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Benefits

Employee Benefits and Enrollment

Designing Your Employee Benefits Program

Risk Strategies understands that employee benefit programs provide health care organizations with a competitive edge to attract and retain employees and that each organization has unique needs and goals.

To deliver your customized strategy, we will:

  • Design customized plans and appropriate funding strategies
  • Request proposals from all third parties and negotiate aggressively on your behalf
  • Provide direct communication and access to insurers
  • Access the best benefit plan resources around the country
  • Deliver all proposal terms, conditions and pricing to your satisfaction
  • Conduct carrier and vendor interviews
  • Make recommendations and manage final negotiations
  • Manage implementation and administration process
  • Continually monitor the program to make sure it meets your expectations
  • Outline the strategy for the upcoming enrollment well in advance of the renewal

Benefits Administration

Rising benefit costs combined with shrinking human resources departments make Benefit Administration an on-going challenge for benefit administrators.

Risk Strategies can provide comprehensive benefit administration solutions; from outsourcing the entire process to focusing on specific areas where you need administrative support, such as:

  • Direct bill and retiree services
  • COBRA administration
  • Enrollment services via call center, online or paper
  • Eligibility management
  • Premium billing & reconciliation
  • Vendor management

Benefits Communications

Communicating employee benefits is challenging and time-consuming for any company’s benefits administration team. Risk Strategies helps companies provide real-time employee assistance to reduce costs and increase productivity.

Risk Strategies’ online self-service offering provides:

  • Cutting edge technology to eliminate significant administrative costs
  • Major reductions in time spent fielding questions, managing plans, providing updates, answering calls and distributing materials
  • Personalized and up-to-date benefit information, policy content and decision support tools through a secure web portal, which allows workers to get information 24/7, and your HR department to focus on more strategic initiatives

Medical Benefits and Self-Funded Stop Loss

Medical Coverage

While Risk Strategies' consultants provide all of the traditional employee benefits consulting services, our specialists’ in-depth knowledge of health care contracting and provider reimbursement methodologies allows us to explore a variety of financing strategies and coverage alternatives that may not be typically considered.

Self-Funded Stop Loss

Self-funded stop loss coverage protects employer-funded health plans from unexpected or catastrophic health claims, limiting risk while maintaining self-funding advantages. Because large-claim occurrences are on the rise and Health Care Reform has eliminated annual and lifetime limits, even the largest employers need some level of stop loss insurance.

As the largest, most experienced broker/consultant in the managed care stop loss business, Risk Strategies professionals can tap into relationships with specialty market carriers largely unknown to traditional brokers to develop unique, cutting-edge approaches to self-insured medical programs.

Stop Loss Insurance Proposal Process

Armed with detailed financial analytics mined from client data, we solicit terms from traditional self-funded stop loss carriers, managed care carriers and other available sources. We also explore risk financing alternatives and enhanced contract provisions not normally found in traditional stop loss contracts.

Factoring in client risk appetite and financial strength, we evaluate all options against our analytics to determine the stop loss program’s final structure. We then negotiate aggressively on the client’s behalf, using our position as the largest managed care stop loss broker to ensure the best outcome.

After coverage is placed, we provide clients with a dedicated Claims Service Center which serves as a central repository for all claim-related activity between the client and the carrier.

Life/Disability/Accident Insurance

Online RFP Platform

Risk Strategies’ online RFP platform is a web-based sourcing exchange for purchasing insurance products in a transparent environment and ensures you get the best possible proposal terms and conditions.

This approach is designed to optimize plan value by strategically evaluating:

  • Carrier pricing, funding alternatives and financial strength,
  • Plan design and policy/contract terms,
  • Carrier service capacity, and
  • Carrier claim and leave management components.

Online Platform Phases

The proprietary online RFP platform has three phases:

1.    Technical evaluation:
Determines which vendors can meet contractual administrative and “Scope of Services” requirements

2.    Financial evaluation:
Allows carriers to rebid in a transparent, online reverse auction to improve their competitiveness

3.    Vendor evaluation:
Final presentation, site visits, and personnel interviews allow the client to judge the best overall fit for their organization at the most efficient price.

Online Platform Process

The online platform process includes a unique open market “sourcing event” (or reverse auction) in which suitable vendors bid their most aggressive pricing/plan. 

Transparency of pricing is the key to the platform’s impact and it creates greater competition as carriers clearly see and understand who they are competing against, what they are competing for, and where their proposal stands relative to their competition. 

The resulting rapid downward price pressure delivers cost reduction results not normally attainable using a traditional RFP process. Average premium savings frequently exceeds 20% in addition to cutting the RFP completion time in half. 

Dental, Vision and Voluntary Benefits

Dental

Dental plans are a key component of a competitive benefits package. With many dental care options, providers and vendors, the choices can be overwhelming. Risk Strategies understands the stringent criteria required by each state’s insurance regulatory agency, as well as the different methods of funding. We can help you find affordable dental coverage that is both comprehensive and competitive.

Vision

As a top-five most-desired benefit for employees, vision care is a key element of a competitive compensation and benefits package.

Risk Strategies works with all major vision care marketplace vendors and fully understands their various plan offerings; from fully or partially sponsored by employers to voluntary, employee-pay-all. We help you decide what type of plan best suits your needs.

Voluntary Benefits

Employers are increasingly turning to voluntary benefits to enhance their employer-paid offerings without adding costs. Risk Strategies’ experience in health care lets us effectively analyze, select, communicate and support creative solutions best suited to this industry. We partner with leading voluntary benefit firms specializing in the health care industry and use a variety of platforms to educate employees, answer questions and provide Human Resources with ongoing administrative service and support.

Pharmacy Benefit Management

Traditional PBM Management

The buying power of our nationwide client network delivers sizable cost savings and pharmacy-benefit discounts from the largest pharmacy-benefit manager in the United States. Those currently doing business with one of these PBMs can roll over existing contracts to take advantage of immediate savings without any disruption in their current prescription drug program.

Transparent (Pass-Through) PBM Models

Under our transparent PBM partnership, our partner PBM is committed to returning (or passing through) 100 percent of all discounts, rebates and associated revenue stream dollars that may have an immediate impact on the plan sponsor. All pharmacy discounts, rebates and other pharmaceutical incentives are completely disclosed, leaving employers with a clear and complete understanding of their prescription costs.

We help clients achieve lower net drug costs, greater financial strength and improved member health and satisfaction through:

  • Unbiased clinical programs
  • Superior customer service
  • Proactive account management
  • Traditional RFP process or reverse-auction approach
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