resources track topics included:
 •   “Managing for High Performance and Retention.” – presented by Corporate Leadership Council

 •   “Creating a Magnetic Culture at your Organization: Recruiting, Engaging and Retaining Top
     Performers.” – presented by East Alabama Medical Center

 •   “Roadmap to Successful Talent Mining.” – presented by Warwick Medical and Professional Center

 •   “Creating a Lean Human Resource Department.” - presented by Charity Health Systems

 •   “On Beyond Excellence: Finding Your Unique Voice.” - presented by GNYHA

 •   “An Innovative Model for Providing Diversity and Cultural Competence Education.” – presented by
     Aurora Healthcare

Human Resources Committee History
 •   Task Force – housed under the Materials Management Committee
 •   Thirteen members – all from HR
 •   2 active contract categories
 •   Over $6 million purchasing volume in 2004
 •   Under $8 million in 2005
 •   March - Task Force becomes its own Sourcing Committee – no longer housed under
     the Materials Management Committee
 •   Thirteen members – all from HR
 •   5 active contract categories
 •   $10.8 million purchasing volume in 2006
 • Thirteen members – 12 HR, 1 clinical
 • 7 active contract categories
 • $13 million estimated purchasing volume in 2007
 • Fourteen members – 10 from HR, 2 Clinical, 2 Contracting/Materials Management
 • 7 active contract categories
 • $15 million estimated purchasing volume in 2008

Current Contracts

Background Check Services (3/01/06 - 2/28/09)
Various background checks such as criminal records and Social Security. Baseline
savings of 32-40%.
    • GS-SV-038 –, Inc. – contact Erin Maxwell 800-300-1821x184
    • GS-SV-039 – Private Eyes – contact Sandra James 925-927-3333x224
    • GS-SV-040 – Sterling Testing Systems – contract Zach Bayer 212-812-1048

Car Rental Services (11/01/05 - 10/31/08)
Nationwide member savings opportunities for your car rental needs.
Up to 25% discount – insurance coverage on business rentals.
    • PP-SS-030 – Hertz Corporation – contact Brian Burtzlaff 404-209-4269

Current Contracts (Continued)
 Executive Recruiting (2/01/08 - 1/31/11)
 Recruitment & permanent placement of executive level hospital employees. Professional fee is
 25-31% of candidates first year total compensation.
      • PP-HR-021 – Anderson & Associates, Inc. – contact Paul Betzold 704-347-0090
      • PP-HR-022 – B.E. Smith* – contact Brian Krehbiel 800-467-9117
      • PP-HR-023 – Korn/Ferry – contact Thomas Giella 312-526-0575
      • PP-HR-024 – Witt/Kiefer, Ford, Hadelman, Lloyd – contact Susan Nalepa 630-575-6109
      * B.E. Smith’s contract also includes Interim Management services.

 Moving Services (8/01/08 - 7/31/11)
 Relocation services. Up to 50% discount off service. Free replacement value protection.
     • PP-HR-025 – Atlas Van Lines, Inc. – contact Nola Leverenz
     • PP-HR-027 – Beltmann Group, Inc. – contact Lorna Jenkins
     • PP-HR-028 – Graebel Van Lines, Inc. – contact Jennifer Jacobs
     • PP-HR-029 – S & D Transfer, Inc. – contact James Mauch

Current Contracts (Continued)

Traveler Staffing (1/01/07 - 12/31/09)
Staffing for RN travelers, per diem and long term assignments. Up to 4% off list price, with the
opportunity to locally negotiate. Various value adds.
      • PP-HR-005 – AMN Healthcare, Inc. – contact Gayle Marsh 858-350-3245
      • PP-HR-006 – Elite Nursing Staffing, Inc. – contact Lisa Robitaille 573-447-4770
      • PP-HR-010 – White Glove Placement, Inc. – contact Deborah Schwartz 866-387-8100x149

Yellow Pages Advertising (1/01/07 - 12/31/09)
Puts advertising buyers and Yellow Pages print and internet publishers together cost-effectively.
2-6% discount off service. Various value adds.
     • PP-HR-001 – BVK Direct – contact Dawn Sanderson 888-214-1343
     • PP-HR-002 – DAC Group/Hutchins – contact Joyce Kanaley 585-546-6480x221
     • PP-HR-003 – The Marquette Group – contact Troy Dowell 309-677-0533
     • PP-HR-004 – TMP Directional Marketing – contact Deb Johnson 770-325-1217

