Services
Health & Welfare Plan Management
We provide employee benefit strategic planning consulting services that focus on articulation of multi-year objectives and the development of corresponding single or multi-year strategies to those objectives.
Our organizational management consulting practice incorporates our extensive knowledge of employee benefit plan administration to improve efficiency, reduce costs, and adopt best practices in employee benefit management.
Vendor Evaluation & Contract Management
We evaluate third party vendors associated with employee benefit plan management, ranging from HMO and PPO networks and organizations, to pharmacy benefit managers and third-party administrators, to insurance companies and disease management and wellness vendors.
Request For Proposal Services
We provide a complete range of Request For Proposal (RFP) services covering all aspects of employee health and welfare benefit plans including standardized RFP and evaluation documents, as well as real-time on-site testing and valuation of vendor capabilities.
Stop Loss Purchasing Services
Our fee-based stop loss insurance purchasing services for self-insured employers, multi-employer plans, and coalition groups provide substantial savings on stop loss insurance premiums.
Health Care Cost Management
Our health care cost management practice is built upon the analytical power of data.
We analyze client claims data to isolate specific factors that drive increases in plan costs from year to year and incorporate that information into a management strategy.
Mergers & Acquisitions
We provide due diligence services related to mergers and acquisitions including evaluation of candidate benefit plans, identification of unfunded or under-funded liabilities and emerging liabilities, merger integration planning and implementation services.
Actuarial, Rating, & Plan Design Modeling
We provide annual accrual ratings and funding projections for self-insured benefit plan sponsors, including plan trend, performance analysis, and actuarial reserve certifications.
We also provide real-time plan design modeling services to evaluate the impact of plan design changes on benefit plan costs and employee out-of-pocket costs (e.g., deductibles, co-pays, co-insurance).
Retiree Liability Measurement & Medicare Part D Certification
We provide actuarial measurement and certifications of post-retirement health care liabilities under FAS 106 and GASB 45 for private sector and public sector employers.
We also provide Medicare Part D attestations for retiree prescription drug subsidy applications.
Employee Benefit Software Systems Consulting
We provide claim system, transaction processing, and repricing system evaluation services on behalf of our self-administered plan sponsor, third-party administrator and health care network clients.
- Medical Claim Payment
- Flexible Spending Accounts
- Dental Claim Payment
- Health Savings Accounts
- Vision Claim Payment
- Health Reimbursement Accounts
- Repricing Administration
- Clearinghouse Services
Coalitions & Consortium's
Coalitions and consortium's offer the opportunity to pool the purchasing power of individual employers and plan sponsors to reduce costs and minimize the risks and fluctuations inherent in benefit plan funding.
We provide the consulting and management services essential to developing and operating a successful coalition or consortium.
Our services are tailored to the specific needs of each of our coalition and consortium clients.
- Program Design and Development
- Program Evaluation and Strategic Planning
- Program Management and Administrative Services
Compliance
Compliance with federal and state laws and regulations has become an increasingly
complex part of the employee health care benefits landscape.
We provide regulatory compliance monitoring, education, and training services to our client organizations.
- ERISA
- COBRA
- Public Health Service Act
- Internal Revenue Code (IRC)
- Center for Medicare Services (CMS) State Law
- Department of Labor (DOL)
- HIPAA Security
- HIPAA Privacy
- HIPAA EDI
- Office of Civil Rights (OCR)
- State Regulation
Plan Document Services
We prepare and maintain plan documents including preparation of plan amendments, as well as periodic updates required to comply with federal or state law.
- Medical Plans
- Prescription Drug Plans
- Dental Plans
- Vision Plans
- Disability Plans
- Flexible Spending Accounts
- Health Savings Accounts
- Health Reimbursement Accounts
- Flexible Benefit/Cafeteria Plans