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Class Insurance Consulting Expertise

  • Employee Benefits
  • RFP and New Broker Search
  • Insurance Agency Advising and Collaboration
  • Direct Contracts for Providers, Employers and Health Plans
  • Vendor Vetting and Vendor Product and Services Improvements
  • Medicare Products and Product Development
  • Association Benefits
  • Health Sharing
  • ICHRA

HEALTH INSURANCE AND HEALTHCARE

HEALTH INSURANCE  HEALTHCARE

 

  • Most companies who ask us for help believe that they have a health insurance problem. But in most cases, that is not correct. The real problem is the way their employees access healthcare and how they pay for that care.
  • If a company has a culture of strong leadership who are willing to lead from the front to change the status quo, we can help.
  • We design and build high performance health plans that are actively managed ensuring employees get access to top quality healthcare at fair prices. In many cases, all cost sharing to employees are waived if they allow steerage to high quality providers.
  • We also bring down costs by using better pharmacy benefit managers (PBM). Removing rebates and other perverse incentives from the pharmacy program saves employees and employers a lot of money each year.

What can we do for your company?

Poor benefits design is not only paid for in wasted dollars, but also in human lives and suffering.

It is important to understand exactly how a company's benefit package affects the bottom line of the company as well as the quality of the lives of its employees.


It is also very expensive to double down on poor benefits design. The cost of providing benefits to employees has become a very expensive line item on the balance sheet and has had a downward force on wage increases in most sectors.


We help the owners, shareholders and the investors of companies make sure that their company's leadership are making good decisions on the selection of brokers, vendors and benefits package designs as well as the effectiveness of programs such as wellness programs.


We make unbiased analyses and recommendations to clients to show them a better way to do this.


This also leads to better health outcomes for employees as well as a lower financial burden to employees when they access healthcare. Happy and healthy employees are more productive.



benefits design

Consulting on your RFP and new broker search

Request for Proposal (RFP)

RFP Consulting

  • Starting the Request for Proposal (RFP) process gives you a lot of leverage when negotiating fees and terms from vendors, carriers or TPAs, PBMs, brokers and with setting up direct contracts with providers.
  • Having the right strategy in place when going through the RFP process will get you your desired results. 
  • It will also save time and money and start engaging with the front runners early.
  • Having a consultant involved to represent your best interests during the RFP process helps you to identify strategic flaws in presented proposals.
  • Independent recommended vendor vetting. Each vendor in the RFP needs to be vetted properly and without bias. This is a tactical and critical step to achieve optimal results while executing a successful RFP.


New Broker RFP

  • Independent consulting on the process of hiring a new broker.
  • We engage with applicants during the process asking critical questions and making unbiased recommendations to you.
  • We can do a search for a new broker and agency that will help you achieve your goals and make recommendations of who to invite to the process.

benefits analysis

Independent Overview for your Benefit Package and Spend/Costs vs Quality/Value

We look at your company benefit package and establish where improvements can be made. 


We can help If your goals are to:

  • Establish whether your current carrier or TPA, vendors and broker/s are providing you the best value and if they are hiding anything you should know about
  • Lower your company's costs of providing quality benefits and Rx
  • Improve your employees access to quality healthcare 
  • Lower the out of pocket costs for employees when they access healthcare


How do we engage?

  • Let's schedule an online meeting to start with
  • We can discuss how we can help your company
  • We can discuss what the next steps will be
  • Fees will be discussed once we understand the scope of the work

Insurance Agency Advising and Collaboration

Collaboration

Insurance Agency Advising

  • We advise brokers and agencies on complicated benefits designs on some of their cases.
  • We make recommendations on improving benefit packages.
  • We make recommendations on vendors that will work well to help the client accomplish their goals.
  • We help retain business by developing better strategies and tactics in the fast changing market place and healthcare system so agencies can break from the status quo offerings and plans.

