7.1 Provide a summary of global benefits consulting services including a list of countries in which you currently operate.

NFP currently support clients in 93 countries globally. Our international consulting team is headquartered in the UK, which was a strategic decision as it gives us the ability to cover all time zones within a normal working day.

We also have a mixture of physical offices and regional partnerships. Where partnerships exist, these are well established and in many cases have been in place for 10+ years. This ensures that we have the relevant local market expertise, language skills, on-the-ground resources and access to local solutions.

The following fundamental pillars support the foundation of how we bring value to our clients and ensure easy access to quality and affordable world-wide care with world-class service:

A health-driven approach to network management and clinical wellbeing, tailoring health advocacy to each member’s unique experience and location. Our integrated Total Health and Network Solution encompasses care access, clinical and wellbeing services, high-performing network partnerships, and a proactive fraud, waste, and abuse program. With a focus on preventive care, our clinical services are delivered by an internal team of over 130 nurses and doctors, dispersed across the globe. These elements unite to improve care delivery, clinical outcomes, and overall employer ROI. Our borderless global network grants Enova members access to over 1.6 million global providers, including nearly 400,000 direct-pay providers outside the U.S., delivering quality and affordable care wherever employees are located.
Locally focused compliance expertise, delivering integrated solutions to manage regulatory complexity and help protect our clients on an ongoing basis. We have an extensive global license base and selling capabilities in more than 45 countries.

Depending on the size and needs of our clients, NFP International typically builds a strategy built around the fundamentals of Compliance, Financial Efficiency and Simplification. We pride ourselves on providing a single point of contact model so any client we work with has a dedicated team looking after all of their global locations (outside of North America). This enables clients to centralize the decision making process and allows us to liaise with local offices, local brokers yet strategically working with HQ. The main areas we work on for our global clients are:

Audits / Benchmarking - Your plan designs in each country goes through a rigorous analysis. We audit it for compliance and examine market competitiveness, independent of any local bias. Global and country-specific benefits experts weigh in with information and opinions. We get all the right eyes on your benefits so every detail is considered.

New Country Start Up – If you are starting up in a new country, we have a dedicated service to assist. What are the new country’s legal requirements and best practices? We prepare a full report for you, then discuss how these will affect your firm and guide the startup. Once the fundamentals are clear, the interesting part starts. What supplemental plans do you want to offer on top of the legally required ones? Will you aim to match your U.S. practices, or model benefits after local norms? Your objectives, combined with our know-how, result in an expert plan.

Ongoing Consulting - NFP International will always look to establish client goals during our ongoing consultancy, and these will determine the key outcomes required by our clients. Everyone wants the best cover at the lowest cost, this is a given. We will take time to understand the requirements of Enova, design and present all the solutions available, including the pro’s and con’s and then work with Enova to determine the best solution for their needs.

NFP International can also assist with areas such as global payroll, global HR, global business culture, global P&C as well as having access to an ‘NFP International Pooling’ solution, in addition to the other core areas above.

7.2 Detail how you develop a benefit communication strategy with your clients. Include what tools and resources you have available to assist your clients in effectively communicating not only the specific plan details, but also, the value of the benefits offered.

Your NFP team will partner with Enova’s leadership and HR team to strategize on communications. It is important to understand the Enova culture, communication style, and employee demographics as we develop your communications strategy.

NFP provides standard communication resources to support open enrollment, total compensation statements, and other annual communications. If more advanced communication resources are needed for video communication campaigns, webinar campaigns, texting campaigns and more, we may engage our communications partners (project based, and subject to additional fees).

We have found that the most effective way to communicate a consistent message to employees is to stay engaged throughout the year, not just during open enrollment. We have worked with our clients to facilitate phased rollouts, different mediums of communications, and metrics to track success and engagement.

