SERVICES
We help groups with self-funded health plans manage their healthcare benefits while lowering costs and improving member outcomes.
We are committed to creating a health benefits strategy that seamlessly aligns with your organization’s goals. We offer multiple solutions, which can be tailored to fit your unique needs.
Our services include stop loss coverage, COBRA and HIPAA administration, non-network negotiation services, subrogation, prescription benefits management, and online services for members and employers.
High-Touch Case Management
Our case managers support employers at every step of the process, so they can focus on their business and employees can focus on their well-being.
- A dedicated case management team
- Customizable plan designs, including high-performance networks with financial incentives to drive utilization and minimize costs
- Preferred stop loss vendors with superior pricing based on the underwriting methodology
Claims Administration
Our case managers support employers at every step of the process, so they can focus on their business and employees can focus on their well-being.
- In-house utilization management
- Disease management team that reviews and adjudicates each claim for accuracy and medical necessity
- Dashboard that provides metrics to measure trends and project future exposure
- A system that captures payroll deductions and eligibility reconciliation for stop loss, reinsurance, and any ancillary providers of additional benefits
Utilization, Financial Reviews and Recommendations
We are stewards of your business and care for your employees’ well-being.
- Multiple premium funding programs, including options for employer participation
- Utilization and disease management to help contain costs
- Modern underwriting processes that produce faster results, reducing the need for health questionnaires or, for groups under 150 eligible employees, reducing the need for claims experience for rate development
- Predictive Modeling that helps deliver the best care, minimizing financial burdens
Connected Technology
We use our proprietary technology to move quickly, and our expertise helps resolve issues that are out of the ordinary, giving our customers the best care possible.
- In-house utilization management
- Disease management team that reviews and adjudicates each claim for accuracy and medical necessity
- Dashboard that provides metrics to measure trends and project future exposure
- A system that captures payroll deductions and eligibility reconciliation for stop loss, reinsurance, and any ancillary providers of additional benefits