ASG Perspectives

FACES of ASG: Meet Christopher Joy

Wednesday, October 03, 2018

 

A YEAR SINCE JOINING US at ASG, Christopher Joy has become an invaluable asset. With a 20-year background in self-funded employee benefits plans, Chris takes a ton of pride in helping employers craft competitive and affordable employee benefits solutions. And since he previously worked on "the other side of the desk" as a Broker and TPA, Chris knows all about building partnerships and structuring stop-loss solutions for the diverse needs of our employer groups.

 

 

What is your job title at ASG?

Underwriter

And what does that role entail?

Assessing risk and pricing coverage accordingly. Negotiating with Brokers and TPAs to arrive at a competitive stop-loss solution for their clients

How long have you lived in Gorham?

Two years

Do you have a family? Please tell us about them.

Yes, married with 2 young children

What was your first job, and how old were you?

Newspaper delivery, age 12

What advice would you give to a new hire in the stop-loss industry?

Don’t be afraid to pick up the phone and communicate with your clients and customers. Learn about the businesses that you are reviewing beyond the information provided on the financial reports.

What is your favorite season? Why?

Winter! I enjoy rising to the challenge presented by our robust Maine winters.

Do you have a favorite quote?

Tomorrow is whole new day!

 

On-Call with Sara Winand, RN: Rates for Air Ambulance Services Taking Off

Thursday, August 30, 2018

 

 

A recent issue of MyHealthGuide newsletter has put the spotlight on air ambulance regulation. In fact, the Health Care Administrators Association (HCAA) and Society of Professional Benefit Administrators (SPBA) recently initiated a targeted letter-writing campaign focuses on rising air ambulance transportation costs for self-funded health plans.

 

Without reform, America’s families, health care providers and the self-funded community face an increasing and often conflicting set of rules and regulations that fail to provide any semblance of financial certainty when life-saving air ambulance services are employed.

– HCAA and SPBA

 

Air ambulances are typically covered by health insurance if determined to be medically necessary, and if the service is limited to the nearest appropriate medical facility. Fees are generally not covered if the air ambulance is used solely for convenience. Almost all air ambulance services are out of network, and since the service must typically be arranged under urgent circumstances,any pre-service negotiation is rarely an option.

At ASG, we’ve seen first-hand instances in which air ambulance charges have skyrocketed into outrageous dollar amounts, especially when used in urgent situations and provided by non-network vendors, oftentimes without precertification. Many times a deposit is requested from the patient/family and without a signed negotiation the member is balanced billed.

For example, we recently worked with a claimant who had an accident in Georgia and was hospitalized there, but needed a specialized rehab facility for recovery. We soon learned there are only fourteen such facilities in the country; the closest location was quoting a three-week waiting period; and due to the woman’s condition, air transport was the only option to get the claimant to any of the other thirteen. On top of these obstacles, the employer group’s plan did not require a precertification for the service.

The claimant was ultimately transported from Atlanta to a rehab center in Chicago. The air ambulance bill: $258,000. Thankfully we were able to negotiate the claim to $136,000, even though the air ambulance company was pushing for immediate payment.

These numbers are not unexpected. A recent study conducted by the Montana Legislature broke down air ambulance costs into two main parts: liftoff fees and per-mile charges. While the former ranges between $8,500 to $15,200, the latter can be anywhere from $26 to $133 per mile. These variable charges are based on distance and staffing needed for the transport.

We and others in our industry are keeping a close eye on Sentinel Air Medical Alliance, an alliance of healthcare payors established in response to the rapid escalation of air medical transport rates. Sentinel's goal is to provide solutions for effectively controlling rates and ensuring proper utilization of air transport services. The alliance's areas of focus include prior authorization for air ambulance services, medical review of transport claims, claim negotiating and repricing, and consulting services to help healthcare payors develop strategies to control air ambulance costs.

Global Emergency Services provided by Assist America are included with every ASG sold stop loss policy. These services are a supplement to the health plan but it is imperative to contact them to make arrangements such as air ambulance as they cannot reimburse for arrangements made by another party. For more information on Global Emergency Services go to http://www.assistamerica.com/.