The NFP team will be actively involved in the Enova annual open enrollment event from initial planning through the completion of the enrollment. We can provide content for benefits guides, announcement emails/ letters, posters, home mailers, mobile websites, all aimed at increasing employee engagement and participation in the enrollment event. Your NFP team will also be available to conduct group meetings to communicate plan changes and answer any employee questions. We find webinars are particularly effective as they can be conducted at times that are more convenient for your team, and can include family members, who often times are the decision makers when selecting benefits.

NFP Connect / Landing Page

NFP Connect is a proprietary technology platform that connects all of your benefits together in one place for your Administrators and Employees to create a better users experience. NFP Connect encapsulates all of your benefit offerings, information, reports, external links, and NFP contact information in one easy to access portal. Additionally, the NFP Connect Landing Page was developed to create an interactive resource for your employees to visit both during open enrollment and throughout the year. It can also be utilized by new hires or potential new hires to educate on the benefits available. Each landing page is customized with client content and is easily accessible for employees via computer or mobile device. Your Benefits Landing Page includes:

Open Enrollment Materials - Benefit Guide, Highlighter, Election Form(s)
Full Benefit Summaries - More details about your coverage
Educational Videos - Learn more about benefits available to you
Carrier Links & Member Resources - Easy to find an in-network provider and Value-Add’s

7.3 Describe your organization’s capabilities in managing life, disability, and leave of absence programs.

We take a holistic approach to managing a benefits program. It is important to understand the overall strategy in order to manage each individual program. Life and disability programs have often not received as much attention as medical programs since they are relatively low on the cost scale compared to the medical program.

NFP specializes in the group life and disability market. We developed a unique approach for cost reduction, consultation, and ongoing administrative services that delivers substantial savings to our clients. We also deliver increased value through plan administration and claims diagnostics. Our life and disability program management includes:

Providing complete consulting operations, including front-end sales support
Providing in-depth contract review
Determining proper plan design based on industry benchmarks and unique client demographics
Developing intrinsic savings through evaluation of the client’s claims experience, retention costs and extended rate guarantees
Providing detailed claims and cost analysis based on our unique pricing, analytic trend models and internal underwriting
Ensuring proper case implementation and superior customer support with dedicated account managers
Delivering customized report capabilities, implementation and billing services
Providing retrospective disability and absence audits
Delivering client-centric custom dashboards
Providing pre and post implementation audits, as required

Absence/Leave Management

NFP has access to numerous solutions and leave management administrators. We would begin with a discovery phase focusing on Enova’s current practices, challenges and objectives. We understand the complexities of Parental, Sick Pay and Family Medical Leave Act regulations and how they must be integrated into the leave process. We find that most of our clients have decided to outsource leave administration and we have assisted in that process. We obtain formal marketplace proposals from best in class administrators and evaluate the responses, negotiate pricing / performance guarantees and present results along with our recommendation to the Enova team. Our due diligence efforts are comprehensive and are intended to ensure Enova has the opportunity to make an educated decision on the administrator that best suits your needs. Once the decision is made we project manage the implementation, we lend our expertise and work with the selected vendor to establish best practices for effective communications and system structure development to ensure the appropriate reporting and tracking mechanisms are in place. On an ongoing basis we advocate on behalf of our clients to ensure service standards are being met. We work with the vendor to develop a reporting package which will capture the ROI of the program and will allow for strategic actionable recommendations based on Enova’s experience compared to industry benchmarks.

7.4 Briefly describe your organization’s philosophy regarding pharmacy management.

NFP Rx Solutions

As a PBM Consulting Company, NFP Rx Solutions is an innovator in tackling skyrocketing pharmacy benefit costs. Our highly successful “coalition” approach to pharmacy healthcare will ensure that your clients receive benefit options that are typically reserved for exclusive entities. With more than 120 years of collective experience in the industry. We are uniquely positioned to manage the entire spectrum of PBM services, from RFP production to annual audits.

NFP Rx Solutions – Our industry-leading PBM coalition includes the 3 largest PBMs in the nation, and we negotiate improved contract rates and rebates with them annually. We combine our aggressive contract savings with our strategic pharmacy consulting expertise, proprietary clinical programs, white glove customer service and AI evidence-based decision-making tools to provide custom-tailored solutions and savings not available directly from the PBMs.

