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Health Care Cost Management - Data Analytics

Actuarial Software

We utilize cutting edge actuarial software supported by Reden & Anders, a nationally recognized actuarial firm. The underlying Reden & Anders database consists of nearly 4.5 million lives of claims experience. This software replicates the tools utilized by carrier underwriters to develop rates and factors. The following tools are employed in both self-funded and fully insured benefit plans:

Stop Loss Analyzer

This tool evaluates the financial impact and appropriateness of various levels and types of stop loss insurance while incorporating employer specific demographic, location, and industry characteristics. Output results include a comparison of premium levels and exposures at alternative specific and aggregate deductible levels, the impact on aggregate experience due to changes in specific deductible levels, and the appropriateness of premium rate levels versus actuarially based rates.

Medical Reserve Calculator

Using client-specific claim information, the Medical Reserve Calculator provides accurate run-out liability and reserve estimates for self-funded plans and illustrates premium versus claim loss ratios for fully insured plans.

PriceModeler

PriceModeler provides the normative benchmarks and benefits modeling necessary to assist in the successful planning and management of health benefit programs. The underlying data provides a benchmarking tool to compare many aspects of an employer’s demographic characteristics, including age and gender and tier distribution, a group’s claim costs per member, and distribution of claims by type of service and location. PriceModeler is a successful planning tool when used to determine the cost implications of changes in medical/Rx plan designs, locations, and demographics. The underlying information is updated annually to account for medical management, utilization, and geographical changes.

We use these calculations to serve as a strong vantage point from which to arrange reinsurance premiums, claim factors, and attachment factors.

Employee Surveys

Survey Monkey is an online tool that, when used with your permission, allows us to create and gather information from company employees on satisfaction levels of benefits, opinions on wellness programs, or many other focused areas of benefit plans. Surveys assist us considerably in the design and educational needs regarding changes to employee benefit programs.

UBA National Health Plan Benchmarking Survey

2015 was the tenth year for the UBA National Health Plan Benchmarking Survey. This survey has become, by far, the largest of its kind in the United States. With UBA member firms working in tandem with clients and prospective clients, the 2015 survey resulted in just over 17,905 plans being reported by over 11,711 employers. This is more than 2.5 times larger than the next three largest (and widely known) surveys combined.
Each client is evaluated against a benchmark report that compares the plan design, total premium costs, employee contributions, and other plan specifications of their benefit plan to national, regional, state, industry, and group size averages.