 

 


Spotlight on: Significa Benefit Services

Thursday, July 19, 2018

The more our ASG team does business with Lancaster, Penn.-based TPA Significa Benefit Services, the more we marvel at the value of a true partnership.

We first began working with Significa this past winter when Sales Executive Steve Shirk came to us with an opportunity to underwrite an employer group that presented several unusual cases, yet required timely coverage.

He recalls, “Time was of the essence and there was some pricing the broker wanted—in a level-funded format—so we worked around these things and ultimately, were able to move forward in a way that we all felt benefitted our customer.”

Get to Know Significa

Over the past months, it’s become clear that the 30-year-old firm shares more than a few core values with us at ASG.

For one, Regional Sales Director David O’Shea David notes that “as a TPA, we’re closer to the customer—we understand the customer’s needs. And that translates into our philosophy that the plan should be customized to fit the group, not the other way around.”

Transparency is key to achieving this end. “Without transparency, a business doesn’t know what to do to get control of its healthcare costs,” he explains. “By having access to claims data, and understanding the usage in that employer’s population, it helps us to design that plan in a way that helps control costs.”

Steve notes, “When we understand the customer, we understand what kinds of carriers and programs we want to bring to the program. Telemedicine programs, bringing in a fiduciary group—we’re tailoring the administration of that plan to meet the customer’s very specific needs.”

The second key is managing claims costs. David points out, “In our world, we’re auditing the emergency room client, we’re monitoring the surgical claims—we’re constantly looking for savings for the customer by managing the risks on a regular basis.”

Lastly, transparency—often a tricky achievement in our line of business, but key to proactively managing costs by managing care. At Significa, says Steve, “We have a robust claim reporting tool. We’re understanding the usage in our groups’ populations. After nine months or so we understand what the population is doing, and at that point, we can make changes to the plan.

“For example, when we see high utilization, we know the plan design is wrong. We want the employer to begin to get some control over costs—so we are able to reduce fourth, fifth, or sixth-year costs through a proactive approach to managing costs, managing care, and providing satisfying health benefits.”

The result of this diligence: knowledgeable employers and happy employees. “We find that once the employers see that full transparency, they’re able to make good decisions about managing healthcare costs effectively,” says David.

A Hands-On Approach

Significa also maintains relationships with vendors that the firm can match with the unique needs of employer groups. Steve explains, “By farming the data and understanding what’s going on, we can bring the right vendor to the table—and then we can control expense and enhance the experience with that customer.”

Significa is applying that model and differentiating itself with a third key partner: brokers. Specifically, by building consortiums, customers can buy in as participants, allowing Significa and its broker partners to grow business together.

“The small employer with 30 lives, 50 lives—they don’t have a lot of negotiating power. But in a consortium with thousands of lives that we can negotiate on their behalf, they now have the power of a large employer with the ability to negotiate insurance costs while spreading risks among several groups.”

Recognized for Experience and Caring

Here at ASG, we’ve often heard about the accolades Significa receives on a regular basis for its highly experienced claims professionals and dedication to customer service. “I think we bring a very good, experienced package with compassion and understanding about how we can assist our customers in managing risk,” notes Steve. “Being able to make recommendations, prove those recommendations to the customer, then implement those recommendations and measure those successes in subsequent years truly sets us apart.”

We value our relationship with Significa and look forward to many years of mutual success and growth!

 

FACES of ASG: Meet the Marvelous Maggie Moynihan!

Monday, May 14, 2018

 

ROCK STAR UNDERWRITER AND AMBASSADOR for all things Portland—ASG's Maggie Moynihan has been a familiar face and voice to TPA and broker partners for more than 12 years. Maggie first joined our team as a part-time administrative assistant while still attending the University of Southern Maine. Since those early days, she has shown unflinching optimism and an unfailing commitment to serving our partners with the best stop-loss products and services possible. No matter the complexity of a challenge a new employer group may pose, Maggie is typically the one leading the charge to come up with a creative solution to make a win-win happen. Her "We Can Do It!" attitude is both infectious and effective!


