Global

Group Health & Welfare

Our approach

Our approach emphasizes innovation, efficiency, and client-focused solutions.

Our Services

Health Plan Assessments

A comprehensive review of your current health benefits, cost drivers, and risk exposure, including:

  • Internal underwriting benchmarks
  • Funding structure alignment
  • Compliance health checks
  • Pharmacy & clinical program evaluations
Data Analytics & Claims Audits

Deep-dive data analysis to uncover savings, eliminate waste, and flag overpayments or inefficiencies:

  • Historical claims audit
  • Utilization trends mapping
  • Network integrity assessments
  • Predictive modeling for emergency risk
Alternative Funding Analysis
  • Fully insured funding models
  • Level funded solutions
  • Fixed indemnity programs
  • Captive strategies
  • Stand-alone self-funding
  • Three-year stabilization
  • Advanced funding solutions
Underwriting & Rate Setting

Internal underwriting projections and custom premium equivalent and COBRA rate development can be run on an ad hoc basis whether at renewal or off cycle for plan year or fiscal year planning.

Advanced Consulting Services

Progressive Accountable Care Expertise

Network Analytics & Direct Contracting

Actuarial Predictive Risk Modeling and Probability Analyses

Value-Based Plan Designs & Benchmarking

Legal & Compliance Support

Feasibility Studies & ROI Assessments

Progressive Accountable Care Expertise

Network Analytics & Direct Contracting

Actuarial Predictive Risk Modeling and Probability Analyses

Value-Based Plan Designs & Benchmarking

Legal & Compliance Support

Feasibility Studies & ROI Assessments

Our Cost-Containment Strategy

Our actively-managed health plan model incorporates four primary levels of cost-containment strategy.

Level 1: Negotiating
  • Proactive Internal Underwriting
  • Financial Modeling & Budgeting
  • Contract Reviews & Negotiation
  • Medical, Stop Loss, and Pharmacy Assessments & Volume-Based Negotiations
  • Performance Guarantee Assessments
  • Market Checks & Balances
Level 2: Plan Design & Management
  • Annual Plan Design Benchmarking
  • Plan Design Predictive Financial Modeling
  • Plan Migration Analyses
  • Ongoing Plan Design Audits & Checks & Balances
Level 3: Waste, Fraud & Abuse Prevention
  • Ongoing Claim Checks & Balances
  • Large Claim Investigations Unit
  • Annual Pharmacy Claims & Contract Compliance Audits
  • Ongoing Eligibility Audits & Checks & Balances
  • Provider Performance Analysis & Negotiation
  • Out of Network Claim Analysis & Negotiation
Level 4: Prevention
  • Ongoing Population Health Analytics
  • Turnover Impact Analysis
  • Preventive Care Gap Analyses & Targeted Strategies
  • Targeted Preventive Care Programs
  • Incentive-Based Models for Prevention & Behavior Outcomes

Contact Us

Get in Touch

Office Hours

Mon - Fri: 8am to 5pm

Phone

(Toll-Free) 347-549-4455

(Main) 405-259-8990

Regional Locations

Oklahoma City  |  Tulsa  |  Dallas 

National Locations

Alabama  |  Arkansas  |  California  |  Connecticut  |  Colorado  |  Delaware  |  Florida  |  Arkansas  |  Georgia  |  Idaho  |  Illinois  |  Indiana  |  Iowa  |  Kansas  |  Kentucky  |  Louisiana  |  Maine  |  Maryland  |  Massachusetts  |  Michigan  |  Minnesota  |  Missouri  |  Nebraska  |  New Hampshire  |  New Jersey  |  New York  |  North Carolina  |  Ohio  |  Oregon  |  Pennsylvania  |  South Carolina  |  South Dakota  |  Tennessee  |  Texas  |  Utah  |  Virginia  |  Washington  |  Wisconsin