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Designed for the mid-market employers, the CAHP Report is a standardized report covering plan design, analysis of rating, employee contribution strategy, funding, and risk management.

 

Using industry experience, we work with our actuary to design a healthcare program that meets participant and employer needs.  In addition, using our actuary’s proprietary models, Health Cost Guidelines and Dental Cost Guidelines, we can readily value benefit design changes to ensure healthcare programs meet employers’ financial constraints.

 

The Renewal Projection helps employers set preliminary budgets prior to receiving the renewals from the carriers.  We complete a pricing calculation to determine the projected premium and compare this to the current premium rates.  A trend analysis allows outliers or seasonality problems to be identified and addressed.

 

The Renewal Evaluation is the final step in the renewal process and is conducted after receiving renewals from the insurance carriers.  We update the calculations completed in the Renewal Projection with various items:  additional claims experience, more recent enrollment, plan design changes, potential carrier changes, proposed administration fees, and stop-loss coverage options.  With this in hand, our consultants and actuaries will review the renewal for proper calculation of reserves, benefit changes, large claims adjustments administration fees, stop-loss premium and profit.

BCT Report – Budgeting, Contribution & Trend Report:

The BCT Report accurately forecasts costs in the coming year and enables the employer to set budgeted rates for self-insured plans.  After budgeted rates are established, our actuary models employee contributions according to your desired strategy.  A trend analysis allows outliers or seasonality problems to be identified and addressed.

 

Designed for groups that are currently self-funded, our Stop-Loss Analysis accesses the risks and costs for various stop-loss coverage levels.  Using Monte Carlo simulation, our actuary provides a graphic display of potential scenarios to determine what options fit the employer’s risk preferences.

 

The FMR brings together claims experience, paid benefits, expenses, and budgets into one financial report for gross and net costs.  It performs preliminary auditing of data to confirm accuracy of reports.  Up-to-date forecasting leveraged through actuarial analysis turns “data” into “information” giving you the ability to manage proactively, not reactively.

 

The IBNR Reserve calculation uses actuarial projection techniques to estimate incurred claims and determine how much you should be holding in reserves to avoid IRS and DOL compliance issues.  We can provide reports annually or quarterly and will help explain results to auditors in light of Sarbanes-Oxley requirements. 

 

FSA Assist™ is an innovative software product that helps employees estimate their out-of-pocket costs for medical, dental and vision coverage.  Used as a decision support tool, FSA Assist™ can increase participation rates and election amounts, saving both the employer and the employee significant tax dollars.

 

Claims Positioning System (CPS) provides in-depth claims analysis of your plan and its relationship to industry benchmarks.  As a foundational tool, our Claims Positioning System will help you understand the causes and potential solutions hidden in your claims experience.  As one of our actuary’s landmark programs, we collect claims information for your medical and prescription drug plans and then process the information through our models.  Most importantly, you can see the position of your plan’s claims relative to our actuary’s industry-leading benchmarks – helping you pinpoint any areas for improvement.  After the standard reports are presented, you can build custom reports using various fields in a spreadsheet format or perform scenario testing of different plan designs.  This is especially useful if you are interested in wellness, disease management, or CDHP plans.