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YOUR DAIMLERCHRYSLER PARTNER


 Welcome to United Group Programs, Inc.

        Your Complete Employee Benefits Solution


Providing Old-Fashioned Customer Service The Way It Should Be.




                     United Group Programs, Inc.
                  Florida ● Georgia ● Pennsylvania
                2500 North Military Trail, Suite 450
                        Boca Raton, FL 33431
                      Toll Free: (800) 842-8770
            Website: www.ugpinc.com/daimlerchrysler.html
                     E-Mail: marce@ugpinc.com
United Group Programs is Your Unique,
Single Source Benefits Provider


United Group Programs was founded in 1968 with
one major goal in mind. Simplify the administration
of health benefits for Employers and Employees.
With over 4,300 corporate clients worldwide and
thirty-seven years of experience, UGP has grown into
an organization that serves clients in every state in
the nation as well as internationally. Additionally, we
have five corporate offices where our Employees
have become a team devoted to providing customer
service that is second to none.



Our goal is to provide tools, training and motivation
to create a unified team who have the desire,
attitude, integrity, confidence and sincere
commitment to provide a partnership internally within
our organization and externally with our clients in
order to exceed their expectations. We provide
service with heart, and take responsibility and
ownership to seize every opportunity to make our
clients feel they have not only been served but also
cared for.
                                                          We will be pleased to offer you a cost-free analysis of
Because of these principles and the efforts of our        your current plan in comparison with the personalized
Employees, United Group Programs, Inc. has                options we offer. Our experience gives us the added
become one of the most prominent third party              confidence of steadfast relationships with insurers
administrators in the nation.       We possess the        and reinsurers, which leads to remarkable savings for
expertise, experience, resources, and commitment          Employers. UGP offers a host of options from fully
required for superior health benefits administration.     insured and self-funded medical and dental plans to
                                                          group life and disability insurance. Through the use
                                                          of National and Regional PPO networks, United
                                                          Group Programs, Inc. can offer Employers the plan of
Our specialization is in providing Employers with very    choice that fits with their needs and values. We also
successful alternatives to control the increasingly       specialize in executive benefit packages. In addition
high cost of providing healthcare benefits to             to Third Party Administration Services, UGP provides
Employees.       UGP’s Third Party Administration         COBRA, Cafeteria Section 125 plans and HIPAA
services are tailored in design to a particular           services to assist Employers and human resource
Employer’s benefit needs and implemented with             departments.         The result is a comprehensive
old-fashioned personal customer service and proven        benefits package that is cost effective and
administration techniques.                                stress-free.




                                                                        Your Complete Employee Benefits Solution    2
Our Goal is Customer Satisfaction
Performance Guarantee                                         Consistency and Reliability
When you choose United Group Programs, Inc. for               Using a detailed proposal developed with the client,
your Employee benefits needs, you can be assured              our specialists manage the implementation
that we will provide you with outstanding service and         of the benefit program from start to finish. Our
unmatched performance. We aim to build long-term              representatives are qualified, accessible and
relationships by keeping our promises and earning your        accommodating. Our staff consists of Employee
trust. Many of our first clients 37 years ago are still our   benefit consultants for self-funded plans and mini
clients today.                                                medical plans, in-house counsel, in-house Certified
                                                              Public Accountant, and a registered nurse. You can
                                                              count on our specialists to know what needs to be
                                                              done and how to do it efficiently.



                                                              24 Hour Claims Processing Policy
                                                              Our efficiency begins with our 24-hour claim
                                                              processing.     Our staff proactively solves claims
                                                              problems immediately and effectively, with as little
                                                              client or human resources involvement as possible.
                                                              For example, a claims processor may contact the
                                                              provider directly if a statement of account, rather than
                                                              a bill, is received, saving time for the human
                                                              resources department.



                                                              Reinsurer Negotiation Policy

Creating Memorable First Impressions                          UGP's approach is not to “shop” the Employee
                                                              benefits reinsurance as others do. Our approach is to
At United Group Programs, Inc., we realize that making        negotiate with qualified and stable “A” rated
a change in your insurance plan seems to be a difficult       Reinsurers with professionalism. With our 37 years of
decision to make. However, difficult decisions must be        experience we are able to negotiate the most
made for your company to run efficiently and prosper.         advantageous Aggregate and Specific Stop Loss
For this reason we offer a cost-free analysis of your         Reinsurance contracts for our clients, providing us
current benefit plan versus those alternatives offered by     with an advantage over our competition.
UGP. This analysis consists of benefit plan design
review, viability of self-funding, and a review of
disability and life insurance policies for adverse
limitations and appropriateness.       When Employers
select a program through UGP, we take that decision
very seriously. As such, we want our new clients to
experience a smooth and comfortable transition.
Therefore, we offer reliable and consistent consultation
with Employers’ Human Resource and Risk
Management Departments.




                                                                             Your Complete Employee Benefits Solution    3
Our Proactive Organization
                                                              Registered Nurse
Internal Organization                                         Our in-house Registered Nurse is available in her
                                                              capacity for our clients when needed.
As a Third Party Administrator, we are proactive. While
we are free to meet for consultation at any given time,
we request informal meetings each quarter, allowing
discussion of secular trends in the industry, claims
experience (including actual and potential shock
losses), proposed changes in legislation, the
interpretation of Employee benefits legislation, and
possible utilization abuse. At the conclusion of the
meeting, we will discuss the client’s alternatives,
renewal options, as well as important Human Resource
and Risk Management issues.

Integrated Claims Administration
UGP provides an integrated claims system to
streamline administration of multiple benefit programs
in a managed care environment. Our clients enjoy
enhanced data integrity and the most efficient claims
operations available. We have built in the flexibility and
adaptability we need to handle unique client
requirements. Our commitment to service excellence
                                                              Benefit Plan Design and Review
creates timely and accurate claims administrative
                                                              Whether your plan is fully insured or self-funded the
services for our clients.
                                                              design of your plan is crucial in affecting your costs.
                                                              United Group Programs, Inc. provides a review of
Strategy and Legal Review                                     your current benefit plan to determine whether your
                                                              plan has excess and unnecessary benefits that
Upon request, our in-house counsel will work jointly
                                                              increase the cost of your plan, or limitations on
with client’s corporate counsel at no additional cost for
                                                              benefits that negatively affect the Employees and
services within the scope of his profession. Our
                                                              executives. Studies have found by offering certain
counsel will guide your company through HIPAA
                                                              benefits the Employer’s cost for health insurance
privacy issues and guidelines and advise you as to the
                                                              goes up, while those specific benefits in no way
appropriate course of action.
                                                              assist in the health of the Employee or provide a true
                                                              benefit. Due to significant increases in the cost of
Financial Reliability                                         healthcare, the implementation of Plan Design
                                                              changes now, allows Employers to save on
Our in-house Certified Public Accountant will work            healthcare costs for years to come.
jointly with our clients to address all tax law and related
issues promptly and professionally at no additional cost      We at UGP are pleased to offer you a cost-free
for services within the scope of his profession. The          analysis of your current plan in comparison with the
billing support staff is trained to work with each client’s   personalized options we offer. Our experience gives
specific accounting practices and bookkeeping needs           us the added confidence of steadfast relationships
to facilitate the production of easy to read monthly          with insurers and reinsurers, which leads to
statements, to troubleshoot any problems if they occur.       remarkable savings for Employers.




                                                                            Your Complete Employee Benefits Solution    4
Our Services
                                                            At the same time, we take the burden of keeping up
Free the Human Resource Department                          with new tax and legal legislation off of the Employer.
                                                            Our in-house counsel and Certified Public Accountant
The human resource department for any Employer              are up to date on all issues that may affect your
should be focused on core business competencies and         company’s Employee benefits programs and we make
company strategies, not on minor administrative issues.     changes where needed to assure compliance with the
                                                            new regulations.
United Group Programs Call Center provides a full
range of services and benefits to Employers. UGP has
the experience, management and staff to handle routine
                                                            Payroll Services
Employee inquiries freeing Human Resources to focus
                                                            Whether a small or medium sized business with payroll
on more important issues.
                                                            processing needs, UGP has an affordable and
Our Toll Free Call Center provides a centralized access     comprehensive payroll solution for each Employer’s
point to resolve all Employee issues. UGP’s Call Center     specific needs. UGP simplifies your payroll process.
can also be utilized for enrollment and re-enrollment.
                                                            At UGP, we directly contact the health care provider,
                                                            requesting the itemized bill by fax in order to process
                                                            the claim immediately. In this way, the claims examiner
Asking all the right questions                              proactively intercedes to insure prompt servicing of the
Our case management is an integrated process that           claim. The Employee is not confused and no time is
assesses, plans, implements, coordinates, monitors,         taken from the workday to resolve this problem.
and evaluates options and services to meet an               Therefore there are no dunning notices and no phone
individual's health needs. UGP communicates with            calls.   The plan runs smoothly for all involved,
healthcare providers and utilizes all available resources   particularly for Human Resources.
to promote a quality yet cost-effective outcome. When
approved by the client, UGP's case management
program targets individual members with catastrophic        Coordinated Billing & Carrier Invoicing -
diagnosis and/or high cost      procedures. Our case        One List Bill for Multiple Products
management team "steers" members through the
complex medical considerations to maximize the              UGP’s services allow Employers to display invoices
member’s health.                                            from multiple carriers into one consolidated report/bill.
                                                            Our billing reports can show the Employer the cost of
Getting all the right answers                               benefits for an entire organization or broken out by
                                                            location or subdivision.
Normally, when an insurance company or Third Party
Administrator (TPA) receives a claim from an Employee       By utilizing UGP’s administration services, Employers
that consists of only a statement or “balance due”, or in   reduce the time wasted in manual reconciliation
some other way incomplete, the insurance company or         of multiple invoices from multiple insurance carriers.
TPA, would return the bill to the Employee with             This immediately reduces administrative costs and
instructions that the Employee obtain the itemized bill     eliminates the human resource department’s
from the service provider. A confused Employee often        involvement in reconciling bills.
brings this problem to their supervisor, who then
                                                            Among multiple carriers offering health, dental, and
involves the Human Resources Department.
                                                            other voluntary and non-voluntary Employee benefits,
                                                            UGP not only coordinates billing, but also eligibility,
                                                            enrollment, and termination.
Unique Administration Services
Unlike most Third Party Administrators, United Group
Programs, Inc. offers a host of extra administration         Coordinated billing allows Employers to receive
services to make your company more efficient and to          monthly a single invoice from UGP and to make a
reduce your overall administration costs.                          single payment to UGP for all of the
                                                                      Employers’ insurance policies.