NFP Rx Solutions understands today's pressing issues. We have developed strategies to help successfully manage your pharmacy benefit and continue to add new innovative programs for our clients.

NFP Rx Solutions Coalition – Best in Class Pricing - The NFP Rx Solutions Coalition offers a top-tier pricing model from the top 3 PBMs in the industry CVS, Optum, and Express Scripts. As a value-based coalition, NFP Rx Solutions can provide economies of scale from a partner that fits best for their membership. By utilizing our buying power of over 1.5 million lives, NFP Rx Solutions ensures accountability and best in class pricing.
Dedicated Account Management Team - The NFP Rx Solutions account team consists of a dedicated Implementation Manager, Account Executive, Pharmacist, and a Business Analyst. This team will work seamlessly to ensure a smooth and seamless transition to your PBM and will then proactively monitor your Rx Benefit and recommend new benefit designs and clinical programs that provide the most cost effective benefit for you and your members, so you can focus on your primary responsibilities.
Clinical Programs - The NFP Rx Solutions is a leader in promoting the most advanced and cutting-edge clinical programs to ensure the best outcomes for your members and families.
IMM (Individual Medication Management) – Our IMM program is designed to help ensure that your pharmacy benefit dollars cover the most clinically appropriate, affordable medications while avoiding ~35 identified medications that provide no clinical benefits.

Protect the integrity of your plan
Minimize the use of designer generics and hyperinflationary drugs
Maximize the use of low-cost generics and lower your plan spend
Communicate with members advocating their use of lower cost drug
Save approximately $2,500 per fill

SCAP (Specialty Co-Pay Assistance Program) – we help maximize the use of available pharmaceutical manufacturer copay assistance cards to offset your plan spend and member coinsurance. By using the copay assistance cards, the specialty plan design changes to 30%-member coinsurance on all specialty drugs. NFP Rx Solutions will proactively enroll members in manufacturer copay assistance cards prior to the SCAP program going live. Our main focus is to protect the integrity of the plan deductibles and the maximum out of pocket limits by removing the copay assistance dollars from accumulators.

DPS (Direct Procurement Solutions) – The NFP Rx Solutions team brings industry expertise and a team of clinical pharmacists to combat the rising utilization of high-cost prescription medications. By accessing alternative sources from PhRMA Manufactures, our Direct Procurement Solutions provides Free Goods for members on high-cost medications.

Vaccination Program – A convenient and cost-effective way for clients to access seasonal influenza and pneumonia vaccinations for program participants 18 years of age and older.

Care Management – Ongoing personalized telephonic, electronic, or mail-based interventions provided by a team of clinical professionals. The objective of Care Management is to motivate members with chronic conditions to take a more active role in managing their conditions and help them achieve optimal health.

Generic Step Therapy – Generic Step Therapy design requires the use of cost-effective generic alternatives, within the same therapeutic class, as first line therapy before targeted brands are covered. GSTP targets highly utilized classes with a high percentage of brand spend despite multiple generic options.

DAW Solutions – Innovative ways for a plan to apply penalties when a multi-source brand medication is available to increase generic utilization.

Prior Authorization – Prior Authorization is a drug management technique that requires select prescriptions meet defined criteria before they are covered by the plan. Affected prescriptions are flagged at point-of-sale and prescribers are required to confirm that the use of an affected drug is medically necessary.

Quantity Limits – Quantity limits incorporated into the plan design maintain control over drugs with potential for overuse, misuse, or member safety concerns without eliminating coverage.

Step Therapy – Automated step therapy edits that review a member’s drug history to verify that a first-line therapy was attempted before the claim can be approved at the point-of-sale.

Specialty Guideline Management – Specialty Guideline Management supports appropriate utilization for specialty medications. This solution helps ensure that members meet sophisticated and robust criteria before a first dispense, experience expected therapeutic outcomes while on therapy, and discontinue unsafe or ineffective therapy. Criteria are established according to evidence-based guidelines, including standard compendia, national guidelines, current literature and clinical trial data.