Get to Know Maggie

What is your role at ASG?

Senior Underwriter

What was the weirdest job you had before joining ASG?

Nursing Home Waitress

If Hollywood made a movie about your life, who would be cast as you?

Meryl Streep

If you had to eat one meal, every day, for the rest of your life, what would it be?

Wine

What music is on your phone?

Fleetwood Mac, The Beatles, Enya, Old Crow Medicine Show, Jurassic 5

What advice would you give to a new hire in the stop-loss industry?

Take initiative and ask questions!

Where is your favorite place in the world?

Maho Beach, St. John, USVI—it’s a great place to swim with turtles!

Who does your sun rise and set on?

My husband Kevin, and our almost two-year-old son, Fox
What are your favorite restaurants in Portland?

Eventide Oyster Co., El Rayo Taqueria, and Scales, all for their great food and amazing drinks
If you could do another job for just one day, what would it be?

Wine Sommelier

Will Justify win the Triple Crown this year?

Yes!

 

SPOTLIGHT ON: INTERLINK COE Networks & Programs—Proactively Managing Plan Expenses

Monday, February 05, 2018

 

There’s a rapidly growing company in Hillsboro, OR, that’s been around for 23 years and is currently on the brink of changing the world.

Well, the world of cancer care management—which could prove to be monumental for all of us in the healthcare insurance industry.


For over 23 years, INTERLINK COE Networks & Programs has provided transplant network services for reinsurance carriers, insurance companies, self-funded employers, and other managed care clients in the United States.

INTERLINK is an established Center of Excellence-based company that recognizes the value of ensuring geographic coverage of evidence-based care protocols for plans across the nation. Its Centers of Excellence network provides access to high-cost, low-frequency medical procedures used by health plans of a range of sizes.

The company was founded by John Van Dyke, a former PPO negotiator, in 1995. In 2010, INTERLINK saw an opportunity to work with reinsurers to develop targeted cancer care management programs into the Centers of Excellence model.

INTERLINK’s CancerCARE program extends the firm’s Center of Excellence networks with specialized cancer case management nurses who provide consultative support for members looking to choose providers and seek treatments. Targeted cancer benefit language for employer plans is also included at no cost.

“Cancer is the number one employer-paid stop-loss deductible; number one reinsurer reimbursed claim at all levels; and also the number one cause of bankruptcy for members who are covered,” notes Van Dyke.

During a time when health plan premiums have increased 7% to 9% per year, the cost of cancer treatment has jumped an average of 20%. Van Dyke adds that health plans have no control over the frequency of cancer diagnoses, but can influence care quality with benefit incentives and definitions when inserted in the plan document.

However, he believes, there is an opportunity to control costs and increase optimal member outcomes, simply through improved quality of treatment. Better treatment translates into minimized complications and risk of reoccurrence—and ultimately, lower plan costs.

“Our CancerCARE program, from a plan level in managing cancer, is the number one investment that a plan could make to manage their members’ cancer care,” he says.

In 2018, the company CEO estimates the expected frequency of transplants will be 14.66 per 100,000 insured members; and of those 14.6 forecasted transplants, nearly half (6.0 of 14.66) will be for a cancer-related diagnoses.

“With benefit caps removed, a single poor outcome transplant can now cost the plan many millions,” says Van Dyke, “but if you put the CancerCARE benefit language in your plan, you could identify 41% of your transplant cases proactively. With this early notice, you can better manage your expenses within the plan."

Taking Risk Management to the Next Level

“Once you put CancerCARE in your plan, you’re already managing your transplant risk.”

–John Van Dyke, CEO

INTERLINK’s TransplantCARE and CancerCARE programs are based on performance narrowed concepts through networks that are built on “value-driven principles, the best providers, and timing for the best cost,” says Van Dyke. “When you performance narrow with INTERLINK, and outcome improving your very low-frequency, high-cost medical procedures, we’re not disrupting care, but improving member decision quality.”