Insurance Agency Collaboration

  • We are always looking for agencies to bring new business to when we help clients with RFPs and new broker searches.
  • We have many cases where we collaborate with other agents and agencies to win new business and improve the benefits packages of clients and prospects.

Direct Contracts for Providers, Employers and Health Plans

doctor patient relationship

Bringing doctors and patients together

When the relationship between a doctor and a patient is streamlined and bureaucracy is removed one of the greatest benefits is better health outcomes.

Doctors and Providers

  • Many doctors and providers are very willing to do direct contracts with patients, employers, Third Party Administrators and other organizations.
  • It lowers the administrative burden and cost of billing traditional health insurance plans.
  • Doctors and providers are paid fast and also receive fair compensation for their work.
  • It creates a pipeline of good business and referrals to their practice.
  • It helps independent providers remain independent. 

Employers and Employees

  • Having high quality providers for employees to get care at creates safe harbors where employees can go without getting surprise medical bills or balance bills.
  • In many cases employers will waive the cost sharing to employees if they get their care with providers where there is a direct contract.
  • Employers can pay for bundled services instead of fee-for-service billing.
  • Employers and employees enjoy price transparency for services and procedures.
  • Employers can help steer employees towards high quality providers, doctors and services.
  • Employees are more likely to get the care they need when they know how much services and procedures are going to cost them than when they don't know the prices and costs or those procedures and services.
  • Employers and employees can save a lot of money on their healthcare spend with good direct contracts in place.

Health Plans

  • When health plans can carve out certain services and move away from carrier network contracts a lot of money can be saved.
  • This also leads to better health outcomes to plan members in many cases when high quality providers are favored.
  • This allows health plans to reduce or waive cost sharing to plan members.
  • Health plans pay for bundles instead of fee-for-service billing.
  • It also avoids balance bills and surprise medical bills to plan members.

Direct Primary Care - DPC

  • A strong foundation for good healthcare is giving people easy access to good primary care.
  • Relationship based primary care that doesn't involve an insurance company between the doctor and the patient has better health outcomes.
  • Removing fee-for-service primary care avoids unnecessary treatment and overtreatment associated with the fee-for-service hamster wheel.
  • DPC doctors have smaller patient panels so that they can spend more time with their patients when they see them.



 

Can Direct Primary Care be a good benefit for your company and employees?

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Benefits for the Employer:

​

With the Direct Primary Care (DPC) model, the employer pays a monthly membership for his employees to have access to DPC doctors.

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What makes this so great?

​

  • Employers can put together more robust health insurance options that work well with DPC. This can lower the amount of money spent on health insurance and provides the employees and the business with better value for the money spent on benefits with lower out of pocket exposure.
  • Employees have easy access to health care with the DPC model. Same day office visits if needed, text, email, video 
    consultations. All at no cost to the employee and very efficient.
  • They don't have to take a long time off from work to see their doctor. In the DPC model, employees can schedule 
    appointments around their work schedule so that they don't lose revenue from wages etc. This also makes it more likely that an employee will see the doctor and not let something that could have been taken care of easily to escalate. 
  • So, less time off work and lower out of pocket costs for employees when they need convenient access to healthcare.
  • Because employees have easy access to primary care, it lowers ER visits and urgent care visits. 
  • Better access to primary care for employees lowers health care costs for employer groups. This could result in lower health insurance renewals and save money in the claims pool for self-funded employers.
  • Happier, healthier and more productive employees.
  • Possibly lower workers compensation insurance premiums at renewals because many minor work injuries could be handled by the DPC doctor and there are no medical claims filed for DPC treatments.

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Benefits for the Employee:

​

With the Direct Primary Care (DPC) model, employees have easy access to their doctor at no cost to them. 

​

What makes this so great?

