Increasing healthcare costs and regulations make your benefit decisions more difficult each year. Our experience over the past 40 years will provide you with the knowledge and resources to make your benefit decisions. We offer a wide range of benefit solution strategies designed to maximize your benefits program and effectively manage your costs.
We offer a wide range of strategies that include Traditional Fully-Insured, Level-Funded, Self-Funded and Reference-Based Pricing options.
A strong Pharmaceutical strategy is a key component to managing costs. Rx costs have a dramatic impact on your renewal. Let us show you how to manage these costs with significant cost-savings to you and your employees.
A Comparison of
Fully-Insured vs. Self-Funded
|Administrative Costs:||Example: Average $65|
|Rate Increases:||15% to %30 each year|
|Claims Disclosure:||Limited to No disclosure|
|Oversight Authority:||All State and Federal requirements|
|Monthly Costs:||A fixed cost each month|
|State Premium Tax:||You are taxed based on the entire premium|
|Medical Customization:||The carriers design your plan|
|Rx Customization:||The carriers decide your pharmacy options|
|Network Choices:||You usually must choose 1 network from your carriers choice of networks|
|Health and Wellness Programs:||A one-size-fits-all approach is usually offered|
|Reserves:||Retained by the the carrier|
|Profits:||Retained by the carrier|
|Administrative Costs:||Example: Average $35|
|Rate Increases:||Your increase applies to your stop-loss based on claims experience|
|Claims Disclosure:||Complete access to all claims data|
|Oversight Authority:||Federal Requirements only|
|Monthly Costs:||This may vary based on claims experience|
|State Premium Tax:||You are only taxed on the stop-loss premium|
|Medical Customization:||You design your own plan with customizations|
|Rx Customization:||You can customize this and choose your own PBM ( Pharmacy Benefit Mgr) to lower costs.|
|Network Choices:||You choose your own networks based on regional and national needs|
|Health and Wellness Programs:||You can customize based on your specific needs|
|Reserves:||You, the employer, retain these to pay for future premiums and reserves|
|Profits:||Retained by the employer|
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