                                                                             Your Complete Employee Benefits Solution   5
Claims Processing
                                                        Customer Service
We strive for 100% accuracy. Our audit procedures,
training programs and system controls are designed      United Group Programs, Inc. maintains a toll-free
to accomplish this objective. Mandatory pre-payment     telephone number for the convenience of clients, plan
audits are conducted for claims that exceed             participants and healthcare providers. During normal
designated dollar amounts.                              business hours (9:00 am to 5:00 pm EST),
                                                        the participant may speak directly with the person
Our system also reprices In-Network claims in           responsible for managing the day-to-day
accordance with the negotiated fee schedules and        administrative activities of the plan. Most inquiries
contracts. Non-Network claims are subject to the        are answered accurately and immediately. There is
usual and customary fee data. When appropriate,         convenient voicemail or e-mail for after-hours
charges are negotiated to obtain maximum savings        inquiries.
for both clients and their employees.

United Group Programs, Inc. is proud that our claims    Reporting our Success
turn-around time is among the fastest in the
industry. Our system permits adjudication of many
claims within 24 hours. Electronic and paper clean      Accounting & Financial Reporting
claims that are identified for review by the built-in
controls are processed within 3 business days.          At UGP, our accounting and financial reporting systems
                                                        interface with all other administrative systems, such as
Our quick turn-around policy results in a number of     eligibility, claims, payables, and collections.       This
desirable effects:                                      integrated system allows us the flexibility to individually
                                                        define and maintain accounting procedures and
   •   Employees perceive their health plan as a        controls to meet the distinct needs of each client.
       true benefit. Thus, morale remains high.

   •   The need for calls by Employees and
                                                        Custom Client Reporting
       providers to check claim status is greatly
       reduced.                                         Timely and meaningful information is critical. UGP
                                                        furnishes certain standard reports to each client
   •   Prevention of harassment of Employees by         monthly, quarterly, and/or annually, and clients may
       providers demanding payment.                     choose from numerous other reports. Our self-funded
                                                        clients can choose to receive up to seventeen reports
Benefit checks along with detailed, easy to             ranging from a monthly enrollment census or claims
understand, explanations of benefit forms are issued    detail history report to a network discount report
to the covered Employee and/or provider, accurately     showing the discounts saved in-network for all claims
and efficiently.                                        processed.

                                                        Stop-Loss Claims Reporting
                                                        UGP maintains an experienced and dedicated Stop
                                                        Loss Department that monitors potential stop-loss
                                                        claims and files all appropriate claims with the
                                                        reinsurance carriers on behalf of clients. The efficiency
                                                        of claims submission and follow-up to assure quick
                                                        reimbursement results in a favorable financial impact to
                                                        the plan.




                                                                         Your Complete Employee Benefits Solution     6
A-Rated Management & Negotiation                          Disease Management
                                                          People are living longer lives than ever before. This is
Utilization Management                                    not because there is less disease in the world. With
                                                          today’s science and technology, people are able to
United Group Programs, Inc. works with Utilization
                                                          live with otherwise deadly diseases for many years to
Review and Case Management programs to assure
                                                          come. For an Employer, this has only been financially
quality patient care delivered in a cost-effective
                                                          possible through high-cost insurance. Now, as part of
manner.     Our integrated database and software
                                                          the Case Management Program developed by UGP,
systems allow our claims examiners, auditors and
                                                          health care costs can be decreased through proper
stop loss department to share information on a
                                                          disease management.
real-time basis.
                                                          UGP first provides all members access to information
Case Management                                           to educate themselves about their disease, thereby
                                                          providing the necessary tools for the members
80% of the health care costs come from 10% of the
                                                          to manage their own conditions.          By providing
population. Unpredictable catastrophes and poorly
                                                          information about diseases such as asthma, diabetes,
controlled serious diseases are a very large source
                                                          congestive heart failure and hepatitis C, for example,
of these costs.       At UGP, Case management
                                                          members may proactively manage their condition and
opportunities are quickly identified and aggressively
                                                          episodes in a quality manner.
pursued, by focusing on members with serious or
chronic illnesses.
                                                          Claims Negotiation
The nurse case manager works closely with
                                                          UGP has designed its programs to encourage
members, family, and physician to assess the
                                                          in-network care.       However, out-of-network care
member's health care needs and to coordinate
                                                          will occur throughout the plan year. In order to save
services. Our case        management team works to
                                                          our client healthcare dollars on care accessed
determine quality and cost-effective treatments of
                                                          out-of-network, UGP proactively negotiates the claim.
services by identification of alternative treatment
                                                          UGP has developed a proprietary database for this
plans, price negotiation, or both.
                                                          purpose. In situations where a member accesses
As an essential component for effective case              care out-of-network, UGP will negotiate discounts for
management, case managers maintain a positive,            physician and facility claims.
professional relationship with healthcare providers to
assure the patient's healthcare needs are met.

The goal is to assist the member to reach their
optimal level of wellness through high quality,
cost-effective care, while reducing potential claim and
minimizing the current claims impact and overall
costs.

Prescription Drug Management
UGP is a national leader in prescription drug
management. We offer our clients the strongest and
most aggressive prescription drug discounts and
networks across the nation.




                                                                         Your Complete Employee Benefits Solution    7
Making Life Easier & More Efficient
Eligibility & Enrollment Services                             United Group Programs, Inc. can readily provide
                                                              guidance and is prepared to assist the Employer in the
Employee enrollment plays a critical role in the success      preparation of these changes. We will also distribute
of any voluntary benefits program.                            the appropriate communication to Employees in the
                                                              form of booklet inserts or payroll stuffers.
Participant enrollment, coverage termination, and other
changes to eligibility information are made using the
unique enrollment systems process by United Group             Auditing & Subrogation
Programs, Inc. This information may also be submitted
electronically or via fax. Upon receipt, all information is   UGP takes seriously the accuracy of its performance
reviewed for plan compliance and immediately entered          on every case. Each claim is audited for errors or
into UGP's eligibility database.                              inconsistencies during the first month of the plan.
                                                              Thereafter, ongoing audits are performed based upon a
UGP provides the following services:                          random sample of claims. Additionally, all high dollar
                                                              claims (over $5,000) are audited and approved before
        One-on-one enrollment                                 being released for payment.
                                                              Quite often, bills presented for payment contain
        Group enrollment                                      charges that are inconsistent with a patient’s condition,
                                                              or they contain duplicate charges. Our staff is trained
        Enrollment by Phone
                                                              to look for these “errors” and to challenge the health
        Internet Web Enrollment                               care provider regarding suspect charges. We are often
                                                              able to reduce hospital bills by up to 25%, resulting in
        Outbound Call Enrollment                              an overall reduced claims experience for the Employer.
                                                              We also will subrogate claims as needed to protect
                                                              Employers’ or Employees’ interests. Reduction in
                                                              claims experience is paramount to the long-term goal of
Case Setup and Management                                     reducing health care costs and in preventing industry
                                                              premium increases.
        Payroll Stuffers and Communication Materials

        Employee Education
                                                              Eliminate Cookie-Cutter Benefits

        Professional Enrollment Counselors                    As a premier national Third Party Administrator (TPA),
                                                              United Group Programs, Inc. understands the need
        Employer Enrollment Reports                           for flexibility and creativity in Employee benefits
                                                              programs.       Reducing costs, therefore, requires
We specialize in enrollment customer service that             something other than a “one size fits all” approach
includes communication and education services before          to obtaining quality care at affordable prices. We
and after enrollment. These areas are quite often             evaluate every situation, create a plan design specific
overlooked. Through our proprietary and innovative            to Employer’s needs, and provide unmatchable
system, we are able to communicate to Employees               customer service to members, while assuring
exactly how a particular benefit will impact upon them        compliance with all applicable regulations and laws.
and their families.
Amendments & Modification                                     ID Cards

From time to time, you may wish to modify your Plan           United Group Programs, Inc. provides a custom ID card
Document for benefit or eligibility changes. There            for plan participants designed to assure that the
may also be times when the Employer Plan Document             healthcare providers receive the complete and current
will need to be amended or modified to comply with            information needed for quick and effective patient
legislative changes.                                          processing.




