The Scioli Group is owned by Paul J. Scioli, CLU, ChFC. The Scioli Group is located in Lubbock, Texas (4412 74th Street Suite A-100, Lubbock, TX 79424). The phone number is local 806-741-1050 or toll free 877-211-1975. The Scioli Group began 24 years ago as a financial planning consulting firm. The consulting role evolved 15 years ago to include employee benefits consulting. The employee benefits consulting services include health, dental, vision; long term disability, short term disability, life as well as voluntary ancillary products. We are an independent agency licensed and appointed to do business with many insurance companies and third party administrators. Our goal consists of developing strategic plans with employers both self-funded and fully insured.
Our services, qualifications and experience include the following:
a. Appointment with many carriers and third party administrators
b. Understanding of employer sponsored insurance products
c. Complete knowledge of self-funded and fully insured plans
d. Preparation of RFP experience, knowledge and understanding
e. Experience in analyzing and evaluating group health plans
f. Experience in evaluation of cost containment
g. Out of network negotiations
h. Implementation of an in-house wellness clinic whereby claims are not run through the health plan
i. Infrastructure to provide customer support service to employees and their dependents
j. Development of project timeline
k. Strategic development around the needs/objectives of the company
l. Review and evaluation of the effectiveness of the current health insurance program
m. Evaluation of possible methods for improving cash flow and premium savings
n. TPA and Reinsurance Carrier RFP development, process, implementation and completion
· TPA interviews
· Carrier interviews
· Analyze proposals
· Prepare side by side comparisons
· Review agreements with TPA and Reinsurance Carrier
· Final negotiations and binding
Work directly with Plan Administrator and HR Department
· Quarterly or Semi-Annual Review meetings
· Review and evaluation the effectiveness of the current health insurance program
· Determine the effectiveness of self-funded vs. fully insured
· Plan design review
· Evaluate, negotiate and recommendations for
· Health
· Dental
· Vision
· EAP
· HRA, H.S.A
· Cafeteria Plans
· Group Life
· LTD, LTC, STD
· Voluntary/Worksite Products
· Coordination of employee open enrollment
· Work closely with HR Department
· Provide a web-based benefits manager program to employers. The system is called GBM (Group Benefits Management)
· No cost for employers to access
· A proven system as an extension of the HR Department and/or Benefits Administration Department
· Liaison/Advocate for employees and dependents
· Claims Issues
· ID Cards
· Network Issues
· Additions/Terminations assistance
Evaluating – The Scioli Group has experience in evaluating all aspects of a group health plan. The first area we have assisted our clients in has been the evaluation process of a TPA (Third Party Administrator) and/or Carrier. The TPA/Carrier should completely understand the expectations of their client. The key is to have a TPA/Carrier that has tremendous reporting capabilities. With the extended number of reports available, we can evaluate how a health plan is running. We can determine the weakest points of a plan design. If utilizing a TPA, it should also be evaluated on their reinsurance carrier relationships. It is critical to have a highly rated reinsurance carrier.
Negotiating – The Scioli Group will work with the negotiations of TPA contracts, reinsurance contracts or carrier contracts. In addition, The Scioli Group has the knowledge, capability and comprehension in negotiating provider contracts. During the evaluation process if it is determined that, for example, the groups’ claims cost for Mental & Nervous is unusually high in comparison to the market, The Scioli Group has the depth to negotiate with healthcare providers within your market or make plan adjustment recommendations. The key is to take advantage of your group size and political stance within the market to develop mutually healthy contracts.
Implementation – The Scioli Group will assist in all implementations for the group health, dental, vision and LTD plan. From new plan design communications to open enrollments, we believe this is a critical time to educate the employees and their dependents on “becoming good consumers of their healthcare dollars.” We believe implementation is vital in the success of the overall plan. The next area is a Third Party Administrator/Carrier/Reinsurance. It is important to match the client with a TPA/Carrier that will relate, respond and communicate well with those highly involved with the groups’ benefit plan. Once the TPA/Carrier has been determined, then the discussion of funding, payroll deductions, benefits, etc will be determined. Evaluation of self-funded vs. fully-insured will have been completed by this point.
