Self Insured Reporting 2018-08-06T17:58:18+00:00

The only web-based platform to completely create financial reporting for a consultant’s self insured clients.

Accurate, robust reporting!

When clients see their projected renewal every single month it is powerful from a planning perspective.  It is also a great sales technique to walk in and show prospects what is possible.

– Employee Benefit Consultant, Atlanta GA

Financial Reporting Module

As a benefit consultant, there are many questions you must help self insured clients know the answer to such as:

  • How is our plan performing versus our budget for the year?
  • After accounting for employee contributions, how are we performing?
  • How is our stop loss contract performing in terms of loss ratio?
  • What are the costs expected to be for the rest of the plan year?
  • What will my renewal be?
  • How are our medical and pharmacy claims trending after accounting for changes in enrollment?
  • Which claims have exceeded 50% of our specific deductible?
  • What percentage of total costs are employees paying?
  • What were our PBM rebates and stop loss reimbursements for the year?
  • How is our network performing?
  • What is our stop loss renewal history?

Historically this work has been performed in excel by benefit consultants, which comes with the natural limitations of excel such as:

  • Lost time in reformatting spreadsheets and ensuring all calculations are correct
  • Typically reports are not attractive and do not contain charts and graphics
  • Limitations on how much analysis you can create based upon time available
  • Teams maintain many different versions
  • Multiple versions of files lead to confusion among team members
  • Spreadsheets are difficult to maintain
  • No visibility across the entire team regarding client cost performance
  • No visibility among managers to understand which clients might be at risk
  • Lost efficiency from maintaining a cumbersome and time consuming process

Our web-based application fully converts this entire process and allows client reporting to stay up to date in 5 minutes per month.

  • Renewal cost projections delivered every month. No more surprises!
  • Employer dashboards reflect plan budget status and changes to plan cost trends
  • Full suite of downloadable reports to view historic cost changes, per employee per month expenses and much more
  • All financial reports are updated with the entry of new claims data and are completely print ready for your next financial review meeting
  • All team members will be emailed their monthly financial reporting automatically each month

“By having the correct reporting each and every month, we have found we can plan ahead and stay more strategic … less reactionary.”

– CFO, Governmental Organization, 1,100 employees

Claim Analytics Module

For employers looking to drill-down into each cost component of their plan, such as which diagnoses are driving costs, the Utilization Reporting module will significantly increase your financial vision.  Our clients are empowered to fully drill-down into the details of their claims and understand where each cost driver.

How are claims trending for conditions such as cancer or diabetes?  Which providers are the most expensive in an area?  Are there opportunities to ‘drive’ services from one provider to a lower cost provider, such as from an emergency room to an urgent care facility?  In order to properly manage the claims of a self funded plan, you need the answers to these types of questions.  The Utilization Module has been designed to help you get these and many more answers quickly and intuitively.

  • Understand what was the diagnosis that led to the claims, and how are these costs changing over time

  • What procedure occurred with the claim, and are certain providers ‘out of range’ with their peers in terms of charges?

  • Which member had claims of a certain type, and are there opportunities for more intensive disease management?

  • Who was the provider, and where are they located physically in a geomap?

We asked self insured employers and their employee benefit consultants, “What do you really need?”  THIS was their answer …