  • Employees have a relationship with their doctors, who knows exactly who they are and what their health history and 
    challenges are.
  • Employees have easy access to their doctors when they need to see or talk to them. 
  • Employees can be proactive about their health instead of reactive.
  • Because this is not a fee for service model, Employees can call, text, email or do a video consultation with their doctor when they have questions or concerns. This saves everyone a lot of time. Most of the time; someone does not have to go in to see the doctor to get help. In the fee for service model, the doctor does not get paid if the patient does not go in to see them, so the doctor can't and won't help the patient unless they go in for an appointment. 
  • Better access to primary care prevents unnecessary hospitalizations and urgent care visits.
  • Employees can have a high deductible health plan, saving them a lot of money on their health insurance premiums.
  • Since Employees have full access to primary care with their DPC membership, they keep their insurance for expensive medical emergencies or illnesses. This way they only pay for insurance that covers what they can't afford to pay and does not use it for inexpensive medical services like primary care.
  • Employees’ doctors can get them better pricing on labs, drugs and radiology as needed.
  • Employees’ doctors have time to be their advocate should someone develop a serious medical condition and needs to be hospitalized or undergo treatment.
  • Employees can get same day appointments if necessary.
  • When an employee goes to see their doctor, they are met by friendly staff in what is in most cases an empty waiting room with almost no waiting time. The employee isn’t questioned about their insurance, they don't have a copay and will not get billed for the consultation. 

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What are the benefits of the DPC model to the Doctor?

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With the Direct Primary Care (DPC) model, the primary care doctors charge a monthly membership fee per patient that are enrolled at their practice. 

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What makes this so great?

  • The doctor has a smaller panel of patients, so they can spend more time with their patients.
  • Many chronic conditions can be treated by the DPC doctors instead of referring them out to specialists.
  • The doctor has time to develop a real relationship with their patients and be very accessible to their patients.
  • Because there are no third parties involved, like insurance carriers, the doctors spend most of their time treating patients. No need for coding or billing and other administrative work.
  • The DPC model has much lower overheads so the doctors get to keep a much higher amount collected from memberships. Compare this to the fee for service primary care model which comes in at 26% of money billed that the doctor gets to keep. This way the doctor can keep monthly membership fees low and very reasonable while providing 
    excellent care and attention to patients.
  • DPC doctors are happier with their careers  and lives because they spend most of their time doing what they love to do.
  • More time with patients means better health outcomes.
  • It also avoids balance bills and surprise medical bills to plan members.

Vendor vetting and vendor product and services improvements

wellness

Vendor Vetting

We can advise on the healthcare vendors and programs you are currently using are providing your company and employees with optimal value and producing desired results.

  • Many wellness vendors make claims about ROI and outcomes that doesn't measure up well with the actual results.
  • Many brokers will suggest more wellness programs and vendors suggesting that this will curtail healthcare spending, which isn't always the case.
  • Many wellness programs do more harm than good and leave employees disgruntled.
  • Employers are better off focusing on programs and vendors that get the desired results, we help identify those for our clients.
  • We make suggestions on the best in class vendors for services they are looking for and why it will work well for their particular situation and workforce.

Vendor Product and Services Improvements Consulting

  • We help vendors improve their products, services and offerings by consulting with them on the customer and client experiences and what works in the industry.
  • When vendors have better products and services they become more competitive and appealing to their target market.
  • Improved products and services also leads to lowers costs and better health outcomes.
  • Effective products and services are the primers for growth in this space.


Medicare Products and Product Development

Medicare

Medicare Products

We can advise clients on their options of products in the Medicare space for employer group plans and individual plans direct to consumer. This includes Advantage Plans, Supplement Plans and Prescription Drug Plans (PDP).

  • The Medicare space has become very competitive for carriers, which has lead to a vast improvement in product offerings to consumers.
  • People have different needs so it is critical to help them find the products that will work best for them and their situation.
  • One of the hardest nuts to crack in the Medicare space is the prescription plan. It is important to work with a good adviser to help with this.
  • We help people on a one by one basis to find the plans that will work best for them. 
  • We help employers implement the best Medicare options to employees that are available in their area.