Ongoing Trend Management and Oversight - NFP Rx Solutions works closely with our clients to deliver tangible results focusing to deliver industry leading trend outcomes.

Specialty – Specialty spending is approaching 50% of the plans annual pharmacy spend. We leverage aggressive claims management to monitor waste avoidance, prior authorization review and plan design compliance to deliver best outcomes and performance.

Benchmarking – Providing best practices so we can accurately benchmark performance to industry peers in generic utilization, mail order optimization, and network management.

Therapeutic High-Cost Management – Industry trends continue to change faster and faster. We manage and inform the plan members so that they can be aware of new to market drugs, generic savings opportunities, and formulary modification strategies.

Pharmacy Carve-Out

As employers continue their efforts to maintain the balance between quality and cost for pharmacy expenditure, tighter clinical pharmacy strategies can help ensure employees make the most cost-effective use of the pharmacy program. NFP can assist Enova in the carve out of the pharmacy plan, which generally leads to savings through lower trend, better guaranteed discounts, lower dispensing fees and better guaranteed rebates. PBMs can offer improved case management due to their focus on pharmacy claims, rather than all medical claims. Close management of clinical programs and Rx utilization can provide long-term savings through increased generic use, maintenance drugs through mail and managed use/adherence, along with greater transparency into the pharmacy plan.

7.5 Describe your approach to helping clients develop a wellness strategy and implement a program that supports the strategy. Are there any additional costs for any of these programs?

The NFP Well-Being Team works with clients to establish customized and comprehensive workplace well-being programs. This starts with a consultation and culture evaluation, including comprehensive medical and pharmaceutical claims data review, and then follow up with a menu of recommendations / suggestions. The Well-Being team then works with each client to execute selected programs and initiatives. They manage all of the heavy lifting, including vendor RFPs, implementation, launch and ongoing support of the programs put in place. The goal is to provide resources and help find solutions that fit each organization’s goals, culture, needs, and budget.

Clients have access to NFP’s established relationships with well-being vendors that offer cutting-edge technology and services from all fields of wellness and health promotion. Using an RFP tool, NFP is able to provide the lowest pricing in the industry, while selecting vendors that meet each client’s specific needs and budget. This includes partners for biometric screenings and a health assessment. NFP does have a national partnership with Health Designs for biometric screenings, but we are vendor agnostic and will work with each client to find the right partner for them.

Execution: The Well-Being team provides strategic guidance of the client company’s well-being program— including managing its relationship with well-being vendors providing benchmarking, creating annual strategies and assisting with execution on said strategies. It also includes, vendor management and coordination, Well-Being monthly newsletter, weekly tips, and resources from the Well-Being library ranging from materials to get started (i.e., employee well-being survey, sample well-being champions role description and recruitment letter, etc.) to tobacco surcharge resources, well-being challenges, and educational materials.

There are no additional cost for NFP’s well-being support. Should you choose to implement an outside vendor or require custom communication campaigns, there would be a separate cost billed directly by the vendor.

7.6 What ROI do you see around the alternative or complementary benefits (e.g. enhanced access to mental health care providers, acupuncture, chiropractic solutions) for populations similar to ours?

NFP will partner with Enova to identify the desired program outcomes based on specific health and well-being improvement opportunities. We then define objective metrics that will demonstrate progress towards these outcomes over time (i.e. key performance indicators). A few examples of key well-being metrics used to determine program Value of Investment (VOI) include; employee satisfaction, reduction in health risks (stress, physical activity, etc.), happiness, retention & turnover. Once metrics are identified, we explore the capabilities of the organization’s current technology stack to ensure reliable data points are available. Data availability varies based on funding arrangements, technology platform, and contractual obligations of the vendor. NFP continually collaborates with these partners to create initiatives to drive the desired outcomes, monitor progress and iterate on strategies as needed. Where possible, we ask vendor partners to provide guarantees around ROI, savings, or performance to ensure they’re providing adequate services and driving the intended results.

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