                                                                              Your Complete Employee Benefits Solution    8
Self Funded Health Plans, Dental, &
Short Term Disability Plans                                 Advantages of Self-Funding
Self-Funding is a successful alternative for Employers      The advantages of self-funding are numerous!
to control rising healthcare costs. While flexibility in
making key decisions on benefits, administration and        Flexibility in Benefits
funding, is attractive to most Employers, limiting          Most importantly, the Employer is able to develop the
liability can be problematic. Partial Self Funding / Self   flexibility it desires in making key decisions on
Insurance with Stop Loss Coverage is an attractive          benefits, administration and funding. Decisions as to
alternative for cost conscious Employers in choosing        what will be covered and what will not become easy,
an Employee benefits plan.                                  allowing the Employer to exclude certain
                                                            vaccinations, drugs, behavioral diseases such as
The goal of every insurance company in a fully              obesity or alcoholism, or infertility. The key here is
insured program is to make the most profit. This            the ability to tailor the plan to meet the specific needs
profit can reach up to 60%. Under a fully insured           and budget of the Employer.
plan, the Employer pays a fixed premium regardless
of the amount of claims paid by the insurance carrier.      Flexibility in Carriers
Annual rates are often increased based upon the
industry standard, otherwise known as “trend”, and          Another major advantage to self-funding is the
not based upon the Employer’s claims experience.            flexibility in choosing a reinsurance carrier. Unlike
                                                            fully insured plans, a shift from one carrier to another
In a self-funded or partially self-funded program,          does not affect the choice in doctors, impose waiting
everything provided in a conventionally fully insured       periods, or require the issuance of new I.D. Cards
program is duplicated in the partial self-funded plan.      and booklets.
All services provided by the insurance company in a
fully insured plan are provided in the self-funded or       Multiple Locations
partially self-funded program. The only difference is
that the Employer retains the funds used to pay             Also, for Employers with multiple locations, the same
benefit claims.                                             plan may be offered to everyone in every location with
                                                            no administrative difficulty. By Self-Funding, an
                                                            Employer can utilize one national network or multiple
                                                            local PPO networks with the same benefit plans.

                                                            Executive Benefits
                                                            Self-Funding provides the unique ability to class out
                                                            the executives to provide 100% of all of their benefits
                                                            where named executives and their families pay no
                                                            co-pays, deductibles or coinsurance.       Employers
                                                            therefore can afford to provide ultimate benefit
                                                            protection for executive personnel at a much lower
How Does Self-Funding Work?                                 cost. This is important in creating Employee longevity
                                                            in a competitive job market.
The Employer purchases reinsurance for protection,
and pays a small fraction of the conventional premium       The bottom line is that Self-Funding saves costs. In a
to the reinsurance carrier. The remainder of the            good claims year, the best scenario would be that
conventional funds (claim funds) is held by the             profit formerly enjoyed by the insurance carrier under
Employer who then invests them, segregates them if          a fully insured plan, now is enjoyed by the Employer
desired, or uses them for general business purposes         who can choose to put it back into the company. But
until they are needed for the funding of claims.            even in a bad claims year, maximum liability is in
When claims do not materialize, the Employer keeps          place to protect the Employer.
the balance of the unused claim funds, hence making
a profit. In this way, the payment of claims is directly
correlated to the premiums paid and the Employer
keeps the profit instead of the insurance carrier.

                                                                           Your Complete Employee Benefits Solution     9
Stand Alone Prescription Drug                            Consumer Driven Health Plans
Carve-Out Plans
                                                         Consumer Driven Health Plans (CDHPs) are an
One popular means of reducing group health               increasingly important alternative to the current
insurance premiums is to eliminate prescription drug     way of providing medical health insurance. Under
plans, leaving Employees footing the bill for elevated   traditional health care programs, Employers are faced
drug costs and financially unable to do so. There are    with double-digit annual cost increases with no
alternatives.                                            relief expected in the foreseeable future. Employers
                                                         cannot absorb the rising costs alone and in turn
UGP offers several Prescription Drug Carve-Out           have begun reducing benefits and raising Employee
options for Employers who need to reduce their group     contributions.      UGP specializes in providing
health premium by offering reduced Rx benefits. By       Employers with very successful alternatives to control
replacing the current prescription drug plan with a      the increasingly high cost of providing healthcare
Generic-Only Plan, Employers can save up to 20% on       benefits to their Employees.
their health insurance premiums. Sometimes using a
Stand-Alone Plan is all that is needed to cut costs.

Multiple Options & Custom Design:
• $5 Generic/$30 Preferred Brand Drug
  Cards
• $5 Generic Only Rx Card

• $10/$20/$40 Copay Discount Rx card

• Discount Generic/Brand Rx Card.


Fully Insured Group Health,
Disability & Life
United Group Programs offers a host of fully insured
                                                         The effectiveness of consumer-driven plans is
Preferred Provider Programs, Point of Service and
                                                         controlling costs which rests on the ability and
Health Maintenance Organization options. Many of
                                                         willingness of Employees to manager their medical
these programs may be adapted to different regions
                                                         care costs. The solution is contingent on raising the
and areas of the country. UGP also offers a host of
                                                         awareness of Employees to the actual cost of
Short and Long Term Disability options, along with
                                                         healthcare. Employers who attempt to cut costs by
many coverages of Life insurance, such as Term Life
                                                         lengthening probationary periods, raising deductibles
Whole Life, and Optional Life.
                                                         or co-pays or severing benefits altogether are only
                                                         offering short-term fixes. The majority of Employees
Dental Plans                                             have no perception how much a doctor’s office visit
                                                         actually costs.      If the co-pay is only $20, the
UGP provides a single source solution for your dental    employee will use the service as frequently as he or
insurance needs. We offer a nationwide network of        she sees fit, with the end result of increased utilization
fully insured and self funded options to make your       and increasing the cost of the employer’s plan.
dental plan a success.
                                                         By educating employees about the correlation
 DHMO * Preferred Provider Organization (PPO) *          between utilization and costs, they become partners
    Indemnity Plan * Fee for Service Plans *             in the solution and are more accepting of benefit
  Voluntary Dental Plans – Direct Assignment/            changes and increased employee contributions.
            Reimbursement Plans.




                                                                         Your Complete Employee Benefits Solution   10
Gap Plans                                                 Worksite – Payroll Deducted Policies
Gap Plans help pay for employees’ out of pocket           Today’s workforce is made of a diverse population
expenses for Hospital and Outpatient services. They       with each employee having his or her own individual
fill the “gap” caused by higher deductible or higher      needs and circumstances. By offering Employee paid
coinsurance plans. Gap Plans are an excellent tool        Voluntary benefits, Employers allow Employees to
for employers who have or are going to implement          purchase coverage in addition to what the Employer
higher deductibles and coinsurance. The Gap plan          may or may not offer based on that Employee’s
picks up the difference caused by the new plan            needs. At no cost to the Employer, these Voluntary
design and can significantly save the employer            Payroll deducted policies have a value added benefit
money on their health plan.                               for Employees.

                                                          Voluntary policies available are:

                                                          •Disability                          •AD&D Policies
                                                          •Term Life                           •Accident Plans
                                                          •Critical Illness                    •Hospital Indemnity
                                                          •Cancer Protection                   •Gap Plans
                                                          •Dental Plans
Mini Medical Plans - Limited Health
                                                          For example, Employees may wish to purchase life
Benefit Plans (Guarantee Issue)                           insurance or disability insurance in addition to what
                                                          the Employer offers to suit their individual needs. Or
 No Pre-Ex Clause $49.99/month                            an Employer may not offer benefits to Employees,
                                                          and by offering Employee paid voluntary plans,
Health Plans for the American Worker, Part Time           Employers allow Employees to get policies not
Workers, & Independent Contractors:                       otherwise attainable.
UGP offers fully insured and self funded “ mini
                                                          Your One Source Solution for Worksite Payroll
medical plans” which offer health insurance benefits
to Employees starting at under $50 a month.               Deducted Policies “Voluntary Plans”

These plans are guarantee issue, with no pre-existing     UGP provides the Employer with a one-source
conditions clauses or evidence of insurability. All       solution for all of his worksite solutions. UGP offers a
Employees are accepted regardless of health               unique in-house solution found nowhere else in the
conditions and are eligible for benefits. With limited,   marketplace: In-house enrollment firm, In-House TPA
capped benefits the monthly premium is substantially      for billing and a In-House TPA directly contracted with
reduced.                                                  Worksite Carriers. Employers & Employee benefits
                                                          consultants can have one source for customer
Benefits offered are:                                     service, enrollment, and billing for all their worksite
                                                          products. They no longer need to outsource their
•Doctor’s Office Visits              •Skilled Nursing     worksite products to multiple parties (enrollment firms,
•ER Visits                           •Substance Abuse     billing entities, and insurance carriers) who then have
                                                          to coordinate amongst themselves. They now have a
•Accident Coverage                   •Mental Illness
                                                          Single Source Solution!
•Daily Hospital Indemnity Benefits   •Life Insurance
•Intensive Care Benefits

Also included are national medical, dental, and vision
PPO networks.

