When it comes to health plan management, the stakes are high – and the risks are even higher. Data is a self-funded gold mine. But employers need to act on the data they have. With so much information to analyze, where – and how – do you start? Nova Healthcare Administrators has identified 4 helpful [...]
The combination of working with a TPA to better understand the health care usage habits of your employee population (through plan data analysis) and having the flexibility to make plan adjustments when needed is a big benefit of the self-funding structure. A TPA with 25-plus years of experience, Integra Administrative Group was asked to bid [...]
Having access to plan data is a unique advantage in self-funding that gives employers the ability to identify cost-driving trends and make the necessary adjustments to address them. Nova Healthcare Administrators, Inc., shares an example of how this diligent data monitoring led one client to recognize a trigger behind the overutilization of emergency room visits [...]
One thing that’s often a real difference maker for self-funded clients is the emphasis that’s placed on health claim review. As third party administrator (TPA) MedBen noted in a recent blog post, the savings opportunities identified can be quite substantial – even on an individual basis. The TPA shares a case study that shows how [...]
When offering health benefits to employees, employers face the risk of experiencing high-cost claims if plan participants are diagnosed with a serious illness or disease. Self-funding allows the flexibility to plan for these situations … proactively. In this example, Tom Doney of Cypress Benefit Administrators shows how implementing two innovative benefit solutions – organ transplant [...]
Searching for a solution that would offset fast-rising healthcare costs and provide more savings than a traditional PPO discount, Custom Design Benefits introduced a reference-based pricing (RBP) program for its self-funded plans that is returning great results. When compared to traditional PPO plans, the third party administrator (TPA) reports fixed cost savings of 15-20%, and [...]
In a self-funded health plan, employers cover claim costs as they’re incurred, so keeping those charges in check is a top priority. Tom Doney of Cypress Benefit Administrators shares how this careful claim review is paying off in the form of significant plan savings. He explains how his TPA firm was able to uncover $6.4 [...]