Medicare Product Development

  • We help carriers improve their products and services so they can remain competitive in this space.
  • We advise carriers on sales strategies to reach more consumers and generate more leads.
  • Products that are consumer friendly and valued by consumers has higher retention rates.


Association Benefits

associations

We advise associations on how to improve their offerings to members in the field of healthcare products and services

  • There are many low cost products and services available to associations and their members.
  • These products and services can significantly lower the costs for members when they access healthcare and make navigating the healthcare system easier.
  • The value added to members far exceeds the costs to the association.
  • We also advise on the current offerings by associations and where improvements can be made.
  • We make suggestions on the best in class vendors for services they are looking for and why it will work well for their particular association.

Health Sharing

health sharing

We can advise businesses on what would be a good strategy on offering health sharing options to employees. 

  • Significantly lower costs to employees and to the employer.
  • Works well with Direct Primary Care (DPC) benefits.


ICHRA - Individual Coverage HRA

ICHRA

We can advise businesses on what would be a good strategy on offering an ICHRA -  Individual Coverage Health Reimbursement Arrangement

  • Businesses who are getting a bad deal in the insurance space does have the option to send employees to the exchange to pick any health plan they prefer and then reimburse them for a portion of the premium.
  • Done right, this could lower costs to the company and to employees.
  • Gives employees more choices.
  • When an employee leaves their employer, their health plan stays the same.
  • Employers get out of the insurance business.
  • We help clients design and implement a good ICHRA strategy that will work well for the company and the employees.


About us

Mitigate Partners

Looking after our clients' best interests. Showing them a better way.

  • Want to make sure you are getting the best value for your money on your current benefits package? We do independent benefits reviews and oversight to show where improvements can be made.
  • There is a lot that your current broker might not be telling you. Partly because they are paid by the insurance company and partly because they don't like to rock the boat and advise against the status quo.
  • There are always many strategies to improve healthcare access for your employees. Even a small step in the right direction is better that keeping doing the same thing over and over again.
  • We have years of experience and an in depth knowledge of what goes on behind the secret curtains as well as to where the money goes employers spend on healthcare for their employees.

Find out more

Mitigate Partners

Mitigate Partners: 

  • We are a collaboration of independent benefit advisors whose purpose is to work together giving ourselves the greatest opportunity to grow and serve clients.  As benefits advisors, we are collectively aligned to support each other, use our collective wisdom and to help each other thrive, and improve the ability of our clients to deliver on their promises to their employees.  Our collaborative helps employers save money on healthcare and take the best care possible of their employees.
  • We are engaged in the pursuit of actively managed EMPLOYER-BUILT Healthcare to replace the archaic passively managed Insurer-Built Healthcare system that has ceased to meet the needs of employers and their employees providing best-in-class benefits at substantially lower costs, all while improving clinical and financial outcomes for our clients’ health plan and their employees.

Find out more
Health Rosetta

Health Rosetta Adviser

 

  • As a Health Rosetta Benefits Associate Advisor, I am committed to an industry-leading standard of transparency and fiduciary responsibility to my clients and their employees. Using data analytics and proven practices, we design health benefits plans that can reduce health care spending by 20% or more -- while achieving better health outcomes. My passion to serve my clients is amplified through this advisor program, providing me access to similarly mission-aligned advisors to share best practices, new ideas, and proven results from across the country.  
  • Health Rosetta is an ecosystem for scaling adoption of practical non-partisan fixes to our health care system by enabling public and private employers and unions to reduce their health benefits spending by 20% or more while improving the quality of care for plan members. Health Rosetta aggregates proven best practices from the best benefits purchasers, then simplifies adoption so you can follow their lead. 

Contact Us

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Class Insurance Consulting

(978) 836-6745

Class Insurance Consulting

gclaassen@classins.com

978.836.6745

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