Monthly premium can be paid solely by the Employee
or the Employer can contribute.


                                                                          Your Complete Employee Benefits Solution   11
We take a unique approach to our cafeteria
                                                         administration in that we perform the discrimination
                                                         tests monthly, even though IRS rules require that they
                                                         be run only once per year. Therefore, if any of our
                                                         clients fail the test, we can move immediately to bring
                                                         the account into compliance before the annual testing
                                                         date.

                                                         UGP is customer service oriented; we have
                                                         established an excellent rapport with our clients’
                                                         Employees and we work closely with them when
                                                         issues arise, from questions about what is covered in
                                                         their Flexible Spending Account, to easing the burden
                                                         on human resources. Reimbursement checks can be
                                                         issued based on the Employer’s desire to
                                                         accommodate their Employees’ needs.


Flexible Account Administration-                         Flex Debit Cards
Section 125 Cafeteria Plans
Also known as Section 125 plans of the IRS Code,
Flexible Spending Accounts (FSAs) offer tax              With a Flexible Spending Account Debit card, your
advantages to both Employers and Employees.              Employees can enjoy the convenience of paying for
These plans offer Employers a way to save taxes on       office visit co-pays, new glasses, prescriptions, and
their group benefit plans and offer Employees a way      other eligible expenses with a Debit Card that is
to save taxes on money spent out-of-pocket for           linked directly to their FSA account. Using the debit
dependent care and medical expenses.                     card, no paperwork is necessary to file a
                                                         reimbursement claim.
Money allocated to a Section 125 Plan is subtracted
from the Employee’s taxable income and held in a
dedicated account. Employees benefit by using the        Section 132 Transportation Accounts
pre-tax income to pay eligible medical and dependent
care expenses. In reducing the Employees’ taxable        Section 132 of the Internal Revenue Code allows
income base in this way, Employer-paid Social            salary reduction and reimbursement for qualified
Security (FICA) and Unemployment taxes are               parking, transit passes, and costs associated
reduced by approximately eight cents on the dollar.      with commuter highway vehicles for transportation
These savings can offset the cost of administrating      from an Employee’s residence to his place of
the FSA program. Health care cost sharing becomes        employment. United Group Programs offers Section
less painful for the Employer and Employees. It also     132 transportation accounts that allow money to be
improves morale by reducing Employee taxes,              subtracted from the Employee’s taxable income to be
enhances your organization's image and attracts new      held in a dedicated account. Employees benefit by
Employees.                                               using their pre-tax income to pay for any eligible
                                                         transportation costs.
UGP offers both medical reimbursement and
dependent care FSA programs, along with premium          Transportation accounts operate much like FSAs in a
only plans (POPs).                                       way that health care cost sharing becomes less
                                                         painful for everyone involved.
Administration services can be interfaced with the
medical and dental plans to allow for automatic filing
and payment of eligible spending account allocations
upon processing of the group benefit plans.




                                                                        Your Complete Employee Benefits Solution   12
Health Savings Account (HSA) –
Plus Debit Card
A HSA is a health savings account that has certain
tax advantages to Employees and their families
covered under a high deductible plan. Like the FSA,
an HSA provides that an Employer may subtract a
certain amount of an Employee’s taxable income to
deposit into a dedicated account. The difference is
that these plans are only applicable for Employees
under current health plans that have a deductible
between $1,000 and $2,600 annually for individuals
and $2,000 and $5,150 for a family. The maximum
amount that may put away is $2,000 a year.

Distributions for qualified medical expenses are tax
free, and an HSA account can earn interest tax-free
and funds in the HSA may be eventually rolled over
into a 401(k). The HSA is owned by the Employee            Debit MasterCard
and is portable. Unlike a Cafeteria account there is
no “use it or lose it” provision and funds can be rolled   For Cafeteria Plans, HSAs & Payroll
over year to year. Employers who choose a health
care plan with high deductibles to decrease costs           The UGP debit card is an excellent and attractive
may lessen the hardship on the Employee by                 benefit for both Employees and Employers. The debit
instituting HSA accounts. At the same time, because        card is used to pay for qualified medical expenses
of high deductibles, Employees experience the true         such as prescription drugs and copays at doctors’
cost of healthcare and start becoming cost conscious       offices and hospitals for both Cafeteria Flexible
health consumers.                                          benefit plans and for Health Savings Accounts. It can
                                                           also be used as a payroll debit card where
                                                           Employees payroll is deposited into the card for
                                                           Employees that may not have bank accounts or who
                                                           cannot wait for paychecks to clear.

                                                           The card increases Employee participation in Flexible
                                                           Spending Accounts (FSAs), because this increased
                                                           Employee contribution and participation means more
                                                           FICA tax savings for Employers and more take home
                                                           pay for Employees. The card reduces the need to file
                                                           claim forms and since it can eliminate the need to pay
                                                           cash for eligible expenses, it makes the plan much
                                                           more attractive and easier to use for Employees.

                                                           Employers love it because the debit card drives FICA
                                                           tax savings by increasing Flex account participation
                                                           and contributions needed to manage the qualifying
                                                           events, track and manage changes to coverage,
                                                           provide ongoing communication, and ensure
                                                           regulatory compliance.




                                                                          Your Complete Employee Benefits Solution   13
HIPAA Administration
                                                         HIPAA administration requires specialized knowledge
                                                         of how governmental requirements relate to individual
                                                         plans. Special notice requirements concerning
                                                         pre-existing conditions, exclusion periods, rights
                                                         regarding prior credible coverage and certificates,
                                                         along with the necessary calculations can be an area
                                                         of great confusion. United Group Programs, Inc. is
                                                         able to eliminate this confusion and assure
                                                         compliance with HIPAA provisions. We prepare the
           Smooth Sailing Benefits Administration        necessary notifications, and work with eligible
                                                         participants to gather prior coverage information. We
COBRA & HIPAA Administration                             verify all information received, calculate periods of
                                                         credible coverage and pre-existing exclusion periods,
COBRA Administration                                     then track those periods within our eligibility and
                                                         claims adjudication systems.
United Group Programs, Inc. offers complete
administration of your COBRA requirements. UGP           This added service provides assurance of HIPAA
will perform the following COBRA administration          compliance without the associated confusion and
functions:                                               time-consuming administrative tasks.

•   Receive COBRA elections from eligible
    participants and process application forms           Compliance can be risky business
•   Track coverage periods as dictated by law and
    maintain proper documentation of COBRA activity      As a national Third Party Administrator, we
                                                         understand that one small mistake could spell
•   Provide expert advice on COBRA related issues
                                                         disaster. Every single detail — from initial notifications
•   Collect participant payment                          to retention of proof — must be handled correctly the
•   Answer inquiries from qualified beneficiaries        first time, every time. UGP employs a staff dedicated
•   Handle monthly reporting                             to assuring that your plan remains in compliance with
                                                         all applicable laws and regulations. There are
COBRA administration is both complex and time            numerous regulations that apply to group health
consuming. By allowing UGP to administer your            plans, and these legal requirements change
COBRA coverage, Employers are assured of                 frequently. Our in-house counsel keeps abreast of
adherence to the ever-changing regulations               the new legislation and court decisions that may
governing it. Like all of our programs, our unique       affect your plan and the administration thereof.
system design provides for the integration of claims
management and COBRA eligibility. Employers are          UGP will consult with you to develop plan language to
relieved of the liability and the burden of staying on   meet both your criteria and legal requirements. Our
top of changing legislation. UGP will handle all         experienced staff, using our unique system, can
member notifications.                                    design and prepare your plan document and
                                                         summary plan description to meet your requirements
Full-Service Administration – Because we manage          and to assure legal compliance.
a large number of clients in our system, we are able
to spread the fixed costs to achieve economies of
scale that an Employer could not. Employers avoid
the expense of the staff and technology associated
with administration of COBRA.




                                                                         Your Complete Employee Benefits Solution   14
Association - Affinity Benefit Programs                    No More Referrals

                                                           UGP provides “open access” to its Preferred
                                                           Providers that represents an extensive spectrum of
                                                           care including all medical specialties. With the belief
                                                           that referrals only cost clients more, Employees can
                                                           avoid the visit to the primary care physician merely for
                                                           the purpose of obtaining a referral. This saves the
                                                           Employee’s costs for the visit, time away from work,
                                                           and reduces claims liability. Our knowledgeable
                                                           customer service staff is available to provide
                                                           information on the specialists appropriate for the
  UGP tailors to the Association’s unique organizational   Employee’s condition.
                          needs
                                                           UGP's National PPO Networks address our clients’
                                                           healthcare needs through a flexible and innovative
                                                           approach. Our networks are the best for your
UGP specializes in the design, administration and          Employees, while offering discounts up to 37% and
marketing of custom private label insurance programs       more nationally.
for Associations and their members.