Upcoming Contract Categories

 •   Service Awards/Promotional Items

 •   Employment Advertising

 •   Travel Management

                     Other Premier contracts
                          of interest to
                       Human Resources

  Employee Purchase/Discount Programs
   •   Computers
        –   Dell
              Stephanie Harrell (800-274-1550 x 728 9999)
        –   Gateway
              Chris Pulscher (800-846-2042 x 25417)
   •   Cell Phones
        –   Sprint
              James Hallock (615-484-1165)
        –   Verizon
              Denise Marcelt (843-696-4900)
   •   Paint Products
        –   The Glidden Company (ICI Paint Store)
              Bill McKnett (615-337-3138)
   •   Car Rental
        –   Hertz
              Brian Burtzlaff (404-209-4269)
   •   Maintenance, Repair and Operations
        –   Grainger
              Mark Lombardo (847-458-8027)

  Current Contracts
Fire/Life Safety/Security Systems (5/1/07 – 1/31/10)
     • PP-FA-052 – Johnson Controls, Inc. Systems & Services, America – contact Dino Coliano
     • PP-FA-053 – GE Security, Inc. – contact Kay McEwing 608-873-3422
     • PP-FA-054 – Siemens Building Technologies, Inc. – contact Melissa Monahan 734-751-
     • PP-FA-055 – Simplexgrinnell – contact Lois Ray-Paliulis 978-731-7666

Parking Management (9/01/07 – 8/31/10)
    • PP-FA-086 – Ampco System Parking – contact Daniel Huberty 713-220-8512
    • PP-FA-087 – Curbside, Inc. – contact David Ryan 978-524-0900
    • PP-FA-088 – American Valet – contact Aaron Berg 602-861-9182
    • PP-FA-089 – Lanier Parking Systems – contact Eric Williams 404-879-7697

Current Contracts (Continued)

Support Services Outsourcing (6/01/07 – 3/31/10)
    • PP-MM-021 – Crothall Services Group, Inc. – contact Duffy Hickey
Support Services Outsourcing (4/01/07 – 3/31/10)
    • PP-MM-022 – Hospital Housekeeping Systems – contact Roman Gonzalez
Support Services Outsourcing (10/01/07 – 9/30/10)
    • PP-MM-029 – Aramark Clinical Technology Services – contact Tim Alba

Systems Office Furniture (1/01/06 – 12/31/08)
    • FA001A – Haworth, Inc. – contact Wendy Burke 704-604-2440
    • FA001B – Herman Miller Inc. – contact Mary Deweerd 616-654-5349
    • FA001C – Knoll, Inc. – contact Patti Wilbourne 843-853-8888
    • FA001D – Steelcase, Inc. – contact Jeff Fredrickson 616-698-5849

Current Contracts (Continued)

Office Supplies (4/01/07 – 3/31/10)
     • PP-MM-011 – Corporate Express – contact Susan Louis 941-926-2456
     • PP-MM-012 – Office Depot – contact Jim Czajka 630-679-1649
     • PP-MM-013 – Office Max, Inc. – contact Cindy Brittain 800-741-7113

Documentation Solutions Systems, Life Enrichment Products, Education &
   Management Training, and Medical Supplies (7/01/04 – 8/31/08)
    • PP-AC-005 – Briggs Corporation – contact Spencer Thomas 865-414-1256

  Current Contracts (Continued)

Health Sciences Books and Referrences (9/01/08 – 8/31/11)
    • PP-MM-056 – J.A. Majors Company I, Ltd. – contact Nicki Carter 972-353-1191

Forms and Related Products (5/01/07 – 4/30/10)
    • PP-MM-014 – Moore Wallace North America, Inc. – contact Tom Wozniak 847-623-3037
    • PP-MM-015 – The Standard Register Company – contact John Pattinson 704-552-7001
    • PP-MM-016 – The Relizon Company – contact William Seemann 414-774-6124
    • PP-MM-017 – Officemax North America, Inc. – contact Cindy Brittain 800-741-7113
    • PP-MM-018 – International Business Solutions Alliance, LLC – contact Rodney White

                     Premier Labor Management
                       Products and Services

OperationsAdvisor™ - Improving Labor
Productivity & Supply Expenses

 OperationsAdvisor™ is a total labor management solution for productivity monitoring,
 assessment, and comparative benchmarking of performance to peers and national benchmarks.