The Data Tell the Story

The INTERLINK performance model addresses all solid organ transplant programs. The data-accepting capabilities of the model was extended in 2017 to accept transplant outcome data for all transplant teams throughout the U.S.

“We’re looking at 25 of the most telling outcomes for all transplant teams,” explains Van Dyke. "Which identifies for us those transplant teams posting the best outcomes.”

That data, says Van Dyke, "comes to us risk-adjusted by transplant center and team—so we have the cleanest data set in healthcare to rank the lowest-rated to the number one outcome provider in the country.”

For example, should a covered member require a liver transplant, he explains, “INTERLINK’s narrow-performance network directs them to a facility where the surgical team is high-performance, high-competency. We’re looking for a great member outcome, which almost always comes with a lower cost.”

A New Era in Cancer Care Management

As Van Dyke continues to work with brokers, consultants and health plans of all types to incorporate the Centers of Excellence model to cancer treatment, he understands that the healthcare market can be slow to adapt to new concepts. Yet after nearly three decades working in the business, he is confident INTERLINK’s solution is about to have a significant impact.

“I see the cancer care and transplant programs as examples of today’s most important initiatives,” he says. “Our focus is on quality care, and the outcome of quality care is reduced price. So if healthcare moves on this pathway, I believe this is how we’re going to solve our healthcare crisis.”


 

On-Call with Sara Winand, RN — Let's Get Creative with Corporate Wellness

Thursday, January 04, 2018

Many wellness programs offer paid time off as a reward for completing certain ongoing tasks—like taking so many steps in a designated two-week period can earn an employee one hour of PTO. For example, Blue Cross Blue Shield South Carolina offers its Get in the Habit of Moving More Challenge to help employees move toward better health. We started looking into this trend, and discovered the following article from Benefits Broker Pro, which we thought would be of interest to any TPA or Broker looking to offer a new twist on corporate wellness.

 

Corporate wellness is having its moment 

A cloud has been hanging over the corporate wellness industry, in no small part due to an often-cited RAND study which shows wellness programs are having little to no effect on reducing employer health costs.

Findings like this spell bad news for wellness solutions, not to mention for the HR departments that have invested billions in them. Does this mean it’s time to throw in the towel? Hardly.

Reverting to business as usual isn’t a winning strategy. Chronic illness, health costs, and lost productivity are all on the rise. Companies that ignore these issues do so at their peril.

All of the above is why I believe in 2017 the wellness industry is having its moment. While the initial hype behind wellness has led to serious disillusionment, we are now at a pivotal turning point, where thoughtful approaches, as well as some hard-learned lessons, start leading to real results.

Lesson #1: Stop creeping out your employees

All too often, wellness programs alienate employees long before any progress can be made. This usually begins with the health risk assessment -- a deeply flawed but widely used tool. These impersonal assessments ask employees to answer invasive questions like, “How many times do you cry per week?”

Lesson #2: You can’t force employees into better health

If your employees believe they are being forced into a program or penalized for not participating, that new Fitbit you’ve rolled out can quickly look like a pair of handcuffs. It’s crucial instead to nudge employees into wanting to participate and be proactive in maintaining or improving their own health.

This level of trust and engagement will never happen in a program where employees feel berated for not losing enough weight or taking too few daily steps. Wellness programs must dig deeper to determine what employees want and what will motivate them to achieve long-term health goals.

It’s important to remember trust goes both ways. Allowing employees to opt-out if they aren’t ready is a leap of faith employers must be ready to take. The focus for these non-participants then becomes determining what they need to feel ready and capable of improving their health.

Sound like a lot of effort? It is. But the alternative is failure. A mandatory, punitive wellness program ultimately won’t create positive engagement or meaningful behavior change.

Gym stipends and other perks such as on-site yoga classes are great. Companies should absolutely offer them if it makes sense for their employees. But workout perks can’t be the final word in a wellness program. Social determinants of health should factor in, too.

