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Transcript of HLU Presentation.Email.Secure
It’s here. It’s time.
Re-Thinking the Traditional Health Plan with YOUR BUSINESS in Mind
Imagine a health plan that offers . . .
Introducing: HLU Consultants
SCALABLE SOLUTIONS
DESIGNED BY YOUNO MORE generic,
cookie cutter plans that consist of identical benefits
and a limited networkof partners
ALL OF THESETHINGS AND MORE
add up tosignificant annual SAVINGS
year after year!
FLEXIBLE, MODERN-DAY
BENEFITSNO MORE same-old
thinking based on the idea of “this is how
we’ve always done it”
STRATEGIES FORMANAGING
OUT-OF-CONTROLCOSTS
NO MORE questionable,error-filled claimsslipping through
HLU CONSULTANTS | Reclaim Control of Your Health Plan
For far too long, choosing a health plan has gone something like this:Renewal time is coming so your broker schedules a visit
The same basic year-end spreadsheets are presented and the dreaded news is relayed: rates are going up AGAIN
Your broker assures you this plan is still the most cost-effective option (besides, switching now would be a huge headache, wouldn’t it?)
You renew, shake hands and hope for the best
1.
2.
3.
4.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
It’s here. It’s time.
But what if there was an
ENTIRELY DIFFERENT SOLUTIONout there for your business that
would mean a change for the better?
The WAY better?
A plan that would help contain costs
from day one and especially focus on
the key item that is so consistently
overlooked: out-of-control claim
costs? And what if that plan included
predictive modeling once it was in
place so you could actually see the
future impact of your out-of-pocket
cost savings?
HLU CONSULTANTS | Reclaim Control of Your Health Plan
HLU Puts Plan Control andCost Savings Back in your Hands
Control of Health Plan Employer Insurance company Insurance company
Provider Network Access
Data Analysis & Forecasting
Large Claim Case Management Analysis
Utilize Independent, Best-In-ClassVendors to Reduce Claim Costs
Pricing Transparency forEmployee Medical Services
Customizable SummaryPlan Description (SPD)
Claim Review Procedure
Compliance & Employee Onboarding
HLU Open-Platform Health Planwith Healthcare Intelligence
Hybrid Plan PlatformASO, Insurance Company, Self-Funded,Level-Funded, Balance Funded Plans
Closed PlatformHumana, Anthem, UHC, MMOH,
Aetna, etc.
Traditional PPO Networks, National Accessand Customizable Networks
Typically 1 or 2 PPO options(One size fits all)
Typically 1 or 2 PPO options(One size fits all)
YES - actionable data Basic claims and expense overview onlyData is not actionable
No data provided
YES - actionable data No No
YES No No
YES No or limited No or limited
No or limited
YES Yes - with limitations No
Claims are itemized and reviewed forovercharges and billing errors
Full Service, Hands-Free Suite: FMLA, COBRA,5500, ERISA, ACA, FTE Record-Keeper and filings
Claims are passed through and paidby a summarized invoice
LimitedUsually reference materials only
Claims are passed through and paidby a summarized invoice
HLU CONSULTANTS | Reclaim Control of Your Health Plan
We offer a smarter approach.It’s an open-platform health plan that provides the highest quality benefits at the lowest costs with better employee health outcomes.
An exciting change for the better, this efficient and cost-effective self-funded plan allows employees and employers to reclaim ownership of their healthcare benefits and costs.
It provides data you can act on and use to tailor your plan for the greatest value . . . it’s structured around a long-term strategy to continually control plan design effectiveness and costs . . . and, it simplifies administration and compliance along the way.
For the employee, it’s empowering. HLU’s Open-Platform Health Plan provides employees with educational resources to help them make informed decisions to select the best available healthcare plans and options for their needs. The result . . . better employee health and lower plan costs.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Consultant vs. The BrokerHLU serves as an independent consultant, not a broker. What does this mean? Operating on our own, we take a totally objective approach to match your
plan with the best benefits and partners.
