M5 MGMT APPROVAL TO IMPLMENT

Question 1

WHY DOES SENIOR MGMT NEED TO REVIEW THIS??

Answer 1

1. Ensures proper oversight
2. Allows a different perspective
3. Gets buy in and support of management team
4. Allows for program refinement
5. Sets in motion program implementation and communication

Question 2

HOW DO YOU CREATE A BUSINESS CASE???

Answer 2

1. State the benefits strategy link to business strategy
   Why r we doing this??
2. Discovery Results
   Share results of gap analysis
3. What are our goals
4. What are our key measures?
   What are potential outcomes?
5. What are our recommendations?
6. What are next steps and our timeline?

Question 3

WHAT ARE THE FIVE STEPS TO PRESENTING A BUSINESS CASE??

Answer 3

1. HOOK - why is this important?
2. RISK - if we don’t do this, this is what could happen
3. Solutions - stick to big points for big key solutions link to business strategy

4. R - recommendations 
    A - Actions
     I - Information 
     S - Steps
     E - Elaboration 

Points

5. Conclusion/ Call to action and Thank you!
   We need a decision by this date or this will happen

Question 4

HOW TO IMPLEMENT THE PLAN

Answer 4

1. Develop and test systems modifications
2. Communicate data to vendors/Carriers

DOCUMENT ALL ACTIONS

3. Determine change Management Strategy and brief managers
4. Develop Employee Communication plan
5. Conduct enrollments - how? Paper? Online?? Self service?
6. What about administration? Set up the structure, confirm requirements, develop manuals and guidelines

Question 5

CAN YOU ISE TECHNOLOGY??

To do what???

Answer 5

1. Access information? Change personal data?
2. Change beneficiary?
3. Health Risk Appraisals
4. Disease management

Question 6

WHAT ARE THE 10 ESSENTIAL FUNCTIONAL AREAS FOR SELF INSURED PLANS??

1. Enrollment
2. Claims processing
3. Communication
4. Utilization review
5. Case Management
6. Loss Prevention and control

Answer 6

7. PLAN DESIGN AND RE-design
8. LEGAL SERVICES
9. CLAIMS REVIEW PROCESS (w/final approval by employer)
10. COBRA administration and processing