Gap Analysis and Proposal Creation Process

Introduction

Gap analysis is conducted only when Spectrum Health rates are bundled with Zurich Gap rates for both Indirect and Direct agents. If a MedPair proposal is received instead of Zurich, the analysis is bypassed.

This document outlines the step-by-step process for creating a proposal, conducting gap analysis, and finalizing the document. Ensuring accuracy at each stage is critical, as errors may result in the obligation to honor incorrect rates.

Step 1: Create the Proposal

Once you receive the Gap proposal from RS Benefits and the Health Insurance quote from 90DB, follow these steps:

1. Locate the Template Proposal:
   • Find “Spectrum Advanced - Template” in \Spectrum Dropbox\Spectrum Health\Spectrum Health Templates.
   • Choose the template corresponding to the network defined in the quote.
2. Prepare the Proposal in Adobe Pro:
   • Open the template proposal in Adobe Pro.
   • Fill in the Prepared For and Proposal Date fields on page 1.
   • Click Organize Pages.

If a MedPair Gap Proposal is Received:

1. Insert the quote details provided by 90DB after the Network Page by dragging and dropping from your files.
2. Delete unnecessary pages:
   • First page of the quote: “Medical Quote Detail Cover Page”.
   • All pages after the census (identified by red Quote #: 123456 at the top) until the signature page.
     • Retain the signature page only if this is a enrolment ‘FIRM’ Quote.
   • Remove GAP pages :
     • “Spectrum Benefits Bundled Gap Insurance”
     • “Spectrum GAP Insurance Proposal”
3. Save the proposal as: (Network) Spectrum Health (Final) - Group Name MM.DD.YY.
4. Modify the Gap Proposal:
   • Open the Gap proposal in Adobe Pro.
   • For Indirect groups only:
     • Delete “Producer Name - Taylor Insurance Services” (TIS information should not be visible to Sub Agents).
   • If “Group Sales” appears, delete it for both Direct and Indirect groups.
   • Save changes.

Step 2: Conduct the Gap Analysis for Zurich proposals

1. Open the analysis template located in \Spectrum Dropbox\Spectrum Health\Spectrum Templates\Spectrum Advanced Comparison Template.
2. Reference the 90DB Quote and fill in the following sections:
   • Heading: Quote Number and Employer Name.
   • Prepared For: Copy employer name, address, and SIC code.
   • Contract Terms: Copy and verify all contract terms.
   • Rates: Input rates for EE, ES, EC, and EF for each plan option (1500, 3000, 5000 HSA, & 7000).
   • Total Annual Fixed & Total Annual Funding:
     • Ensure all rates match those in the 90DB Quote. Total Annual Contribution should match the quote provided by 90DB.
3. Input Zurich Proposal Data:
   • Enter Composite Numbers in:
     • Rates (Counts)
     • Gap Insurance Rates (automatically updates if Rates Counts are correct).
   • Enter Gap rates for EE/ES/EC/EF:
     • For 500, 1500, 2000, and 3000 rates.
4. Review for accuracy!
   • Incorrect rates sent to clients may result in honouring the provided rates.