We’re not limited to working with a small ecosystem of defined partners or big-name vendors, but rather, we’re connected to a wide-ranging network of systems, resources and solutions to match accordingly with clients.
We don’t tack on costly brand-name fees and our business isn’t driven by extra incentives or sales commissions.
Your account is handled by the same consultant,not handed off from rep to rep.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
Understanding Health Care Hikes & Hidden Costs
Health care costs are rising faster than inflation and wages. Another problem on top of that?The traditional health plan is bloated with waste and inefficiency and offers very minimal control.
20-40%+Rate Increases9.3%
Employee Health Plan Costs Increase
10xAmount Overchargedby Some Hospitals
80%Family PremiumsIncrease
There was a 9.3% increase in employee health plan costs from 2011-2012 (Kaiser)
Over the last 10 years, family premiums have gone up an average of 80% (Kaiser)
In 2012, the 50 hospitals with the highest prices were found to be charging 10 times more than what’s allowed by Medicare (The New York Times)
Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more for 2016(2015, The New York Times)
HLU CONSULTANTS | Reclaim Control of Your Health Plan
How can your business possibly
keep up with such unpredictable hikes?
HLU CONSULTANTS | Reclaim Control of Your Health Plan
Here’s the thing –
But thingscan change . . .
Most companies have no idea how much their health claims are costing them or that the issue of excess, unnecessary charges has become so incredibly routine.
All too often, claims get processed and paid without a thorough review to catch errors and inconsistencies.
Common issues like overcharging, miscoding and duplicate charges are slipping through the cracks resulting in ridiculously high payments that are eating away at your bottom line.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
HLU’s Winning Formula
LOWERCLAIM COSTS
EMPOWEREDEMPLOYEES
IMPROVEDQUALITY OF CARE &BETTER OUTCOMES
AN AVERAGEOF
27%
TO REDUCE OVER-UTILIZATIONAND IMPROVE CARE
HLU CONSULTANTS | Reclaim Control of Your Health Plan
ConsiderFixed Costs vs. Flexible
In a traditional plan, you pay a set
amount no matter what your
employees’ collective claims add
up to at year’s end. But what if you
pay more than the care your group
actually receives? That money is lost.
In the open-platform, self-funded
plan, you pay only for the care
that’s administered. Your dollars go
directly toward the cost of claims,
and stop-loss insurance kicks in
to cover the very large claims, as
needed. This approach eliminates a
substantial portion of the overhead
and profits paid to a traditional plan.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
On top of sky-high claim costs, the old, outdated plan model means:• A major lack of flexibility
• Less engagement and education among employees, often resulting in unnecessary and costly care
• Limited or no claim data to use in being proactive and making informed decisions
• Limited selection among benefit solutions and vendors
• Renewals driven by extra perks like incentives and commissions
• High turnover rates among staff and a lack of experience in who is managing your account
• More manual compliance management and HRadministration needs
HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why HLU Open-Platform Health Plan?The reasons are plenty. Simplified compliance is a big one.HLU Open-Platform Health Plan puts YOU back in control through:
Employee onboarding with 360-degree reporting and billing that’s seamless and integrated
FMLA and COBRA compliance that’s hands-free and full-service
ACA compliance and employee notifications for your added convenience
1095-C or 1094-C tracking and reporting
HLU CONSULTANTS | Reclaim Control of Your Health Plan
It’s simple. This is a smarter way to manage health benefits … one that works AND saves you money now and for the long-term. HLU Open-Platform Health Plan puts YOU back in control through:
Meaningful data with the ability to analyze, model and forecast … this significantly reduces the costs of administration, insurance and claims, and allows you to adapt your plan whenever and however needed
Better care and improved outcomes because employees are more engaged in their care … this leads to more effective disease management and reduces excess office visits, lab tests, hospital admissions, etc.
