One of the greatest challenges facing health and welfare trustees/sponsors today is adapting quickly and successfully to the continuously changing medical marketplace. This is true whether change is caused by legislative or regulatory action, economic and competitive factors, or medical innovation. We provide clients with insights and an early warning system so that decisive steps can be taken to avoid problems, seize opportunities and achieve better outcomes for the Plan and its beneficiaries today and well into the future.
Our Health & Welfare clients tell us they have engaged Cheiron because of the expertise, depth of experience, integrity and independence of our consultants, in combination with our innovative consulting tools. Specifically, we:
At the heart of our projection capabilities is H-scan, which enhances our ability to see and understand the underlying trends and to communicate this analysis more effectively to trustees/sponsors.
Our refined analysis enhances our ability to project expected monthly expenditures for the following year, so either Cheiron or the plan administrator can monitor the actual expenditures versus our projections. Potential problems can be identified at an earlier stage, so that corrective measures can be developed early on to mitigate financial difficulties. Finally, we typically reconcile the prior year’s actual expenditures with our projections, and quantify any deviations. This helps the fund/program understand the reasons for the deviations and what actions it can take to prepare for the future.
Below is a list of our most common Health & Welfare consulting services. Cheiron also provides additional customized solutions to meet the special needs of our Health & Welfare clients.
Our report covers: a) historical trends, b) monthly projections for the following plan year, c) reconciliation of actual versus projected income and expenditures, and d) sensitivity analysis for selected items like medical trends and population changes. Our presentation is interactive in order to demonstrate sensitivity of selected items. The analysis shows the self-funded claims experience, benefits paid and contributions made, administrative expenses, costs of insured benefits, and other relevant items. This is part of the H-scan analysis.
This is one of our greatest strengths. When analyzing plan design and cost management issues, we incorporate the interactive features of H-scan so that trustees can quickly test a variety of plan design options simultaneously. This methodology allows for the data to be the most up-to-date. Most importantly, it allows sensitivity analysis to be performed so that trustees/sponsors can better understand the impact of their decisions. Learn more about our approach plan design consulting here.
In addition to helping clients respond to new (or ongoing) regulatory requirements, on a proactive basis we provide periodic briefings on key items clients need to consider, on topics either being discussed at trustee meetings, or current events that we believe are relevant. For example, we are providing significant ongoing support to clients addressing the myriad changes being brought about by PPACA. (Learn more here.)
Our services include estimating the cost of changes to self-funded benefits and assisting with the development of RFPs and being present at meetings to ask questions of possible vendors. We can also prepare a vendor comparison sheet, including aggregate costs and other financial implications of each proposal.
Our consultants have worked for and with leading insurance companies and managed care organizations that service the group and individual health and life marketplace. We have decades of experience in negotiating health and welfare plan contracts with health and life insurance providers. Our knowledge of the range of administrative fees charged, types of experience-rated contracts offered, and the impact of selection by participants in calculating the rates, often allows us to negotiate lower cost contracts for our clients. Our consultants frequently discover errors (both procedural and mathematical) which, when addressed, have reduced our clients’ premiums significantly.
Our health and welfare consultants are well versed in the retiree liability issues surrounding FAS 106, SOP 01-2, and GASB’s OPEB disclosure requirements. In addition to providing information requested by the auditors, we help clients establish funding objectives and develop a plan to fund these liabilities.
Our attendance at meetings greatly enhances our ability to provide the program the best possible service, and often can be arranged on short notice. We can make use of our H-scan modeling tools at Board meetings to help illuminate the rationale for key decisions and recommendations.
We coordinate these services carefully with the plan administrator and the plan counsel, whether our role is limited to reviewing documents or redrafting the entire SPD.
Establishing COBRA premiums for self-insured plans are a natural by-product of our annual report and analysis.
We provide estimates of claims incurred but not paid for our clients’ financial statements and financial planning.