Group Health & Welfare
With the rising costs of providing employee health care benefits, employers more than ever are demanding value added, cost-saving strategies and solutions and a tangible ROI in every investment they make.
PremierSource’s significant market share and business volume places it as a top-tier broker-consulting firm among multiple carriers and payers affording our team preferred access to all markets. Even so, we don’t rely on this volume alone to support our negotiation strategy, and we don’t favor any particular vendors. At all times, we represent the employer and align our interests with those of the employer.
We combine our volume-based leverage with an aggressive and proactive approach to negotiations that includes actuarial internal underwriting for any size group, sophisticated data analytics, predictive financial modeling, and a strategic approach to ongoing market due diligence. We are well positioned to represent our clients to achieve best pricing, ultimate flexibility from market underwriters, and the most responsive service available from the markets.
PremierSource applies multiple levels of cost management and risk reduction strategy where we consider your immediate renewal negotiations a minimum expectation. Our belief is that in order to bend the cost curve and beat healthcare inflation, it takes a much more strategic focus and multiple levels of cost management and risk reduction strategy:
Through the years we have learned that each health plan has a story, and that your data tells that story. Having electronic access to detailed data, when available, leads us to the right priorities and strategies that will have the greatest overall impact on cost. We assess your data in such a way that your unique story comes out loud and clear. Your story then guides us to the optimum, tailored solutions for improved health outcomes and reduced costs and risk exposures specific to your plan. We walk you through a systematic prioritization process that allows us to develop a joint strategic plan for tackling both immediate and long-term cost savings one step at a time.
Our team begins with a very comprehensive opportunities assessment where we gather data and information on your existing plans. In addition to your data, we ask you to list for us your top priorities and explain what is working well and what is not. From there, we perform a deep, analytical dive into the data including a detailed claims analysis, benchmarking of the top diagnostic risk groups, detailed provider performance assessment, financial modeling of design alternatives, evaluation of plan documents, detailed contract terms and a complete internally underwriting and actuarial assessment.
This complete process allows us to identify the top diagnostic risk groups that are driving your claims volume in addition to telling you what your next renewal should be before you ever receive it. We further model your historic and future trends, paying careful attention to patterns. Upon completion of this assessment, your story and priorities are made clear and we help you build a strategic action plan to tackle your top priorities over the one, three and five year time frame.
Our model takes each element of your group health and welfare plan and assigns designated specialists dedicated exclusively to that portion of your plan.
For example, our prescription drug specialists focus daily on analyzing pharmacy contracts, pricing arrangements, contracts and solutions to the rising cost of prescription drugs. These professionals are exclusive pharmaceutical specialists and are experienced at seeking out the best actively managed prescription benefit managers to manage your pharmacy programs. Our teams further possess the experience and resources for the negotiations and management of Group Purchasing Organization (GPO) contracts, Own-Use, First-Fill, and 340b strategies, where applicable. Your lead consultant delivers the packaged or unbundled solutions that best meet your needs based on your specific priorities. Your senior account executive coordinates the combined effort.
Our model further includes access to the added experience of approximately 40 labor, employment and employee benefit attorneys focusing specifically on the complexities of all aspects of human resources, labor, employment and group benefit plans. These attorneys are collaboratively seated at the table with our consultants and are fully integrated into our service model. This approach allows us to strategically and proactively plan for our clients to deliver the most effective knowledge and stay out front of all regulatory and compliance issues in these areas.
Rather than simply review case studies to determine the most viable options, our ERISA attorneys are among the few who are making case study history. These professionals are the innovative elite who are appointed to boards with the IRS and DOL and have challenged these and other governing bodies to set the standards of compliance for other professionals in the industry.
Depending on the options selected by our clients, this ongoing support is provided seamlessly as part of an efficiently packaged solution.
Upon much research, due diligence and testing, PremierSource has combined the knowledge of several leading benefits consulting teams under the PremierSource health and welfare consulting model. Depending upon the specific case demographics, client priorities, required experience and resources, PremierSource hand-selects well-qualified specialists among these consulting teams to represent its clients. PremierSource attorneys and relationship management teams provide the ongoing relationship management and integration of regulatory audits and compliance oversight for their clients.
PremierSource researches the market on an ongoing basis to continue to uncover the “best in class” for all disciplines represented under its health and welfare model. This research opens up additional pools of leading industry resources in very specialized areas such as pharmacy benefit auditing, network contract analysis, vendor contract review, TPA auditing, actuarial services, legal, compliance and more.
Our teams analyze the optimum funding mechanism for each employer, comparing fully insured funding to minimum premium options and self insured programs, along with all the ancillary products that accompany such plans.
Sample plans that fall under the healthcare consulting and brokerage division:
- Fully-insured health plans
- Self-funded health plans
- Minimum premium health plans
- Pharmacy benefit management
- Dental plans
- Vision plans
- Group life
- Group disability
- Long-term care
- Voluntary benefits
- Cafeteria plans