1. Lighthouse Insurance Group
Benefits Division

2. General Introduction

3. Lighthouse Insurance Group
• Largest privately held insurance
agency in Michigan with 30
locations statewide and over
300 employees
• Insurance Leaders in all Lines:
Benefits, Business, Personal, &
Title
• Locally headquartered in Grand
Rapids, MI

4. Lighthouse Insurance Group
Grand Rapids Business Journal’s
2015 Top Area Employee Benefit
Consultants/Administrators and
Top Area Business Insurance
Agencies!

5. Our Mission Statement
Employee Benefits
To assist our clients with their employee benefit programs through
exceptional service and guidance, thereby allowing our clients the
time and energy they need to concentrate on their corporate
objectives.

6. Knowledge & Continuing Education
With the constant changes in our industry, we believe and
stress the importance of continuing education for our team
members. Many of our staff have received or are working
toward accreditation with the following designations:
• Certified Employee Benefits Specialist (CEBS) – includes:
• Group Benefits Advisor (GBA)
• Retirement Plan Associate (RPA)
• Compensation Management Specialist (CMS)
• Licensed Insurance Counselor (LIC)
• Chartered Benefit Consultant (CBC)
• Registered Employee Benefits Consultant (REBC)
• Registered Health Underwriter (RHU)

7. Client References
At Lighthouse Insurance Group, we have long term relationships with
many clients and are more than happy to provide client
references.

9. The Lighthouse Benefits Division is comprised of over forty
team members focused solely on Employee Benefits,
Compliance and the Affordable Care Act. Some examples of the
services we provide:
• Healthcare Reform Guidance, Reporting and Consultation
• Compliance Consultation and Communication
• Annual Financial Reviews & Renewal Marketing (Financial
Analyst)
• Billing/Enrollment - Member Management Division
• Eligibility Support – Carrier Audits
• Employee Support/Patient Advocacy
Benefits Division

10. Lighthouse Group Benefits Division – cont’d
• Dedicated and Experienced Service Team
• Experts in Healthcare Reform Guidance and Education
• Proactive, not reactive approach
• Expert Legal Guidance from our Internal and External
Connections
• Philanthropy and Community Involvement

11. Insurance Carriers
some of our preferred partners
We work with many financially solid carriers in
the following areas:
• Health Plan Design and Administration
• Dental
• Vision
• Short & Long Term Disability
• Group Life & AD&D
• Group Accident, Hospital, & Critical Illness
• Flexible Spending Accounts (FSA), Health Savings
Accounts (HSA), Health Reimbursement
Arrangements (HRA) – Variety of Vendors
• Long Term Care

12. Voluntary Benefits
• We offer the latest in product innovations to help protect your
employees:
• Short & Long Term Disability and Life
• Dental and Vision
• Accident
• Hospital Indemnity
• Critical Illness
• Professional sales approach
• Carriers or LHIG can offer on-line enrollment
• Benefits are tailored to each client – compliance with HDHP

13. Carrier Evaluation
We believe that strong carrier evaluations and relationships are
important, particularly in difficult claims scenarios. Each
implemented carrier has a responsibility to the employer and
their employees – their main function is to pay incurred claims
accurately and efficiently.
The Carrier’s Responsibilities and Core Functions:
• Meet established client expectations
• Pay eligible health care claims efficiently and accurately
• Provide member service
• Maintain eligibility

14. Employer Strategies & Solutions
Group Medical Insurance
As costs continue to rise each year, we work closely with the
carriers to develop solutions and strategies. We discuss and
consult with our clients on these emerging solutions so you can
make an educated decision moving forward.
• Defined Benefit vs Defined Contribution Model (10+ enrolled
employees) – iSelect, Glidepath, Coverage for Companies (Private
Exchanges
• Group Self or Shared Funding Financial Mechanisms
• Offering Multiple Plan Designs Creates Flexibility and Choice (11+
enrolled with minimum participation required)
• Newly Emerging Carriers – pros and cons
• Consulting on Terminating the Medical Plan – Ramifications

