Innovative Programs for a Better Health Care Solutions

Solve both over-delivery and under-delivery of medical benefits. Customize offerings in detail to maximize a program specific for each trust's requirements.

Self-insured

Fully Insured

Consumer Driven Health Care

Health Savings Accounts (HSAs)

Negotiations with Carriers

Request for Proposal (RFP) Assistance

Contract Language Assistance

Audit & Recovery/ Contract Compliance

Focus on the details of dental plans to increase benefit and curb costs. Analysis of dental programs typically reveals significant savings opportunities and ways to increase control through more active financial management.

Self-insured

Fully Insured

Negotiations with Carriers

Request for Proposal (RFP) Assistance

Contract Language Assistance

Audit & Recovery/ Contract Compliance

Vision benefits are important to trust benefit participants. Changes in vision benefit delivery -- new networks, new discounted programs, new treatment methods -- make it necessary to restructure this program on a regular basis to take advantage of cost reductions.

Self-insured

Fully Insured

Negotiations with Carriers

Request for Proposal (RFP) Assistance

Contract Language Assistance

Audit & Recovery/ Contract Compliance

Our team excels at generating pharmacy program savings through structural analysis and vendor negotiation. The prescription delivery system is complex and competitive, but our team of experts can absolutely direct the system to perform in trusts' favor.

Self-insured

Fully Insured

Pharmacy Benefit Manager Audits [PBM]

Negotiations with Carriers

Request for Proposal (RFP) Assistance

Contract Language Assistance

Audit & Recovery/ Contract Compliance

Life insurance is often viewed as a lower-priority add-on in the trust benefit portfolio, while the individual participant sees it as essential. With close management of these programs and aggressive carrier negotiation, participants can receive higher benefits and more education while the trust pays lower rates.

Term Insurance

Life Win Product

Negotiations with Carriers

Request for Proposal (RFP) Assistance

Contract Language Assistance

Health and Welfare Trusts often have antiquated technology platforms. Today there are a wide variety of full, partial and stop-gap system solutions to meet technology challenges specific to trusts. Modernizing internal data management systems benefits both trust administrators and trust participants. The investment typically pays for itself through saved work hours, integration of processes and automated participant processing.

Eligibility Management

Trust Fund Management

Employee/ Member Self-Service [24/ 7]

Consolidated Billing and Reconciliation

Custom Reporting

Electronic Data Interchange and Transfer with Existing Trust Fund Systems

TPA Services and Integration

Data Warehousing

Data Mining

Centralized Data

Online Data Management

Online Communication

Automated Eligibility

Electronic Data Interchange [EDI] with Carriers

Ad hoc Reporting

Additional Services

Promote more responsible use of Health & Welfare benefits by implementing specific medical information to inspire individual medical management. By sponsoring a knowledge-based information system that is updated daily with current research, the trust can actively educate and assist every member with the personal management of their healthcare.

Assist member/employee in understanding their illness, injury, diagnosis and treatment options

Speak directly with a doctor as needed

Provide support groups and clinical trials

Locate international expert providers that are in network

Assist in scheduling appointments

Expedite physicians' wait lists

Assist member in transferring medical records

Assist members and their families with prescription drug details

Assist Trustees, members, and trust funds in their communications providing direct information to their health plans, members, and the trustees