Employee Benefits Consulting

All of your employees will have access to a dedicated Client Care Specialist to support them with their benefit needs. More than just an advocate, they know your plans inside out, and will exhaust themselves making certain your employees have an amazing experience with their healthcare plan. For emergency questions that arise outside of normal business hours of 9-5pm our team of dedicated service professional are on-call to support your employees with their benefit emergencies.

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Our approach to managing risk for your organization is strategic and proactive rather than reactive. We do not feel that it is an effective ‘strategy’ to live from year to year simply lowering your healthcare spend through carrier negotiations and shifting costs. Our benefits consultants will help your organization to develop a long-term strategy from the moment we engage with you.  Through this strategy we will use tools such as claims and financial analysis, utilization reporting, and actuarial modeling to help us make informed decisions. We spend the time evaluating how to best allocate the dollars you have. Using our expertise, we will guide you through the process of creating an ongoing employee benefits strategy that attracts, retains and engages your best talent.

Our underwriting team scours the market to ensure you have the most competitive healthcare plans and offerings. We continually monitor your plan performance to provide recommendations and use our market expertise to validate pricing and negotiate fair program fees. We have full knowledge of carrier plan designs, underwriting requirements, and strong carrier relationships.  In addition to strategizing, marketing, and negotiating clients current benefit packages, our underwriting team provides data analytics to our clients to help them make the best decisions regarding their benefit packages.

Using our proprietary analytical tool, we can anticipate your renewals and provide clarity on the drivers of cost increases. By analyzing your plan utilization as it compares to our benchmarks we are able to recommend market competitive benefits plan designs and programs that fit your needs.

Since going beyond the norm is our everyday M.O., we are excited to exceed our clients’ expectations. It starts with customized open enrollment materials to assure your employees of the caliber of your benefits plan. And everything’s done in the language of your company culture, so your employees feel comfort in the level of care, and confidence in the plans you selected.  As your employee benefits broker, work with you to craft and deliver a story that communicates the value of your healthcare plans to foster trust and commitment from your employees.

Exude Solution Builder™ is an exclusive program that gives employers greater control, more options, and increased cost savings. With this program, middle market employers can leverage their collective purchasing power to drive down costs and spread risk in this partially self-funded program.

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A self-funded group health plan is one in which the employer eliminates obligations to a health plan provider by assuming the financial risk for providing health care benefits directly to its employees. In this arrangement the employer has the most control and greatest access to data. However, your organization needs to open to taking on more risk and have positive cash flow in order to pay for the claims as they come in.  Read more about the Pros and Cons of Self-funding here. A few key questions to consider when thinking about self-funding or alternative funding:

• What are the organization’s goals? Immediate cost savings, turnkey administration, long term cost control?
• What is the strategy behind the approach being considered? Independence, cooperative purchasing power, risk sharing?
• What are the intricacies involved with the funding solution?
• Variability in monthly payments, protection for catastrophic claims, fiduciary responsibilities, applicable state mandates?

A Captive program is a Self-Funded plan with the protection of other similar or non-similar companies that buy-in to the Captive together. A captive is an independent insurance company created and owned by at least one non-insurance company that assumes the employee benefit risks.  Participating in a Captive allows members to benefits from partially owning an insurance company. In this arrangement, plan designs are completely customizable and employers have freedom of choice for Network and Pharmacy Benefit Manager.  There is a possibility that fixed costs may be more expensive.  However, potential to receive 100% of surplus along with dividends is attractive. Employers might choose to form a captive as an alternative to traditional insurance in order to better control costs and manage the risks associated with providing employee benefits.

A consortium program is a Self-Funded plan with the protection of Stop Loss Purchasing power.  Employers will have the protection to be rated along with hundreds of other companies under the same Stop Loss carrier and therefore receive Stop Loss discounted rates. This benefits program gives middle market employers (50-1000 employees) collective purchasing power that drives down costs and spreads risk, allowing them to design a long-term cost-effective benefits plan that’s self funded with limited risk. Exude’s clients have exclusive access through Exude’s Solution Builder program.

There is a rise in popularity in Level-funding plans within in the 51-99 market segment.  Level-funded arrangements enable employers to benefit from the regular and predictable cost of a fully insured plan with the flexibility of a Self-insured plan and without the uncertainty of fluctuating claims costs. These plans are emerging as a great compromise between fully and self-insured plans as a way to minimize risk with cost predictability. Level-Funding provides all the same advantages of self-insurance, including greater flexibility than a fully insured plan, so employers can tailor plans to their specific health care needs.  Unlike fully-insured plans within the 51-99 market segment, Level-Funded plans allow employers to gain reporting on claims utilization that otherwise is not provided by the carriers within this market segment.

Reference Based Pricing (RBP) is a cost containment strategy that allows employers to set a pricing cap on what they will pay for certain medical services. Compared to traditional funding arrangements, this model can result in total claims savings between 15-30% depending on your area. Employers are able to save significantly on claims because they are essentially telling the healthcare system that they will not pay more than what the Medicare price dictates for certain services. Learn more about Reference Based Pricing here.