15. Capabilities & Value Added
Services

16. Expert Legal Guidance
In the complex environment of Healthcare Reform you can be
confident in Lighthouse Group’s guidance as you adjust to these
changes. Our trusted legal partners are experts in Healthcare
Reform and general employee benefits compliance:
• Miller Johnson Attorney’s and Counselors (Grand Rapids, MI)
• Warner, Norcross, & Judd (Michigan)
• Giarmarco, Mullins, & Horton, P.C. (Troy, MI)
• Mika, Meyers, Becket & Jones (Grand Rapids, MI)

17. Human Resource Capabilities & Services
sponsored by Lighthouse Group
Our employee benefits consultant can play a vital role in assisting with daily
Human Resource questions and concerns. Lighthouse Group has invested in
assisting our clients in these areas through our HR Generalist! Many of
these services come as a value add service to our clients.
• Employee Handbooks
• HR Navigator
• Workshops
• HR Audits
• Client Staff Education
• General HR Questions

18. Financial Consulting
Our financial analyst has over 18 years experience
consulting with self-funded and fully insured large
employers. Some of his responsibilities include the
development and delivery of contribution strategies,
cost analysis, plan design cost projections, rate
negotiations and stop loss marketing.
His team has developed over 15 customized cost
reports that enable employers to monitor their
health care costs on a monthly, quarterly and annual
basis.

19. On-Site Medical Clinics
for employers with 200+ employees
Lighthouse as an owner of ProMedio help employers with
innovative onsite medical clinics that lower plan costs, reduce
employee out-of-pocket expenses, and improve overall employee
health and satisfaction.
Will we assist with determining the effectiveness of an onsite clinic
for your organization. Specifically, how it can reduce your health
care claims vs. the direct costs associated with the clinic.
Within Muskegon, MI several large employers shared the cost in
building two clinics that their employees and families share. They
are realizing the return on their investment from reduced claim
costs.

20. Wellness Programming Consulting
Lighthouse Insurance Group brings facilitation and expertise to the world of
Wellness to be sure our clients are gaining a good return on health. The goal
of our internal wellness advisor is to match the company with the perfect
wellness provider to ensure the highest possible level of engagement,
outcomes and customer satisfaction.
• Wellness plans utilizing carrier
resources and vetting wellness
vendors
• Value based health plan designs and
reporting
• Tiering benefits to promote healthier
lifestyles
• Developing strategies around wellness
and total health management
• Oversee the development, progress,
renewal, and return of health for each
program

21. Healthcare Reform Guidance
Healthcare Reform (PPACA) is constantly changing . We consistently
monitor all major employee benefits and news sources including:
• International Foundation of Employee Benefits
• Kaiser Family Foundation
• The National Underwriter
• Wellness Councils of America
• National Association of Health Underwriters (NAHU)
• Department of Labor (DOL)
• Centers for Medicare & Medicaid Services (CMS)
• Department of Health and Human Services (HHS)
• Health Insurance Marketplace (healthcare.gov)

22. Healthcare Reform Guidance (cont’d)
The implementation of PPACA has had a large effect on employers
and individuals since 2014 with regard to plan design, structure,
and cost. We believe that our clients deserve and expect
Healthcare Reform guidance and consultation.
• Member Level Rating – employers with less than 50
FTE’s
• Full Time Equivalent (FTE) Employees
• Employer Mandate
• Affordability & the 9.5% test
• Marketplace vs. Group Health Plan
• Fully Insured 3:1 Ratio Requirement
• Required Deductible Limits
• Required Metal Tiers (Catastrophic, Bronze,
Silver, Gold, Platinum for employers with
less than 50 employees)
• Minimum Value Plans
• Essential Health Benefits
• True-Out-Of-Pocket (TROOP)
• 90 day new hire waiting periods
• 30 Hour Eligibility Requirement

23. Medicare Consulting
When an employee or employee’s dependent nears the age of
65, they are inundated with communication regarding
enrollment in Medicare. Lighthouse Group firmly believes in
supporting these members with consultation and advice and
can even enroll them in Medicare Plans that fit their plan goals
and budget.
• Is the employee retiring?
• Continuing to work?
• Do they want to continue contributing to
an HSA plan?
• When is it beneficial to postpone
enrollment?
• What are the late penalties?