Branding and private labeled services for association      Primary Networks:
benefits is one of the key elements to maintaining and
expanding overall member participation. It will also       •   Over 550,000 providers and more than 2,000
increase the association's image by enabling them to           hospitals
offer a total benefits program that is "exclusive" to
their organization and only available to their             •   Centers of Excellence
members.
                                                           •   Online customized PPO Network directories

                                                           Supplemental Networks:
Our PPO Networks
                                                           •   Over 600,000 providers and more than 4,000
A key to our success, United Group Programs, Inc.              hospitals
offers choice, flexibility, quality and ease of access
with its established relationships with the largest PPO    •   Online provider locations through our website.
Networks in the country as well as strong local and
regional PPOs.        In today's Employee benefits
environment, Employers are often faced with a
trade-off between providing comprehensive benefits         For Agents & Consultants:
packages to their Employees and controlling costs by
limiting or eliminating excellent provider networks.       Employers turn to their Employee benefits consultants
UGP’s network discounts enable Employers to                for guidance in their benefit and administrative
enhance their existing benefit package by offering         solutions.  UGP provides a winning formula for
significant healthcare savings without limiting choices    Employee benefits consultants:
for providers.
                                                           Excellent Customer Service & Quality Product Choices =
                                                            Opportunity to Grow Their Business and to Retain It.




                                                                          Your Complete Employee Benefits Solution   15
UGP Overcomes Common Employer
Misconceptions                                            UGP’s Customer Service
At UGP, we understand that making a change in             Customer Service “the way it should be.”
Employee benefits plans seems like a difficult
decision and that implementation will be arduous.         UGP has one customer service philosophy. To excel
Knowing this, we specialize in overcoming these           in customer service and provide the most responsive
perceived obstacles.                                      and personalized service for Employers.

Here are some common misconceptions:                      Clients are assigned a dedicated account team that is
                                                          cross-trained on the Employer’s plans, so that the
“We do not have enough payroll slots to offer             Employer always has someone to call for immediate
other voluntary or non-voluntary products.”               answers and solutions.
By offering a consolidated bill, UGP can combine
different products and provide the Employer with one
list bill with one payroll deduction for Employees for
multiple products.

“We cannot offer more insurance products to my
Employees nor are we willing to switch insurance
carriers because we don’t have the support staff
to take on additional work and the stress of a
move.”

Choosing United Group Programs services will
immediately release the client’s staff from
administrative burdens they previously had with other
products or carriers.     UGP provides a seamless               Worldwide Insurance & Financial Specialists
solution with the support staff to assist and take over          Florida Georgia Pennsylvania
some of human resource duties, so that human                            National Headquarters
resources can focus on what’s most important –                        United Group Programs
Increasing the Bottom Line.                                     2500 North Military Trail, Suite 450
                                                                       Boca Raton, FL 33431
                                                                       (800) 842-8770 x 2922
                                                               www.ugpinc.com/daimlerchrysler.html
                                                                        marce@ugpinc.com




