Eric Pangburn sits down with Benistar president Don Trudeau to learn more about the company he founded, the services it provides, and how it benefits retirees.
Eric Pangburn: Could you explain how Benistar came to be?
Don Trudeau: I formed Benistar in 1978 with the goal of addressing the needs of retirees for dependable medical plans. Back then, there was a real dearth of high-quality medical plans available, and the few that were available tended toward prohibitively high premiums. Things have improved considerably since then, and I’d like to think that our efforts over the years have had a lot to do with that.
EP: How do you feel that your firm benefits individuals and organizations?
DT: Benistar was established with the goal of providing a wide range of services essential to retirees aged 65 and older. These services include the design, installation and administration of medical benefit plans, with particular focus on medical and prescription drug plan administration. Again, there wasn’t really much in the way of companies or individuals providing such services in those days, and we felt that we were addressing a very real need when we set up the company.
EP: Do you work or partner with other firms in providing your services?
DT: Yes, we actually maintain an extensive network of partner firms and providers, all of whom help us deliver a better and wider of services. Among these are top brokers and consultants, who really help expand the range of services we provide, and ensure more consistent quality. These firms help provide a variety of medical and prescription plans for public companies and privately-held firms, labor unions, city and county government organizations, educational institutions, and religious organizations.
EP: How large is your client base?
DT: We currently provide health and retirement plans and administration services to more than 400 sponsors across the country. All told, we administer more than $100 million in premiums every year.
EP: Could you go into more detail about your company’s primary focus?
DT: Our services essentially cover group retiree medical benefits, prescription drug solutions, and consulting and administration services. Our group retiree medical benefits program is designed to help clients pay for costs that are recognized by Medicare, but don’t qualify for coverage under Parts A and B of the plan. You can watch some videos on our services: https://www.youtube.com/channel/UC-l2qOdc6p9vRJJyUpZB3hA
Our prescription drug plans for retirees fall under the Employer Group Waiver Plans or EGWPs set up for groups belonging to Medicare Part D. Finally, our consulting and administration services are intended to help those in the post-65 age group with analyzing their current retiree programs with regard to their feasibility, and then coming up with ways by which their existing plans could be improved.
EP: In many ways, Benistar could be considered the link between retirees and plan sponsors. What is your approach to customer service and how do you best serve the needs of individuals and sponsors?
DT: Client satisfaction is our ultimate goal, and this goes for our company clients as well as their own clients. We make it easy for clients to obtain medical care from the providers of their choice, with no restriction as to networks and referrals. Our prescription drug solutions are designed to fill in the holes in Medicare Part D coverage, and we even maintain a pharmaceutical network comprised of more than 56,000 pharmacies all over the country.
EP: Could you discuss Medicare Part D particularly with regard to how your service helps employers with that particular section?
DT: The Medicare Part D specific services that we offer are intended to help employers manage prescription drug benefit plans. More specifically, we offer employers the EGWP or Employee Group Waiver Plan, which falls under the category of a group Medicare Part D prescription drug plan. Our EGWP plans provide a number of significant benefits to employers and their employees that have reached retirement age. These include full insurance, nationwide access to plans, no maximum amount on annual plans, and a flat co-payment or co-insurance payment. Our plan is also designed to fill in the coverage gap in Medicare Part D, which is commonly known as the ‘donut hole’, and we offer our clients a tremendous range of flexibility with regard to how the plan is designed. Clients may choose from a selection of standard plans, or they may have a custom plan designed with underwriting approval.
EP: Describe working in the Medicare field. What are the most significant upsides and downsides?
DT: One thing that many clients initially find challenging is how detailed the Medicare landscape is, and how it changes so constantly. For those unfamiliar with the details of this particular section of the program, it can all be a bit confusing. The good news is that we are fully aware of most retiree concerns, and we are prepared to assist our clients with key information about the most essential aspects of the program. In addition, we also provide proven advice on the most suitable plans that companies can in turn provide to current and prospective clients.
Another challenge is providing our clients with a wide range of cost-effective options in medical plans and prescription drug plans. As I mentioned earlier, there aren’t as many high-quality plans available at affordable rates. The way we addressed that particular concern is by partnering with some of the most reputable and highly-rated insurance carriers in the business. This extensive network of carriers helps ensure our ability to provide companies with a variety of flexible medical and prescription drug plans at competitive rates, which they can then provide to their clients.
EP: A number of changes were recently made to the Medicare Shared Savings Program. What do you feel are the most significant implications of these changes?
DT: The changes announced by the Centers for Medicare and Medicaid Services or CMS involved the updating of the Medicare Shared Savings Program in order to enhance the delivery of quality services to Medicare beneficiaries. The update essentially builds on the features of the earlier version of the program, and of the Pioneer Accountable Care Organization (ACO) Model. The changes were made with the goal of providing support and assistance to the collective community of care providers, so that they may be able to deliver better quality and ensure the welfare of their clients even as they utilize resources more efficiently.