Medical Benefits: CHALLENGES & OBJECTIVES
What employers and employees both want is a benefits program that provides sufficient coverage, costs less and is well administered. What they get is often significantly different.
At medical benefits enrollment meetings, employees want to know basic information: Is my doctor on the provider list? Will I have access to the hospital I would want to go to? What will my contribution, co-pay, and deductible be next year? When I need more information how do I get it? What should be a time of comfort and clarity, often ends in confusion and stress.
Likewise, employers face their own challenges as they battle with exploding costs, uncertain risks and complex administration requirements.
Typically our medical costs are 8% to 14% lower than incumbent expenses
PROGRAM FEATURES
We offer access to the largest commercial preferred provider organizations, (PPOs) in America, Aetna Signature Administrators, our lead PPO, and dozens of national or regional PPOs such as Wellpoint and Blue Cross. These PPOs vet the providers and negotiate excellent rates. This means that if your company has dispersed employee groups there is a good chance that we can efficiently service more of your company under a unified plan, streamlining the task.
Our IT systems have been developed by INDECS, (a third party administrator) and have achieved high competence in supplying the necessary information on demand, online for Fortune 500 clients since the 1980s.
Employees and employer can get provider information online by name, community or zip code, also available are employee claim information and status of deductibles and co-pays.
Case-specific information is available for employees to access online, 24 hours a day. It can give them information about their medical condition, treatment options, and available benefit coverage. The information even includes medical questions that would be useful to discuss with the doctor, enabling the doctor to better service the needs of the patient and improve the outcome of the appointment.
Employers also have web-based access to valuable summarized reports of incidents, trends, costs, and risk exposure updates.
All patient information is protected under appropriate privacy and need to know policies that abide by State, Federal and employer reporting requirements. Self–funded employers have access to any records they need when following HIPAA, APA and other pertinent regulations established by appropriate bodies of applicable legal jurisdictions.
VALUE ADDED
Typically our medical costs are 8% to 14% lower than incumbent expenses, based on code-by-code charges for treatments rendered by provider.
By self-funding medical expenses employers are not funding state insurance taxes, insurance company reserves or profits. Neither do you have to follow state insurance mandates for benefits. All of the above provides more freedom to define your benefits the way you want them.
NEXT STEPS
Grant Allied Benefits a discovery meeting. We will come with a team of individuals able to answer detailed questions. We will summarize the meeting with detail on whether we believe our programs are a fit to your requirements, and list the outstanding problems that will have to be solved, together with the process we will use to resolve issues.
If you are encouraged that we may be able to work together, a list of data requirements will be presented that will be necessary in order that we can complete a savings statement and make the case toward signing a contract.