                                                                        Your Complete Employee Benefits Solution   16

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  • 1. YOUR DAIMLERCHRYSLER PARTNER Welcome to United Group Programs, Inc. Your Complete Employee Benefits Solution Providing Old-Fashioned Customer Service The Way It Should Be. United Group Programs, Inc. Florida ● Georgia ● Pennsylvania 2500 North Military Trail, Suite 450 Boca Raton, FL 33431 Toll Free: (800) 842-8770 Website: www.ugpinc.com/daimlerchrysler.html E-Mail: marce@ugpinc.com
  • 2. United Group Programs is Your Unique, Single Source Benefits Provider United Group Programs was founded in 1968 with one major goal in mind. Simplify the administration of health benefits for Employers and Employees. With over 4,300 corporate clients worldwide and thirty-seven years of experience, UGP has grown into an organization that serves clients in every state in the nation as well as internationally. Additionally, we have five corporate offices where our Employees have become a team devoted to providing customer service that is second to none. Our goal is to provide tools, training and motivation to create a unified team who have the desire, attitude, integrity, confidence and sincere commitment to provide a partnership internally within our organization and externally with our clients in order to exceed their expectations. We provide service with heart, and take responsibility and ownership to seize every opportunity to make our clients feel they have not only been served but also cared for. We will be pleased to offer you a cost-free analysis of Because of these principles and the efforts of our your current plan in comparison with the personalized Employees, United Group Programs, Inc. has options we offer. Our experience gives us the added become one of the most prominent third party confidence of steadfast relationships with insurers administrators in the nation. We possess the and reinsurers, which leads to remarkable savings for expertise, experience, resources, and commitment Employers. UGP offers a host of options from fully required for superior health benefits administration. insured and self-funded medical and dental plans to group life and disability insurance. Through the use of National and Regional PPO networks, United Group Programs, Inc. can offer Employers the plan of Our specialization is in providing Employers with very choice that fits with their needs and values. We also successful alternatives to control the increasingly specialize in executive benefit packages. In addition high cost of providing healthcare benefits to to Third Party Administration Services, UGP provides Employees. UGP’s Third Party Administration COBRA, Cafeteria Section 125 plans and HIPAA services are tailored in design to a particular services to assist Employers and human resource Employer’s benefit needs and implemented with departments. The result is a comprehensive old-fashioned personal customer service and proven benefits package that is cost effective and administration techniques. stress-free. Your Complete Employee Benefits Solution 2
  • 3. Our Goal is Customer Satisfaction Performance Guarantee Consistency and Reliability When you choose United Group Programs, Inc. for Using a detailed proposal developed with the client, your Employee benefits needs, you can be assured our specialists manage the implementation that we will provide you with outstanding service and of the benefit program from start to finish. Our unmatched performance. We aim to build long-term representatives are qualified, accessible and relationships by keeping our promises and earning your accommodating. Our staff consists of Employee trust. Many of our first clients 37 years ago are still our benefit consultants for self-funded plans and mini clients today. medical plans, in-house counsel, in-house Certified Public Accountant, and a registered nurse. You can count on our specialists to know what needs to be done and how to do it efficiently. 24 Hour Claims Processing Policy Our efficiency begins with our 24-hour claim processing. Our staff proactively solves claims problems immediately and effectively, with as little client or human resources involvement as possible. For example, a claims processor may contact the provider directly if a statement of account, rather than a bill, is received, saving time for the human resources department. Reinsurer Negotiation Policy Creating Memorable First Impressions UGP's approach is not to “shop” the Employee benefits reinsurance as others do. Our approach is to At United Group Programs, Inc., we realize that making negotiate with qualified and stable “A” rated a change in your insurance plan seems to be a difficult Reinsurers with professionalism. With our 37 years of decision to make. However, difficult decisions must be experience we are able to negotiate the most made for your company to run efficiently and prosper. advantageous Aggregate and Specific Stop Loss For this reason we offer a cost-free analysis of your Reinsurance contracts for our clients, providing us current benefit plan versus those alternatives offered by with an advantage over our competition. UGP. This analysis consists of benefit plan design review, viability of self-funding, and a review of disability and life insurance policies for adverse limitations and appropriateness. When Employers select a program through UGP, we take that decision very seriously. As such, we want our new clients to experience a smooth and comfortable transition. Therefore, we offer reliable and consistent consultation with Employers’ Human Resource and Risk Management Departments. Your Complete Employee Benefits Solution 3
  • 4. Our Proactive Organization Registered Nurse Internal Organization Our in-house Registered Nurse is available in her capacity for our clients when needed. As a Third Party Administrator, we are proactive. While we are free to meet for consultation at any given time, we request informal meetings each quarter, allowing discussion of secular trends in the industry, claims experience (including actual and potential shock losses), proposed changes in legislation, the interpretation of Employee benefits legislation, and possible utilization abuse. At the conclusion of the meeting, we will discuss the client’s alternatives, renewal options, as well as important Human Resource and Risk Management issues. Integrated Claims Administration UGP provides an integrated claims system to streamline administration of multiple benefit programs in a managed care environment. Our clients enjoy enhanced data integrity and the most efficient claims operations available. We have built in the flexibility and adaptability we need to handle unique client requirements. Our commitment to service excellence Benefit Plan Design and Review creates timely and accurate claims administrative Whether your plan is fully insured or self-funded the services for our clients. design of your plan is crucial in affecting your costs. United Group Programs, Inc. provides a review of Strategy and Legal Review your current benefit plan to determine whether your plan has excess and unnecessary benefits that Upon request, our in-house counsel will work jointly increase the cost of your plan, or limitations on with client’s corporate counsel at no additional cost for benefits that negatively affect the Employees and services within the scope of his profession. Our executives. Studies have found by offering certain counsel will guide your company through HIPAA benefits the Employer’s cost for health insurance privacy issues and guidelines and advise you as to the goes up, while those specific benefits in no way appropriate course of action. assist in the health of the Employee or provide a true benefit. Due to significant increases in the cost of Financial Reliability healthcare, the implementation of Plan Design changes now, allows Employers to save on Our in-house Certified Public Accountant will work healthcare costs for years to come. jointly with our clients to address all tax law and related issues promptly and professionally at no additional cost We at UGP are pleased to offer you a cost-free for services within the scope of his profession. The analysis of your current plan in comparison with the billing support staff is trained to work with each client’s personalized options we offer. Our experience gives specific accounting practices and bookkeeping needs us the added confidence of steadfast relationships to facilitate the production of easy to read monthly with insurers and reinsurers, which leads to statements, to troubleshoot any problems if they occur. remarkable savings for Employers. Your Complete Employee Benefits Solution 4
  • 5. Our Services At the same time, we take the burden of keeping up Free the Human Resource Department with new tax and legal legislation off of the Employer. Our in-house counsel and Certified Public Accountant The human resource department for any Employer are up to date on all issues that may affect your should be focused on core business competencies and company’s Employee benefits programs and we make company strategies, not on minor administrative issues. changes where needed to assure compliance with the new regulations. United Group Programs Call Center provides a full range of services and benefits to Employers. UGP has the experience, management and staff to handle routine Payroll Services Employee inquiries freeing Human Resources to focus Whether a small or medium sized business with payroll on more important issues. processing needs, UGP has an affordable and Our Toll Free Call Center provides a centralized access comprehensive payroll solution for each Employer’s point to resolve all Employee issues. UGP’s Call Center specific needs. UGP simplifies your payroll process. can also be utilized for enrollment and re-enrollment. At UGP, we directly contact the health care provider, requesting the itemized bill by fax in order to process the claim immediately. In this way, the claims examiner Asking all the right questions proactively intercedes to insure prompt servicing of the Our case management is an integrated process that claim. The Employee is not confused and no time is assesses, plans, implements, coordinates, monitors, taken from the workday to resolve this problem. and evaluates options and services to meet an Therefore there are no dunning notices and no phone individual's health needs. UGP communicates with calls. The plan runs smoothly for all involved, healthcare providers and utilizes all available resources particularly for Human Resources. to promote a quality yet cost-effective outcome. When approved by the client, UGP's case management program targets individual members with catastrophic Coordinated Billing & Carrier Invoicing - diagnosis and/or high cost procedures. Our case One List Bill for Multiple Products management team "steers" members through the complex medical considerations to maximize the UGP’s services allow Employers to display invoices member’s health. from multiple carriers into one consolidated report/bill. Our billing reports can show the Employer the cost of Getting all the right answers benefits for an entire organization or broken out by location or subdivision. Normally, when an insurance company or Third Party Administrator (TPA) receives a claim from an Employee By utilizing UGP’s administration services, Employers that consists of only a statement or “balance due”, or in reduce the time wasted in manual reconciliation some other way incomplete, the insurance company or of multiple invoices from multiple insurance carriers. TPA, would return the bill to the Employee with This immediately reduces administrative costs and instructions that the Employee obtain the itemized bill eliminates the human resource department’s from the service provider. A confused Employee often involvement in reconciling bills. brings this problem to their supervisor, who then Among multiple carriers offering health, dental, and involves the Human Resources Department. other voluntary and non-voluntary Employee benefits, UGP not only coordinates billing, but also eligibility, enrollment, and termination. Unique Administration Services Unlike most Third Party Administrators, United Group Programs, Inc. offers a host of extra administration Coordinated billing allows Employers to receive services to make your company more efficient and to monthly a single invoice from UGP and to make a reduce your overall administration costs. single payment to UGP for all of the Employers’ insurance policies. Your Complete Employee Benefits Solution 5
  • 6. Claims Processing Customer Service We strive for 100% accuracy. Our audit procedures, training programs and system controls are designed United Group Programs, Inc. maintains a toll-free to accomplish this objective. Mandatory pre-payment telephone number for the convenience of clients, plan audits are conducted for claims that exceed participants and healthcare providers. During normal designated dollar amounts. business hours (9:00 am to 5:00 pm EST), the participant may speak directly with the person Our system also reprices In-Network claims in responsible for managing the day-to-day accordance with the negotiated fee schedules and administrative activities of the plan. Most inquiries contracts. Non-Network claims are subject to the are answered accurately and immediately. There is usual and customary fee data. When appropriate, convenient voicemail or e-mail for after-hours charges are negotiated to obtain maximum savings inquiries. for both clients and their employees. United Group Programs, Inc. is proud that our claims Reporting our Success turn-around time is among the fastest in the industry. Our system permits adjudication of many claims within 24 hours. Electronic and paper clean Accounting & Financial Reporting claims that are identified for review by the built-in controls are processed within 3 business days. At UGP, our accounting and financial reporting systems interface with all other administrative systems, such as Our quick turn-around policy results in a number of eligibility, claims, payables, and collections. This desirable effects: integrated system allows us the flexibility to individually define and maintain accounting procedures and • Employees perceive their health plan as a controls to meet the distinct needs of each client. true benefit. Thus, morale remains high. • The need for calls by Employees and Custom Client Reporting providers to check claim status is greatly reduced. Timely and meaningful information is critical. UGP furnishes certain standard reports to each client • Prevention of harassment of Employees by monthly, quarterly, and/or annually, and clients may providers demanding payment. choose from numerous other reports. Our self-funded clients can choose to receive up to seventeen reports Benefit checks along with detailed, easy to ranging from a monthly enrollment census or claims understand, explanations of benefit forms are issued detail history report to a network discount report to the covered Employee and/or provider, accurately showing the discounts saved in-network for all claims and efficiently. processed. Stop-Loss Claims Reporting UGP maintains an experienced and dedicated Stop Loss Department that monitors potential stop-loss claims and files all appropriate claims with the reinsurance carriers on behalf of clients. The efficiency of claims submission and follow-up to assure quick reimbursement results in a favorable financial impact to the plan. Your Complete Employee Benefits Solution 6