If an employee is dealing with anxiety that makes getting out of bed a daily struggle, what good will a gym membership do them? In addition to exercise and nutrition components, a wellness program should fulfill behavioral health needs. Services such as stress management workshops, financial counseling, and substance abuse treatment can make a world of difference in the health of employees.

Lesson #4: Culture is king

What these lessons have in common is that they are all points to consider before rolling out a wellness program in the first place. To that point, there is no value in offering a program until leaders have a thorough understanding of their company’s culture.

I tend to view corporate culture as the iceberg that lives beneath the surface of any wellness program investment. Culture single-handedly determines how much ROI is observable at the top. Companies which lack strong cultures -- where employees feel valued, believe in their company mission, and trust peers and leadership alike -- will continue to see their investments in wellness sink, dragged down by internal dysfunction, fear and mistrust.

There’s no quick and easy way to make wellness programs work, but the right formula is simple. Successful programs accurately reflect employee health needs at the individual level, are built on solid work cultures, and engage employees in a spirit of co-creation. When these dynamics are in place, a wellness program is primed to provide useful, personalized solutions which lead to a healthy return on investment for employees and the company alike.

 

Spotlight on Moreton & Company: Data, Innovation & Service — Oh My!

Thursday, December 14, 2017

 

Almost universally, there is a belief among business-to-business companies that two key ingredients make a relationship work: quality and trust. According to Julie Acocks, manager of the underwriting department at Moreton & Company, the relationship with ASG fits that bill just right.

As Utah’s largest independent insurance broker with more than 100 years of experience providing brokerage services to organizations in the Salt Lake Valley and across the United States, Moreton & Company has built a solid business on a foundation of superior customer service and innovative solutions for its clients’ most challenging insurance needs.

Julie’s perspective takes that commitment a level deeper. She says, “When it comes to stop-loss, many think it’s a commodity, but it is not: the difference lies in when it comes to getting the claim paid and dealing with difficult things — because things come up, and that’s a reality with stop-loss.

“The promise then becomes, who can I count on to be there to deal with this situation, handle the tricky conversations about how to make it work, and eventually, ensure the claim gets paid? We have been in that situation, and I have always felt like ASG has had my back.”

 

We’ve been honored to help make the tough stuff happen for Moreton, a company that has a great reputation for integrity and honoring its work. In fact, we first started working with the firm when our Vice President Mike Holland flew out to Utah to introduce himself personally — an effort that was not lost on Julie: “Mike met our team, and really wanted to make sure I felt comfortable with the company and what’s going on in the marketplace. We became a great partner from then on.”

Julie notes that Moreton tends to be proactive about staying current with industry trends and helping its clients stay informed and knowledgeable. “In the time I’ve worked with ASG, I so appreciate that they take the same approach to working with clients. I would tell you that ASG is probably my top stop-loss partner.”

We also appreciate that brokers like Moreton are always working with one eye toward the future. Julie explains that Moreton stays ahead of the curve by providing its clients not just with insurance coverage, but with the tools and knowledge they need to evaluate their needs, choose coverage that is right for them, and protect their company and their employees.

For example, Julie notes that she and the firm are “all about the data — presenting the data to the client and making sure that they get the most bang for their buck. The whole brokerage industry requires being entrepreneurial and innovative, especially when there’s enough flexibility in the client’s budget to dig into the data.”

She recalls a jumbo group she had been working with: “Of the hundred million dollars they were spending, 30% of it was cancer. That’s a big budget, so you have to go out and find someone who can cover it. You have to look at the top claims on a client-by-client basis — because hundreds of thousands on a big claim can make a big difference. And when you work with a company like ASG — a company that you know has your back — you are able to evolve with the times and deliver innovative solutions to your clients.”

We look forward to continuing our partnership with Julie and the team at Utah’s largest independent insurance broker!

Moreton & Company is the Assurex Global Partner in Utah. Assurex Global is an exclusive partnership of the most prominent independent agents and brokers in the world, and it enables Moreton & Company to find and place coverage for its clients in all parts of the world.


 

 

On-Call with Sara Winand, RN — Sleep: It Does a Body Good!

