Stop-Loss Coverage Marketing & Placement
We have relationships with over 20 stop-loss underwriting facilities; however we do not “shotgun” every prospective employer group. We take the time to understand the broker’s perspective and what they are looking to accomplish for the employer client. We tailor our marketing efforts to the best fitting option available.
Available programs
Level Funding with 100% Surplus Returns
5 to 150 Covered Employees - PPO & Reference-Based Pricing
Aggregate Only Level Funding - Reference-Based Pricing
Traditional Specific & Aggregate Coverage (Advance Funding Options)
Specific Only Coverage
Aggregate Only Coverage - Minimum Essential Coverage (MEC)
Organ Transplant Carve-Out Coverage - Eliminate High-Cost Risk
Virtual Telehealth Program, including over 300 free prescriptions
Hospital Bill Eraser Program
Network access & reference-based pricing
Depending on the employer size, we can offer multiple network options such as:
National Networks
Regional “Narrow Networks” or Direct Contracts
Modified Reference-Based Pricing with physician network component
Pure Reference-Based Pricing - best savings, possible employee noise
Care Navigation Programs
To supplement network or reference-based pricing programs, we can include Care Navigation services. This type of program utilizes bundled all-inclusive surgery programs that generate significant savings and use high quality providers. Incentives such as Deductible and Out-of-Pocket waivers and cash incentives are offered so employees will access these types of programs.
Pharmacy Programs
Pharmacy programs can be very deceptive with formulas for rebate dollars that may or may not be shared by the incumbent carrier or TPA. This is hidden money being retained by the carrier, TPA, or PBM that is never disclosed in many programs, leaving the employer to pay more than required when providing prescription benefits.
We only offer a fully transparent pharmacy benefit program using an experienced preferred partner called EHIM RX, with over three million members enrolled. The employer receives the best price on all prescriptions and EHIM “Cares Program”addresses high-cost specialty drug issues. Cost for the program is either on a per-prescription or per-employee per-month unit basis.
Third Party Administrators
Third party administrators come in many variations and with our experience in managing TPA’s, we select the entity that matches best with a particular program offering. We only suggest administrators that have multiple years of experience, a great reputation, and share the same goals in offering the most cost-effective programs.