I. Stop-Loss Insurance
"The foundation of Self-Funding"
BPA will negotiate specific and
aggregate stop-loss insurance
Recommendations are based on:
• Costs and stabilization
• Financial rating of carrier
• Contract type
• Contract terms and features
• Flexibility
II. Claims Administration of Self-Funded Plans
BPA will negotiate services with various
vendors. A critical vendor is the claims
administrator (TPA).
Services offered by TPA's may include:
• Employee eligibility
• Medical, Dental, RX and Vision Claims
• Maintaining managed care networks on
their systems
• COBRA and Retiree administration
• Compliance reporting
• Plan documents
III. Network Providers
BPA will review claims experience, if
available, and match actual claim providers
to available networks.
The goal is to make sure the claims receive the
largest discounts available
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IV. Custom Reporting
BPA will complete a thorough claims analysis
on a quarterly basis to monitor where claims
dollars are spent.
Analysis can include:
• Average cost per employee per month
• Top providers utilized
• Top diagnosis/CPT Codes
• Reports are customized for each client
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Partial Self-Funding can
help you: |
| Contain your health
benefits costs! |
| Save money by reducing the expenses
included in the premiums that would otherwise go to an insurance
company! |
| Improve your cash flow by paying
only fixed plan expenses and only those claims that actually
occur! |
| Earn interest on funds until
utilized! |
| Save additional money when claims are
lower than projected in a given plan year! |
| Cap your overall risk exposure at a
manageable level! |
| Provide long-term stability in your
health benefits program costs! |
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