Thursday, October 12, 2017

Aahh.... sleep.

We all love it, but sleep quality can make the difference between a productive worker and an on-the-job snoozer.

Translated into dollars, a 2011 study by the Associated Professional Sleep Societies found that poor sleep quality can result in a productivity loss of $2,280 per worker, per year.

In addition to improving employee retention and reducing absenteeism, good sleep habits among employees can no doubt have a profound impact on your organization’s bottom lin. Well-rested employees report that they are happier, less stressed, and more focused on the job, compared to their sleep-deprived colleagues.

In particular, a new study recently released from the American Heart Association has found sleeping less than six hours a night could more than double the risk for death for people with metabolic syndrome!

Do you or someone you care about have metabolic syndrome? People that have at least three of the five following conditions, have metabolic syndrome:

1. Abdominal Obesity

2. High blood pressure

3. Elevated fasting blood sugars

4. High triglycerides

5. Low HDL levels (the good cholesterol) or high triglyceride levels

Having this syndrome puts you at higher risk for cardiovascular disease, stroke and type 2 diabetes. The increased risk for death as it relates to less sleep was associated with all five factors, although findings show the sleep effect is strongest among those with high blood pressure and high fasting blood sugars.

Metabolic syndrome is preventable, so to reduce your risk and not become a statistic, consider taking the following steps toward prevention:

– Eat better: whole grains, fruits, veggies, lean meats, fish; avoid processed food

– Be active: exercise or walk, and put at least 150 minutes per week into your routine

– Lose weight by combining healthy eating with healthy physical activity

– Take prescribed medication to control blood, pressure, blood sugar and cholesterol

– Track your sleep habits with wearable tech devices

– Get 7-8 hours of sleep per night as recommended for adults (and that does not include naps!)

Encourage your employer groups to take advantage of the many types of wellness programs and health screenings offered by professionals within their communities to identify risk factors early before they cause major complications such as heart attack, stroke, atherosclerosis, poor healing, or renal failure.

Still not convinced? Check out this segment that was recently aired on CBS This Morning explaining how sleep affects people with metabolic syndrome. 

 

Millennials: Getting a Pulse on Today's Workforce Needs

Saturday, September 16, 2017

With employer clients kicking off summer intern season, their thoughts will be moving to full-time hires in short time. As a TPA or Broker partner, the following article reprinted from Benefits Broker Pro offers insight into what may be keeping your groups up at night – and what's going on in the heads of today's emerging workforce.

Millennials spurn jobs with poor insurance offerings

A new survey from Anthem finds poor insurance offerings contribute to 35 percent of millennials turning down a job offer.

Poor millennials — they’re reviled for self-interest, stuck in lower-paying jobs, and laden with student debt.

But that self-interest might be doing them a really good turn when it comes to jobs, since an Anthem survey reveals they’re looking out for themselves when it comes to jobs that don’t offer good insurance benefits.

Money appears to be millennials’ primary motivator, with the survey finding they are more likely than the previous generation (29 percent of 18–34 year-olds, compared with 19 percent of 35–54 year-olds) to have engaged in long-term financial planning over the past year.

Employers are jumping on the financial wellness bandwagon, hoping that financial wellness programs will aid them in recruiting and retaining younger employees beset by employee stress that’s centered on the number-one cause in the U.S. — money. But Anthem says bosses are missing a big opportunity by not also beefing up their insurance offerings.In fact, the survey finds poor insurance offerings contribute to the fact that 35 percent of millennials have turned down a job offer, compared to 27 percent of U.S. respondents overall: job refusals were either fully or partially due to dissatisfaction with insurance offerings.

One particular type of insurance Anthem suggests is disability coverage, since such policies can provide benefits not just to employees but employers as well. Integrated disability and medical benefits, it says, can help save money by helping employees get back to work sooner and by reducing benefits administration costs.

And the benefit to employees — particularly those who aren’t especially well paid — can be substantial, since workers living paycheck to paycheck could not only end up jobless because of an injury or illness leaving them unable to work but also end up moving back in with mom and dad.

