Why Select J & K

J & K Consultants, Inc., has a staff of qualified specialist providing consulting in retirement pans, group benefits and risk management. Our goal is to provide our clients with concise, accurate and usable advice. We believe in professionalism, stability, high standard of quality and management involvement, and have established these four tenets as the foundation of our business.

Corporate Profile

Today's business environment argues against using a "pre-packaged" approach to address problems. J & K Consultants' consulting philosophy is that employee benefits and business risk should be viewed and managed as a system, which should fit a firm's business plan. Further, this system should complement management's objectives in meeting that plan and not conflict with short or long-range goals. Therefore, when we examine a problem, we examine it within the larger business framework.

Our Services

Flexible benefits and long-term care are some of the more widely identified group benefits that address the changing needs of our active and retired work force. New funding approaches and medical care delivery systems have been developed as a legislation and litigation have constrained planning and required increased administration and cost. J & K offers problem-solving capabilities in these areas:

General Group Benefits:

  • Establishment of management objectives
  • General plan revise
  • Plan design recommendations & associated costs
  • Health care cost management planning
  • Flexible benefits feasibility & implementation consulting
  • Cost projections & plan year-end accounting analysis
  • Renewal negotiations
  • Tax & benefit law compliance issues
  • Discrimination testing & cost impact of discriminatory plans
  • Ancillary benefits consulting (dental care, vision care, group universal life, employee assistance programs, prescription drugs, group legal, wellness programs, long-term care)
  • Industry surveys & studies
  • Post-retirement group benefit liability projections
  • Continuation coverage (COBRA) consulting

Group Benefit Funding

  • Insured versus self-funded alternatives
  • Retrospective premium arrangements
  • Minimum premium plans
  • Section 419 welfare benefit fund consulting
  • Section 419A qualified assets account calculations
  • Retention analysis
  • Reserving requirements
  • Trend & utilization factors
  • Margin analysis
  • Special experience funds
  • Pooling level studies
  • Claims Projections

Alternative Delivery System

  • Selection of health maintenance organizations
  • Development of HMO corporate policy
  • Management of HMO options
  • Analysis & selection or preferred provider (PPO) arrangements

Communications

  • Personalized benefit statements
  • Employee handbooks/SPD
  • Audio-visuals for employee education

Professional Risk Management Consultants

Professional Risk Management Consultants, a division of J & K Consultants, INC. Is an impartial consulting firm specializing in the risk management field? Risk management utilizes the application of a logical and systematic approach to uncertainty regarding fortuitous loss. It involves identifying, analyzing and evaluation the risks to which a firm is exposed and the development of the most advantageous method or methods of treating them. The fundamental objective of the risk management process is the preservation of assets and earning power from loss or destruction. Exposure to risk is controlled through application of various alternatives: Financing, elimination, reduction, retention or transfer.

Services

Consulting Activities:

  • Checking current insurance contracts for completeness & accuracy
  • Conducting insurance audits
  • Reviewing corporate contracts with respect to insurance provisions
  • Assuring Retrospective rating adjustments
  • Reviewing claim reports for serving accuracy & emerging trends
  • Analyzing insurance products

Development Activities:

  • Risk management & risk retention programs
  • Internal insurance monitoring systems
  • Loss prevention programs
  • Claim information system
  • Captive & self-insurance feasibility studies
  • Insurance specifications & proposal review
  • Quantitative analysis & statistical forecasting
  • Effects of mergers & actuations with respect to insurance
  • Government regulations updates
  • Self-insurance programs

J & K Consultants, INC  

J & K Consultants, Inc. Is an employee consulting firm, specializing in health and welfare benefits only.

In any premium dollar, there are four basic components: claims, reserves, administration and pooling charges. 95% out of every dollar spent will be on claims, reserves and pooling charges. 5% will go to pay for fixed charges such as claims adjudication, utilization review, network accessing, etc. It is obvious that because 96% out of every dollar pertains to claims that great care must be used to manage the flow of the claims dollars.

We do that by first identifying potential problem areas through the use of an electronic review. If the electronic review identifies a need for further aiding, then an outside auditing firm is brought in to complete this aspect of the evaluation. As soon as the evaluation of the incumbent, the plan and the adjudication process has been completed, steps are then taken to correct any potential claims problem areas (such as duplicate billings, third party liability recoveries, coordination of benefits recoveries, unbundling, upcoming and inappropriate medical protocols).

Furthermore, an evaluation of the Summary Plan Description through out Plan Data Questionnaire will tighten the SPD to conform to the corporation's ideological beliefs. For example, if a corporation does not believe in abortion, we make sure that the SPD also helps reduce, if not eliminate, selection against the plan. An example of selection against the plan would be those employers who pay additional monies to their employees to have them drop their existing health and welfare because their spouse works for your corporation. There are countless other examples, but the SPD is amended to prevent this from hurting our clients.

We know that roughly 40% to 50% of all your claims are medically inappropriate and/or medically unclearly. This is supported by the Milligan & Robertson study, the Rand study and the HIAA studies. Therefore, war has special insurance company/third party administrator questionnaires that help assure the fact that the claims adjudication process is a great deal more accurate. We concentrate on managing your claims dollars. All invasive procedure and all endoscopes procedures greater than $250 are reviewed on a prospective basis, therefore assuring the fact that medically inappropriate claims are not incurred and therefore are not the responsibility of the insured employee and/or the corporation.

J & K Consultants, Inc, does a full evaluation of the existing needs, wants and ideological beliefs of our corporate clients. We also have employee surveys to ascertain their needs and wants as well. We feel that through employee education, stricter controls on preventing selection against the plan, and the reduction of fraud (which is nearly impossible to eliminate) and unique billing practices (such as upcoming and unbundling of claims), our corporate clients will have a reduction for their claims level anywhere between 20% and 45%. We have the questionnaires available to evaluate networks, insurance companies, third party administrators, utilization review firms, etc. We use their tools to start the evaluation process, follow-up up with on-site visits to the third party administrator, insurance company, utilization review firms and networks.

We have certain suppliers such as utilization review firms and networks who work on a percentage of savings bases. We too have a program where we work on a percentage of savings bases. An example would be that J & K Consultants, Inc. Would receive no remuneration unless claims are reduc3ed by a mutually agreed-upon percentage and evaluated 14-27 months after the inception of the changes recommended by J & K.

A typical example would be that unless the existing claims are reduced by 17%, then neither J & K nor the utilization review carrier would receive any remuneration. Their remuneration would be 25% of the reduction in claims over the previous 15 months. Further remuneration would be done on a capitates basis (per employee per month).

J & K Consultants, Inc., provides services in there areas :

  • Actuarial services & consulting for defined benefit plans
  • Record keeping services & consulting for defined contribution plans
  • Administration & consulting for 401(k) plans
  • Risk Management consulting
  • Group benefit plans consulting
  • Flexible benefit plans consulting
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