  • 7. A-Rated Management & Negotiation Disease Management People are living longer lives than ever before. This is Utilization Management not because there is less disease in the world. With today’s science and technology, people are able to United Group Programs, Inc. works with Utilization live with otherwise deadly diseases for many years to Review and Case Management programs to assure come. For an Employer, this has only been financially quality patient care delivered in a cost-effective possible through high-cost insurance. Now, as part of manner. Our integrated database and software the Case Management Program developed by UGP, systems allow our claims examiners, auditors and health care costs can be decreased through proper stop loss department to share information on a disease management. real-time basis. UGP first provides all members access to information Case Management to educate themselves about their disease, thereby providing the necessary tools for the members 80% of the health care costs come from 10% of the to manage their own conditions. By providing population. Unpredictable catastrophes and poorly information about diseases such as asthma, diabetes, controlled serious diseases are a very large source congestive heart failure and hepatitis C, for example, of these costs. At UGP, Case management members may proactively manage their condition and opportunities are quickly identified and aggressively episodes in a quality manner. pursued, by focusing on members with serious or chronic illnesses. Claims Negotiation The nurse case manager works closely with UGP has designed its programs to encourage members, family, and physician to assess the in-network care. However, out-of-network care member's health care needs and to coordinate will occur throughout the plan year. In order to save services. Our case management team works to our client healthcare dollars on care accessed determine quality and cost-effective treatments of out-of-network, UGP proactively negotiates the claim. services by identification of alternative treatment UGP has developed a proprietary database for this plans, price negotiation, or both. purpose. In situations where a member accesses As an essential component for effective case care out-of-network, UGP will negotiate discounts for management, case managers maintain a positive, physician and facility claims. professional relationship with healthcare providers to assure the patient's healthcare needs are met. The goal is to assist the member to reach their optimal level of wellness through high quality, cost-effective care, while reducing potential claim and minimizing the current claims impact and overall costs. Prescription Drug Management UGP is a national leader in prescription drug management. We offer our clients the strongest and most aggressive prescription drug discounts and networks across the nation. Your Complete Employee Benefits Solution 7
  • 8. Making Life Easier & More Efficient Eligibility & Enrollment Services United Group Programs, Inc. can readily provide guidance and is prepared to assist the Employer in the Employee enrollment plays a critical role in the success preparation of these changes. We will also distribute of any voluntary benefits program. the appropriate communication to Employees in the form of booklet inserts or payroll stuffers. Participant enrollment, coverage termination, and other changes to eligibility information are made using the unique enrollment systems process by United Group Auditing & Subrogation Programs, Inc. This information may also be submitted electronically or via fax. Upon receipt, all information is UGP takes seriously the accuracy of its performance reviewed for plan compliance and immediately entered on every case. Each claim is audited for errors or into UGP's eligibility database. inconsistencies during the first month of the plan. Thereafter, ongoing audits are performed based upon a UGP provides the following services: random sample of claims. Additionally, all high dollar claims (over $5,000) are audited and approved before One-on-one enrollment being released for payment. Quite often, bills presented for payment contain Group enrollment charges that are inconsistent with a patient’s condition, or they contain duplicate charges. Our staff is trained Enrollment by Phone to look for these “errors” and to challenge the health Internet Web Enrollment care provider regarding suspect charges. We are often able to reduce hospital bills by up to 25%, resulting in Outbound Call Enrollment an overall reduced claims experience for the Employer. We also will subrogate claims as needed to protect Employers’ or Employees’ interests. Reduction in claims experience is paramount to the long-term goal of Case Setup and Management reducing health care costs and in preventing industry premium increases. Payroll Stuffers and Communication Materials Employee Education Eliminate Cookie-Cutter Benefits Professional Enrollment Counselors As a premier national Third Party Administrator (TPA), United Group Programs, Inc. understands the need Employer Enrollment Reports for flexibility and creativity in Employee benefits programs. Reducing costs, therefore, requires We specialize in enrollment customer service that something other than a “one size fits all” approach includes communication and education services before to obtaining quality care at affordable prices. We and after enrollment. These areas are quite often evaluate every situation, create a plan design specific overlooked. Through our proprietary and innovative to Employer’s needs, and provide unmatchable system, we are able to communicate to Employees customer service to members, while assuring exactly how a particular benefit will impact upon them compliance with all applicable regulations and laws. and their families. Amendments & Modification ID Cards From time to time, you may wish to modify your Plan United Group Programs, Inc. provides a custom ID card Document for benefit or eligibility changes. There for plan participants designed to assure that the may also be times when the Employer Plan Document healthcare providers receive the complete and current will need to be amended or modified to comply with information needed for quick and effective patient legislative changes. processing. Your Complete Employee Benefits Solution 8
  • 9. Self Funded Health Plans, Dental, & Short Term Disability Plans Advantages of Self-Funding Self-Funding is a successful alternative for Employers The advantages of self-funding are numerous! to control rising healthcare costs. While flexibility in making key decisions on benefits, administration and Flexibility in Benefits funding, is attractive to most Employers, limiting Most importantly, the Employer is able to develop the liability can be problematic. Partial Self Funding / Self flexibility it desires in making key decisions on Insurance with Stop Loss Coverage is an attractive benefits, administration and funding. Decisions as to alternative for cost conscious Employers in choosing what will be covered and what will not become easy, an Employee benefits plan. allowing the Employer to exclude certain vaccinations, drugs, behavioral diseases such as The goal of every insurance company in a fully obesity or alcoholism, or infertility. The key here is insured program is to make the most profit. This the ability to tailor the plan to meet the specific needs profit can reach up to 60%. Under a fully insured and budget of the Employer. plan, the Employer pays a fixed premium regardless of the amount of claims paid by the insurance carrier. Flexibility in Carriers Annual rates are often increased based upon the industry standard, otherwise known as “trend”, and Another major advantage to self-funding is the not based upon the Employer’s claims experience. flexibility in choosing a reinsurance carrier. Unlike fully insured plans, a shift from one carrier to another In a self-funded or partially self-funded program, does not affect the choice in doctors, impose waiting everything provided in a conventionally fully insured periods, or require the issuance of new I.D. Cards program is duplicated in the partial self-funded plan. and booklets. All services provided by the insurance company in a fully insured plan are provided in the self-funded or Multiple Locations partially self-funded program. The only difference is that the Employer retains the funds used to pay Also, for Employers with multiple locations, the same benefit claims. plan may be offered to everyone in every location with no administrative difficulty. By Self-Funding, an Employer can utilize one national network or multiple local PPO networks with the same benefit plans. Executive Benefits Self-Funding provides the unique ability to class out the executives to provide 100% of all of their benefits where named executives and their families pay no co-pays, deductibles or coinsurance. Employers therefore can afford to provide ultimate benefit protection for executive personnel at a much lower How Does Self-Funding Work? cost. This is important in creating Employee longevity in a competitive job market. The Employer purchases reinsurance for protection, and pays a small fraction of the conventional premium The bottom line is that Self-Funding saves costs. In a to the reinsurance carrier. The remainder of the good claims year, the best scenario would be that conventional funds (claim funds) is held by the profit formerly enjoyed by the insurance carrier under Employer who then invests them, segregates them if a fully insured plan, now is enjoyed by the Employer desired, or uses them for general business purposes who can choose to put it back into the company. But until they are needed for the funding of claims. even in a bad claims year, maximum liability is in When claims do not materialize, the Employer keeps place to protect the Employer. the balance of the unused claim funds, hence making a profit. In this way, the payment of claims is directly correlated to the premiums paid and the Employer keeps the profit instead of the insurance carrier. Your Complete Employee Benefits Solution 9
  • 10. Stand Alone Prescription Drug Consumer Driven Health Plans Carve-Out Plans Consumer Driven Health Plans (CDHPs) are an One popular means of reducing group health increasingly important alternative to the current insurance premiums is to eliminate prescription drug way of providing medical health insurance. Under plans, leaving Employees footing the bill for elevated traditional health care programs, Employers are faced drug costs and financially unable to do so. There are with double-digit annual cost increases with no alternatives. relief expected in the foreseeable future. Employers cannot absorb the rising costs alone and in turn UGP offers several Prescription Drug Carve-Out have begun reducing benefits and raising Employee options for Employers who need to reduce their group contributions. UGP specializes in providing health premium by offering reduced Rx benefits. By Employers with very successful alternatives to control replacing the current prescription drug plan with a the increasingly high cost of providing healthcare Generic-Only Plan, Employers can save up to 20% on benefits to their Employees. their health insurance premiums. Sometimes using a Stand-Alone Plan is all that is needed to cut costs. Multiple Options & Custom Design: • $5 Generic/$30 Preferred Brand Drug Cards • $5 Generic Only Rx Card • $10/$20/$40 Copay Discount Rx card • Discount Generic/Brand Rx Card. Fully Insured Group Health, Disability & Life United Group Programs offers a host of fully insured The effectiveness of consumer-driven plans is Preferred Provider Programs, Point of Service and controlling costs which rests on the ability and Health Maintenance Organization options. Many of willingness of Employees to manager their medical these programs may be adapted to different regions care costs. The solution is contingent on raising the and areas of the country. UGP also offers a host of awareness of Employees to the actual cost of Short and Long Term Disability options, along with healthcare. Employers who attempt to cut costs by many coverages of Life insurance, such as Term Life lengthening probationary periods, raising deductibles Whole Life, and Optional Life. or co-pays or severing benefits altogether are only offering short-term fixes. The majority of Employees Dental Plans have no perception how much a doctor’s office visit actually costs. If the co-pay is only $20, the UGP provides a single source solution for your dental employee will use the service as frequently as he or insurance needs. We offer a nationwide network of she sees fit, with the end result of increased utilization fully insured and self funded options to make your and increasing the cost of the employer’s plan. dental plan a success. By educating employees about the correlation DHMO * Preferred Provider Organization (PPO) * between utilization and costs, they become partners Indemnity Plan * Fee for Service Plans * in the solution and are more accepting of benefit Voluntary Dental Plans – Direct Assignment/ changes and increased employee contributions. Reimbursement Plans. Your Complete Employee Benefits Solution 10