Survey results indicate that, among U.S. adults working at a company with at least two employees, 26 percent indicated they do not have short- and/or long-term disability insurance. And of survey respondents who did not have disability insurance, many say they didn’t have it either because their employer did not offer it (53 percent) or because it was too expensive (32 percent).

“Disability benefits protect financial wellness, but they are also an important part of overall health and wellbeing,” Mike Wozny, president of Anthem Life Insurance Company, says in a statement.

Wozny adds, “Anthem recognizes that physical, emotional and financial health is interconnected, and by treating the whole patient, health care professionals of all specialties can help patients get better faster and also save money in the process.”

 

 

Click here to access the original article.

A Value-Based (and Very Smart) Approach to Partnerships

Thursday, June 29, 2017

It’s always gratifying to be called number one, and we were especially pleased when we came out on top of the list of preferred carriers for western Nebraska’s Regional Care, Inc. (RCI), an independent TPA.

That’s according to RCI’s Vice President of Sales Tom Applehans, who recently chatted with ASG about a number of steps the firm has been taking to provide more value to the marketplace.

“Our leadership team has taken a hard look at how we were interacting with our stop-loss partners. We felt that we maybe could do better if we worked a little bit closer with some of the carriers and the reps that had done the best job for us. So I surveyed the team and asked: of all the partners that we work with, who are the ones who are the most responsive, the most reliable on renewables, and so forth. ASG was a resounding number one on the list of responses from the team.”

He continues, “We like that ASG takes pride in their interpersonal relationships. The group gets along well with the team, and ASG is consistently competitive in its underwriting. You’ve also been reasonable in terms of medical underwriting and blocking in proposals. The biggest thing right now is finding partners that are reliable and that we like.”

That input prompted the RCI leadership team to green-light a preferred program within the company. While the program is “somewhat informal” at this point, its objective is to narrow the wide net of potential markets the company goes to for the bulk of its business.

This relationship-building aspect of our partnership translates into serious value for RCI, which serves over 200 clients with members in all 48 states from its headquarters in western Nebraska.

“What we’ve been explaining to our clients is that there is exposure if we aren’t selective and working closely with our stop-loss markets,” Tom notes. “So by taking this approach, we can do more business with vetted carriers, which reduces their exposure and improves our competitive position—it’s a way of managing risk and driving competitive pricing via consolidation and relationships, while still providing quality information and services. Rather than over-shop, we’re encouraging our people to simply do a better job working within defined markets.”

Tom points to the equal importance of bringing proactive solutions to existing and prospective clients. “It can be as simple as going back and looking at the network that’s in place, and taking the time to perform a discount analysis to uncover whether there’s an opportunity to improve pricing through a change,” he says.

The firm has also recently introduced telemedicine, and added a clinical program to help clients who have employers with high claims. Enhanced wellness and well-being programs (which include biometric screenings) and a new pharmacy program help RCI provide more thoughtful strategies while also controlling costs.

The goal in providing these tools, says Tom, is to enable RCI representatives to become trusted advisors with their clients. “And as we have those conversations, we’re working closer with our stop-loss partners so they have an idea of the direction we’re taking,” he says, adding that “if we can impact risk, that’s ultimately factored into the renewal and pricing on the front end.”

Response to the updates has been favorable among RCI clients. Tom notes the staff is also excited for the opportunity “to have those types of conversations, and try to get at underlying cost drivers rather than taking a more transactional approach to marketing.”

It’s all hands on deck at RCI headquarters, he adds. “We’ve been making some pretty sweeping changes over the past couple of years. It’s a work in progress, so every week we meet with our respective teams and leadership groups to try and constantly refine how we’re doing things internally and working with our clients. Everybody is being asked to find best in class solutions to address the kinds of problems our clients are facing. Historically, this company has had a very good reputation—as having great people, offering great service, etc.—so I think that we’re building on that, but also pushing the boundaries toward a high degree of excellence.”

Speaking for ASG, we are thrilled to be leading the charge with our valued partners!

Click here if you’d like to find out more about RCI.

 

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