Thorough claims review to identify overcharges and billing errors and address them before claims are processed and paid
Best-in-class partnerships without being limited to a minimal number of vendors
A “pay for what you use” approach to care with a plan built from the most appropriate modules
Pricing transparency for medical services is achieved by giving employees the resources they need to make the best choices and avoid overpaying for provider services
Why HLU Open-Platform Health Plan?
HLU CONSULTANTS | Reclaim Control of Your Health Plan
A Real Example: Diabetes Management
TRADITIONAL PLANAn employer needs more coverage
focused on diabetes care, but the current, not-so-flexible
plan only includes basic disease management services.
HLU OPEN-PLATFORM HEALTH PLANWe offer award-winning programs that address disease management and make
employees active participants in their own care. This emphasis on disease management lowers costs to the plan and to the employee . . . and, it also results
in better employee health through well-coordinated outreach programs.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why is HLU for You?Benefits Done Better: Our Roots
• We are fully independent consultants with each employer’s best interests in mind
• We have 55 years of experience in the industry, backed by ateam of professionals who truly understand what works in a plan and what doesn’t
• We are a focused and efficient company with national reach that takes an objective approach to finding the best vendors
HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why is HLU for You?Benefits Done Better: Our Method
• You’ll work in partnership with the same account representative who is focused on the full relationship,from sales to implementation and strategy
• You’ll receive one-on-one customer service with ahigh-touch, hands-on approach
• You’ll never have to worry about brand-name fees,incentives or sales driven by commission coming into play
HLU CONSULTANTS | Reclaim Control of Your Health Plan
It works for everyone.
While some plans might make sense from the
owner/CFO perspective, they don’t function for
the HR team. And vice versa.
Here’s the good news about the open-platform,
self-funded design: it works for everyone.
The plan saves you for the long-term, not just
the first 365 days.
Plus, the switch is seamless. It doesn’t put a
strain on your HR department or result in any
troublesome compliance gaps.
HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Right Solution: CFOs/OwnersThe Before: CFOs/owners see that plan costs are rising sharply and quickly, making it hard to achieve a profit. Any experience shopping other traditional plans has typically been limited to some first-year savings, but increased rates (once again) beyond that.
The After . . .
HLU CONSULTANTS | Reclaim Control of Your Health Plan
The After with HLU: Our clients have experienced an average health plan cost increase of less than 3% since 2007.
They also benefit from better health plan intelligence through detailed claim reporting that allows them to:
• Take action on trends and issues that impact the bottom line
• Analyze what-if-contingencies to predict improvement cost and effect
• Gain visibility into questionable billing trends
• See ROI on cost control features
• Take an effective wellness approach to lower costs and improve quality of care
The Right Solution: CFOs/OwnersAverage
health plancost increase of
since 2007
HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Right Solution: HR TeamThe Before: For HR groups that have tried other plans without seeing results, it’s hard to believe a successful alternative actually exists. Plus, it often feels like there are too many moving parts with hiring, open enrollment, changing insurances, etc., to consider. There’s also the fear that any change in the process could result in mistakes, compliance issues and added headaches.
The After . . .
HLU CONSULTANTS | Reclaim Control of Your Health Plan
The After with HLU: Things are simpler and more streamlined than ever with our technology-rich solutions. A few ways your HR team will benefit:
• Employees keep the same benefits for many years, andthere’s no need to tweak deductibles and copays to manage plan costs
• Universal ID Cards and Employee ID Numbers remain thesame even if you change insurance providers
• The renewal process is streamlined, with advance noticeof rate changes . . . no need for employees to complete new applications to shop for new providers
• A dedicated customer service team provides personalizedservice and is available to handle billing and answeremployee questions
The Right Solution: HR Team
It’s here. It’s time.
Learn more about HLU Consultants:
Are You Ready for a Smarter Health Plan that has YOUR BUSINESS in Mind?
hluconsultants.comBrowse our site or sign up for a webinar