24. Employer Tools & Employee
Communications

25. Compliance
Compliance requirements are becoming increasingly more
important as we continue under Healthcare Reform. We work
with you to keep your group in compliance so all necessary
documentation is in order.
• Summary Plan Descriptions (SPD)
• Summary of Benefits and Coverage (SBC)
• Medicare Part D Creditable Coverage Notifications
• Section 125 Plans (Full FSA or Premium Only)
• COBRA, FMLA, ADA, HIPPA
• Marketplace (Model) and HIPPA Notices
• 5500 Administration

26. Benefit Administration Systems
brought to you by Lighthouse Insurance Group
Lighthouse Connect is a
Benefit Administrative
System that allows your
business the capability to
manage your employee
benefits on our online
platform!
*Available to Lighthouse clients with
over 25 enrolled employees

27. Member Management
Do you spend a significant amount of
time enrolling new employees in
their benefits? Lighthouse Group’s
Member Management program may
be a great solution!
• CONSOLIDATED enrollment form for
all coverage (custom built)
• We take the time to enroll the
employee with each insurance
carrier
*Available to Lighthouse clients with over 20
enrolled employees.

28. Customized Documentation & HR Solutions
There are likely many times that Human Resource and/or compliance scenarios
arise where a qualified, substantiated answer is needed. Lighthouse
Insurance Group is invested in this technology and offers an online portal
without cost to clients that is used for the following:
• HR Online Chat – get questions answered immediately by
qualified, expert individuals
• Search for compliance related inquiries – documents are up-to-
date and already reviewed by legal experts.
• Survey Benchmarking – research what other companies in your
field are doing
• Healthcare Reform questions – newly released legislation
• Employee communication and education – surveys

29. Plan Benchmarking
attract & retain quality employees
Curious what other employers offer
their employees?
Lighthouse Group has invested in
providing clients with national and
local benchmarking surveys which
allow our clients to competitively
compare their employee benefits to
competitors both nationally and
locally!
*Available to clients with over 50 enrolled employees

30. Employee Communication:
Benefit Customized Booklet
The “Benefit Update” Booklet contains a
concise overview of:
• All Benefit Coverages, core and ancillary
• Costs – both employer and employee for
transparency
• Legally Required Compliance Notices
• Final Benefit Summaries
• Contacts – carrier, client, and agent
- Available to employers with more than 20 enrolled employees.
EMPLOYER LOGO
Employee Benefits Enrollment Guide
Plan Year: 2015
Who is Eligible?
How to Enroll?
When to Enroll?
How to Make Changes?
Who To Contact For Questions:
Account Manager
Lighthouse Insurance Group
800 344-3531 x7890

31. Employee Communication:
Transparency Reporting
Our Employee Reporting capabilities
allow an employer to illustrate an
employee’s full compensation package –
it can be tailored in various ways to meet
the employer’s needs. Some popular
fields include:
• Employer contribution (medical, dental,
vision, etc.)
• Worker’s Comp
• STD and LTD, Basic Life/AD&D
• Supplemental Life
• Voluntary Benefits
• Paid Time Off
• And more…
- Available to employers with more than 20 enrolled employees.

32. Patient Advocacy
Regardless of all else, a group medical plan is in place to protect the
employee and/or employee’s dependents from a catastrophic,
high cost claim. When these situations arise, we are able to step
in and assist the employee and employee’s family with:
• Claims Payments
• Coordination between carrier and plan design
• Communication between provider and carrier
• In the event of death, working with the Life insurance carrier for
expedient claims payment
• And much more…
*Upon receipt of signed HIPAA release form from the member.

33. Thank you!