                 Labor Management                                                  Supply Expense Management
• Key features of Labor Management solution                   • Key features of Supply Expense Management
                                                                solution (SupplyFocus™)
      Quarterly Benchmarking application with over
      470 hospitals submitting data                                    SupplyFocus™ is an embedded module within
                                                                       the Operations Advisor™ database
      Integrated Productivity Measurement tool for
      Internal productivity monitoring                                 Over 700 participating facilities
      Custom peer group capabilities at facility and                   Ability to analyze high supply cost service
      departmental levels                                              areas (e.g., operating room and pharmacy)
      Link quality/outcome indicators to productivity

OperationsAdvisor™ Offers
Robust Benchmarking                                                                                                                        Engage in

 To engage in the benchmarking process, turn to OperationsAdvisor™ Quarterly
 Benchmarking component.

  •   Large, open database with                                            FTE per CMI Adjusted Occupied Beds:
      ~470 hospitals actively submitting                          Comparison of Operations Advisor Clients to All US hospitals

      quarterly data
                                                                                5.5                                                       $9,000
                                                                                5.0                                                       $8,000
  •   Focus on facilitating the value of a                                                                                                $7,000
      benchmarking process                                                                                                                $6,000
                                                                                4.0                                                       $5,000

      – Data ties directly to source systems –                                                                                            $4,000
        avoids ‘data normalization’                                             3.0
                                                                                2.5                                                       $1,000
  •   160+ departments profiled                                                 2.0                                                       $-
                                                                                      2000      2001      2002       2003      2004

                                                                                      4.71      4.63       4.67      4.67      4.92
  •   Custom peer group capabilities at facility               US hosp median
                                                               OA clients median      4.02      3.99       4.11      3.96      4.03
      and departmental levels
                                                               Dollar impact per AOB $6,037.89 $5,611.04 $4,890.78 $6,203.76 $7,784.26

  •   Job code level detail                             US hospital data is from the 2003 Almanac of Hospital Financial and Operating Indicators

  •   Over 700 hospitals submitting supply
      expense data (SupplyFocus)
                                                            Premier maintains a client renewal rate of 94%
                                                                         with its products.

Premier Performance Partners™
Change Agents for Improvement

 Premier’s Performance Partner program is an on-going program of consultation designed to
 empower hospitals and health systems in the evaluation, development, and installation of
 innovative and improved systems for providing high-quality, cost-effective patient care.

                                                                Performance Partners Enable Sustained

                                                                  Coach Executives and Department Managers
                                                                  on best practices within Labor Management
                                                                  Coordinate the implementation of routine (bi-
                                                                  weekly) productivity reporting
                                                                  Use comparative data to evaluate / create
                                                                  effective departmental labor targets
                                                                  Establish comprehensive Position Control
               Premier Performance                                processes
                    Partners                                      Facilitate/Support performance improvement
    Premier’s Performance Partners deliver significant            projects
    results. Facilities with programs average 3.84
    FTE/AOB, while those without average 4.39

                       Source: Operations Advisor 4Q2006 data

                           Premier Consulting Solutions

                              A different approach to consulting


                               Labor Management Strategy

                               Comparative Assessments

                               Labor Standards Development

                               Focused Reviews

The difference is found in the results

                               Improved performance

                               Increased efficiency

                                Enhanced revenue cycle

                               Widespread collaboration
                               across your facility

Recent Project Results

Spartanburg Regional Healthcare System

• Project Focus: Labor and process improvement, revenue
  cycle, physician office staffing, new hospital staffing

• Objectives
   – Refine staffing levels
   – Improve revenue cycle operations

• Result: $9.9M in annual margin impact approved

Recent Project Results

West Jefferson Medical Center

• Project Focus: Financial Improvement Plan for Bond
  Insurers, Administration and Board of Directors

• Objectives
   – Meet Bond Insurer financial guidelines regarding cash flow
   – Establish operating model that is financially sustainable and will
     enable WJMC to continue meeting community need

• Result: $11.2 M in annual margin impact approved

Contacts for Premier HR Service Offerings

 • Allison Golding (858-509-6583), HR Committee Director - HR
   Committee/HR Networking related questions.

 • Beth Randolph (704-733-5791), Contract Management - HR contract
   related questions.

 • Becky Harrison (706-625-9029) Region Director - Any Premier contract
   related questions.

 • Kevin Fahsholtz (704-733-2318), Product Director, Operations Advisor.

 • Barton Gill (940-367-4361), Principal, Premier Consulting Services.

                      Questions & Answers

Contact Us

  For more information on Premier Insurance Management
  Services and our insurance offerings, please contact us:

   2. Premier Solution Center       877.777.1552

                   Visit our website at


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