  • 11. Gap Plans Worksite – Payroll Deducted Policies Gap Plans help pay for employees’ out of pocket Today’s workforce is made of a diverse population expenses for Hospital and Outpatient services. They with each employee having his or her own individual fill the “gap” caused by higher deductible or higher needs and circumstances. By offering Employee paid coinsurance plans. Gap Plans are an excellent tool Voluntary benefits, Employers allow Employees to for employers who have or are going to implement purchase coverage in addition to what the Employer higher deductibles and coinsurance. The Gap plan may or may not offer based on that Employee’s picks up the difference caused by the new plan needs. At no cost to the Employer, these Voluntary design and can significantly save the employer Payroll deducted policies have a value added benefit money on their health plan. for Employees. Voluntary policies available are: •Disability •AD&D Policies •Term Life •Accident Plans •Critical Illness •Hospital Indemnity •Cancer Protection •Gap Plans •Dental Plans Mini Medical Plans - Limited Health For example, Employees may wish to purchase life Benefit Plans (Guarantee Issue) insurance or disability insurance in addition to what the Employer offers to suit their individual needs. Or No Pre-Ex Clause $49.99/month an Employer may not offer benefits to Employees, and by offering Employee paid voluntary plans, Health Plans for the American Worker, Part Time Employers allow Employees to get policies not Workers, & Independent Contractors: otherwise attainable. UGP offers fully insured and self funded “ mini Your One Source Solution for Worksite Payroll medical plans” which offer health insurance benefits to Employees starting at under $50 a month. Deducted Policies “Voluntary Plans” These plans are guarantee issue, with no pre-existing UGP provides the Employer with a one-source conditions clauses or evidence of insurability. All solution for all of his worksite solutions. UGP offers a Employees are accepted regardless of health unique in-house solution found nowhere else in the conditions and are eligible for benefits. With limited, marketplace: In-house enrollment firm, In-House TPA capped benefits the monthly premium is substantially for billing and a In-House TPA directly contracted with reduced. Worksite Carriers. Employers & Employee benefits consultants can have one source for customer Benefits offered are: service, enrollment, and billing for all their worksite products. They no longer need to outsource their •Doctor’s Office Visits •Skilled Nursing worksite products to multiple parties (enrollment firms, •ER Visits •Substance Abuse billing entities, and insurance carriers) who then have to coordinate amongst themselves. They now have a •Accident Coverage •Mental Illness Single Source Solution! •Daily Hospital Indemnity Benefits •Life Insurance •Intensive Care Benefits Also included are national medical, dental, and vision PPO networks. Monthly premium can be paid solely by the Employee or the Employer can contribute. Your Complete Employee Benefits Solution 11
  • 12. We take a unique approach to our cafeteria administration in that we perform the discrimination tests monthly, even though IRS rules require that they be run only once per year. Therefore, if any of our clients fail the test, we can move immediately to bring the account into compliance before the annual testing date. UGP is customer service oriented; we have established an excellent rapport with our clients’ Employees and we work closely with them when issues arise, from questions about what is covered in their Flexible Spending Account, to easing the burden on human resources. Reimbursement checks can be issued based on the Employer’s desire to accommodate their Employees’ needs. Flexible Account Administration- Flex Debit Cards Section 125 Cafeteria Plans Also known as Section 125 plans of the IRS Code, Flexible Spending Accounts (FSAs) offer tax With a Flexible Spending Account Debit card, your advantages to both Employers and Employees. Employees can enjoy the convenience of paying for These plans offer Employers a way to save taxes on office visit co-pays, new glasses, prescriptions, and their group benefit plans and offer Employees a way other eligible expenses with a Debit Card that is to save taxes on money spent out-of-pocket for linked directly to their FSA account. Using the debit dependent care and medical expenses. card, no paperwork is necessary to file a reimbursement claim. Money allocated to a Section 125 Plan is subtracted from the Employee’s taxable income and held in a dedicated account. Employees benefit by using the Section 132 Transportation Accounts pre-tax income to pay eligible medical and dependent care expenses. In reducing the Employees’ taxable Section 132 of the Internal Revenue Code allows income base in this way, Employer-paid Social salary reduction and reimbursement for qualified Security (FICA) and Unemployment taxes are parking, transit passes, and costs associated reduced by approximately eight cents on the dollar. with commuter highway vehicles for transportation These savings can offset the cost of administrating from an Employee’s residence to his place of the FSA program. Health care cost sharing becomes employment. United Group Programs offers Section less painful for the Employer and Employees. It also 132 transportation accounts that allow money to be improves morale by reducing Employee taxes, subtracted from the Employee’s taxable income to be enhances your organization's image and attracts new held in a dedicated account. Employees benefit by Employees. using their pre-tax income to pay for any eligible transportation costs. UGP offers both medical reimbursement and dependent care FSA programs, along with premium Transportation accounts operate much like FSAs in a only plans (POPs). way that health care cost sharing becomes less painful for everyone involved. Administration services can be interfaced with the medical and dental plans to allow for automatic filing and payment of eligible spending account allocations upon processing of the group benefit plans. Your Complete Employee Benefits Solution 12
  • 13. Health Savings Account (HSA) – Plus Debit Card A HSA is a health savings account that has certain tax advantages to Employees and their families covered under a high deductible plan. Like the FSA, an HSA provides that an Employer may subtract a certain amount of an Employee’s taxable income to deposit into a dedicated account. The difference is that these plans are only applicable for Employees under current health plans that have a deductible between $1,000 and $2,600 annually for individuals and $2,000 and $5,150 for a family. The maximum amount that may put away is $2,000 a year. Distributions for qualified medical expenses are tax free, and an HSA account can earn interest tax-free and funds in the HSA may be eventually rolled over into a 401(k). The HSA is owned by the Employee Debit MasterCard and is portable. Unlike a Cafeteria account there is no “use it or lose it” provision and funds can be rolled For Cafeteria Plans, HSAs & Payroll over year to year. Employers who choose a health care plan with high deductibles to decrease costs The UGP debit card is an excellent and attractive may lessen the hardship on the Employee by benefit for both Employees and Employers. The debit instituting HSA accounts. At the same time, because card is used to pay for qualified medical expenses of high deductibles, Employees experience the true such as prescription drugs and copays at doctors’ cost of healthcare and start becoming cost conscious offices and hospitals for both Cafeteria Flexible health consumers. benefit plans and for Health Savings Accounts. It can also be used as a payroll debit card where Employees payroll is deposited into the card for Employees that may not have bank accounts or who cannot wait for paychecks to clear. The card increases Employee participation in Flexible Spending Accounts (FSAs), because this increased Employee contribution and participation means more FICA tax savings for Employers and more take home pay for Employees. The card reduces the need to file claim forms and since it can eliminate the need to pay cash for eligible expenses, it makes the plan much more attractive and easier to use for Employees. Employers love it because the debit card drives FICA tax savings by increasing Flex account participation and contributions needed to manage the qualifying events, track and manage changes to coverage, provide ongoing communication, and ensure regulatory compliance. Your Complete Employee Benefits Solution 13
  • 14. HIPAA Administration HIPAA administration requires specialized knowledge of how governmental requirements relate to individual plans. Special notice requirements concerning pre-existing conditions, exclusion periods, rights regarding prior credible coverage and certificates, along with the necessary calculations can be an area of great confusion. United Group Programs, Inc. is able to eliminate this confusion and assure compliance with HIPAA provisions. We prepare the Smooth Sailing Benefits Administration necessary notifications, and work with eligible participants to gather prior coverage information. We COBRA & HIPAA Administration verify all information received, calculate periods of credible coverage and pre-existing exclusion periods, COBRA Administration then track those periods within our eligibility and claims adjudication systems. United Group Programs, Inc. offers complete administration of your COBRA requirements. UGP This added service provides assurance of HIPAA will perform the following COBRA administration compliance without the associated confusion and functions: time-consuming administrative tasks. • Receive COBRA elections from eligible participants and process application forms Compliance can be risky business • Track coverage periods as dictated by law and maintain proper documentation of COBRA activity As a national Third Party Administrator, we understand that one small mistake could spell • Provide expert advice on COBRA related issues disaster. Every single detail — from initial notifications • Collect participant payment to retention of proof — must be handled correctly the • Answer inquiries from qualified beneficiaries first time, every time. UGP employs a staff dedicated • Handle monthly reporting to assuring that your plan remains in compliance with all applicable laws and regulations. There are COBRA administration is both complex and time numerous regulations that apply to group health consuming. By allowing UGP to administer your plans, and these legal requirements change COBRA coverage, Employers are assured of frequently. Our in-house counsel keeps abreast of adherence to the ever-changing regulations the new legislation and court decisions that may governing it. Like all of our programs, our unique affect your plan and the administration thereof. system design provides for the integration of claims management and COBRA eligibility. Employers are UGP will consult with you to develop plan language to relieved of the liability and the burden of staying on meet both your criteria and legal requirements. Our top of changing legislation. UGP will handle all experienced staff, using our unique system, can member notifications. design and prepare your plan document and summary plan description to meet your requirements Full-Service Administration – Because we manage and to assure legal compliance. a large number of clients in our system, we are able to spread the fixed costs to achieve economies of scale that an Employer could not. Employers avoid the expense of the staff and technology associated with administration of COBRA. Your Complete Employee Benefits Solution 14
  • 15. Association - Affinity Benefit Programs No More Referrals UGP provides “open access” to its Preferred Providers that represents an extensive spectrum of care including all medical specialties. With the belief that referrals only cost clients more, Employees can avoid the visit to the primary care physician merely for the purpose of obtaining a referral. This saves the Employee’s costs for the visit, time away from work, and reduces claims liability. Our knowledgeable customer service staff is available to provide information on the specialists appropriate for the UGP tailors to the Association’s unique organizational Employee’s condition. needs UGP's National PPO Networks address our clients’ healthcare needs through a flexible and innovative approach. Our networks are the best for your UGP specializes in the design, administration and Employees, while offering discounts up to 37% and marketing of custom private label insurance programs more nationally. for Associations and their members. Branding and private labeled services for association Primary Networks: benefits is one of the key elements to maintaining and expanding overall member participation. It will also • Over 550,000 providers and more than 2,000 increase the association's image by enabling them to hospitals offer a total benefits program that is "exclusive" to their organization and only available to their • Centers of Excellence members. • Online customized PPO Network directories Supplemental Networks: Our PPO Networks • Over 600,000 providers and more than 4,000 A key to our success, United Group Programs, Inc. hospitals offers choice, flexibility, quality and ease of access with its established relationships with the largest PPO • Online provider locations through our website. Networks in the country as well as strong local and regional PPOs. In today's Employee benefits environment, Employers are often faced with a trade-off between providing comprehensive benefits For Agents & Consultants: packages to their Employees and controlling costs by limiting or eliminating excellent provider networks. Employers turn to their Employee benefits consultants UGP’s network discounts enable Employers to for guidance in their benefit and administrative enhance their existing benefit package by offering solutions. UGP provides a winning formula for significant healthcare savings without limiting choices Employee benefits consultants: for providers. Excellent Customer Service & Quality Product Choices = Opportunity to Grow Their Business and to Retain It. Your Complete Employee Benefits Solution 15
  • 16. UGP Overcomes Common Employer Misconceptions UGP’s Customer Service At UGP, we understand that making a change in Customer Service “the way it should be.” Employee benefits plans seems like a difficult decision and that implementation will be arduous. UGP has one customer service philosophy. To excel Knowing this, we specialize in overcoming these in customer service and provide the most responsive perceived obstacles. and personalized service for Employers. Here are some common misconceptions: Clients are assigned a dedicated account team that is cross-trained on the Employer’s plans, so that the “We do not have enough payroll slots to offer Employer always has someone to call for immediate other voluntary or non-voluntary products.” answers and solutions. By offering a consolidated bill, UGP can combine different products and provide the Employer with one list bill with one payroll deduction for Employees for multiple products. “We cannot offer more insurance products to my Employees nor are we willing to switch insurance carriers because we don’t have the support staff to take on additional work and the stress of a move.” Choosing United Group Programs services will immediately release the client’s staff from administrative burdens they previously had with other products or carriers. UGP provides a seamless Worldwide Insurance & Financial Specialists solution with the support staff to assist and take over Florida Georgia Pennsylvania some of human resource duties, so that human National Headquarters resources can focus on what’s most important – United Group Programs Increasing the Bottom Line. 2500 North Military Trail, Suite 450 Boca Raton, FL 33431 (800) 842-8770 x 2922 www.ugpinc.com/daimlerchrysler.html marce@ugpinc.com Your Complete Employee Benefits Solution 16