Self Insured Reporting 2017-01-05T16:29:11+00:00

Project Description

Self Insured Reporting

As a broker, after you have placed your client’s reinsurance contract your job is far from over. Your client then immediately looks to you to tell them how claims are performing, what is and isn’t working well, and what future costs are expected to be. From their perspective, this is part of your job responsibilities.

Our proprietary claims reporting system is the only one in existence completely dedicated to completing these responsibilities for the benefit consultant. When we place your reinsurance, we will then upload all historical claims data into the system on your behalf. Our staff will also update ongoing monthly claims as they occur, thus allowing for all of the systems capabilities to work on your behalf including:

  • Claims trend reports

  • Budget and expected plan costs versus actual costs

  • Renewal costs projections

  • Online employer login, completely branded to your firm

We can even provide more extensive support should you need the additional help on a particular client. Our internal underwriting and actuarial support team can provide quarterly commentary on plan performance as well as client conference call assistance. Contact us for more details.

Healthcare Plan Claims Analysis

As healthcare costs continue to press upwards, the burden for employers to understand and project forward costs as an employer continue to increase. Leverage our in-house expertise as an extension of your company:

  • Calculate self-funded budget rates for active and retired groups

  • Calculate actuarially certified COBRA rates and Incurred But Not Reported (IBNR) claim reserve

  • Short-term and long-term reserving of Health Reimbursement Arrangements (HRA)

  • Analyze historical claims experience and compare it with national benchmarks

  • Evaluation of onsite clinics on a pre-implementation and post-implementation basis

  • Illustrate financial impact of various levels of stop-loss reinsurance

  • Evaluate medical and prescription drug discounts

Measure the Impact of Plan Design Changes

  • Deductible, coinsurance, co-payments, out-of-pocket maximums

  • Prescription drug plan designs

  • Consumer-driven health plans (HRA, HSA, and High-Deductible Plans)

  • Modeling of employee anti-selection for dual option plans

  • Modeling using normative data or actual claims experience

  • Nondiscrimination testing for health and section 125 plans

  • Benchmarking of plan design and costs

Self-Insured Academy
Self-Insured Academy

In a post Affordable Care Act (ACA) world, it is no longer possible for employee benefit brokers to ignore the possibility of their clients moving toward a partially self-funded medical plan arrangement. Today’s marketplace is one where if you are not discussing this type of financial structure with your clients, then you can rest assured someone else is.

To assist, we are proud to have developed our Self-Insurance Academy to help brokers develop in their understanding of self funding. Our overall vision is to assist employee benefit consulting firms across the full continuum of experience levels.