Employee Benefit Consulting

As a consultant, we are accountable for the overall quality of our employer-sponsored health plans and beholden to limiting the cost of health care being passed on to employers and their employees.

Self-Funding Expertise

Very few brokers and consultants understand all of the moving pieces and legal components that are required to manage a successful self-insured health plan. Allegeant will guide you every step of the way to ensure that you consider each component of the plan and put protections in place to cap your financial exposure.

 

So you are now in the health insurance business. Allegeant understands that this is not why you are in business and will help you implement a long-term strategy to curb costs and ultimately improve the health of your population. Finding the right TPA that will provide payment integrity and timely access to claim data is critical to a successful risk management program. Emphasis on high-value primary care will help prevent the healthy population from becoming chronic cases. Establishing bundled pricing at centers of excellence help curb the high-end acute care costs. Establishing alternative drug sourcing programs to save from exorbitant drugs costs. These are some of the many strategies that employers and Allegeant deploy to deliver better care for their employees. 

 

Allegeant can draw on years of experience and success in managing self-insured plans. But do not take our word for it, call us for references.

Plan Benchmarking and Evaluation

  • Review plan costs and funding arrangement

  • Compare costs, contributions and design with industry surveys and Allegeant's book of business

  • Evaluate communication and open enrollment strategy

  • Perform an enrollment audit across all vendors 

  • Establish company's goal and strategy with the benefit plan and compare that strategy with results of the benchmark report

Pharmacy Benefit Management (PBM) Consulting

  • Audit and evaluate contracts to ensure employers best interest

    • Pass-through vs Traditional​

    • % of rebates

    • Fiduciary responsibility

  • Assess risk management programs: Opiod Management, Site of Service, Specialty Rx, Case Management

  • Identify alternative drug sourcing programs 

  • Identify the right formulary for the employer: steeper discounts vs wider access

Population Health and Wellness

Allegeant's Population Health and Wellness strategies are always taken in tandem with a robust Primary Care program.  

 

We identify, through a collaborative experience, the right blend of incentives, engagement, and encouragement necessary to ensure a culture of wellness for you and your members.

  • Strategic program design

  • Promoting regular screenings from the USPSTF guidelines

  • Developing the appropriate employee engagement model with robust marketing & communication campaigns

    • ​Educating members on nutrition, exercise and well being

  • Committee organization

    • Draft committee charter

    • Foster program improvement

    • Empower advocates

 

Wellness should surround employees in the workplace environment - workplace design, food options and access to exercise opportunities. 

Benefit Administration & Consolidated Billing

An efficient administration system that tracks and transmits accurate eligibility files is the foundation of a benefit plan. Attention to detail and patience is required to ensure that the benefit administration is handled timely and accurately. Allegeant understands that as an administrator we must be able to manage your unique myriad of benefit rules but have a user interface that is intuitive and simple for employees to elect coverages.

 

  • Provide online enrollment SAAS platform 

    • Mobile responsive design​

    • Step-by-step enrollment with videos regarding each benefit

  • Set up electronic file feeds (daily, weekly or monthly) with all vendors and carriers;

  • Perform monthly audits of the feeds to ensure accuracy 

  • Consolidate all premiums into one bill for you to pay with detail backup. You pay one amount to Allegeant and we will remit to the carriers and vendors.

Compliance

  • Perform a compliance audit

  • File 5500

  • Audit, prepare and file 1094/1095-C forms 

  • Assist with drafting Plan Documents

    • Self-Funded Plan Language such as: Leaves of Absence and FMLA, Exclusions and Allowable Payment Amounts (particularly with out-of-network claims)

    • Restatements vs Amendments ​

    • Summary of Material Modification(s) (SMM)

  • Disclosure notices

  • Regulatory updates: ERISA, OSHA, ACA, HIPAA, COBRA, FMLA, etc 

Contact us to learn how to deliver affordable quality health care.

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9475 Deereco Road, Suite 408

Timonium, MD 21093

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