View "The Competitive Value of HealthCare Expense Reduction Experts"
Our strategy aligns the interests of the Employer, Employee, Dependents and the Provider to provide a turn-key, fully integrated Consumer Directed Health Plan. It also delivers lower cost solutions to control healthcare claim costs that are not passed to the insurance company. The Plan fuses unparalleled technology, point of service adjudication, real-time data, and first of its kind anti-fraud controls.
Services include an ERISA compliant CDHP health plan, HSA administration with banking, medical claims administration, TPA functions, better pharmacy management, stop loss reinsurance, real-time Utilization Review and Care Management, Health Coaching, Comparison Shopper, Health & Wellness programs, Health Travel and a host of on-line tools for Employers and Members.
We measure (in real time) disparate data sets with the proprietary software, allowing firms to finally manage, control and consolidate healthcare management within a single system. This will combine transparent dashboards, systematic work-flows, predictive analytics, simulations and member marketing campaigns, not only improving health plan efficiency, but, increasing member engagement - immediately reducing the entity’s total healthcare expenditure.
Our “GOLD Standard” solution retains employee self-insurance, which is defined as deductible plus co-insurance plus all co-pays. We then formulate a “deductible” that fits on top of the plan participant’s maximum out of pocket that the employer fully funds but only pays if the claim exceeds the plan participant’s liability. Healthcare expenses that exceed the employer’s funding pass to the insurance company, just like their current fully insured plan. Employer’s funding that hasn’t been spent on claims, belongs to the employer; these funds do not transfer to the insurance company.