Health Plan Evaluator
This tool provides each employee with a web portal to determine which health plan
option best suits the employee’s needs.
Features
Uses Actual Customer Data
- Actual claims information. We use our claims modeling system to
model each employee’s claims for the plan year. This system utilizes the employees’
actual medical & prescription drug utilization and charge information from previous
plan years to assist with the prediction of future costs, which is far more valuable
to the employee than providing nationwide averages for utilization and charges of
healthcare services.
- Actual plan designs. We then take the actual claims information
and demonstrate which plan option makes sense for each employee given the plan design
provisions for copays, deductibles, and coinsurance. This is done by loading the
employer’s medical & prescription drug plan designs into our modeling
programs.
- Actual premiums. Each employee’s customized analysis reflects
the premium contributions that the employee will make for each plan option based
on the criteria that the employer lays out.
Dynamic and Customizable
- Dynamic environment. The real value to this tool is that it provides
the employee with a customized answer the second they log on. However, a small percentage
of employees will want to do “what-if” testing by determining which
option is best if they increase/decrease their utilization of certain services.
This testing can be accommodated right on the website.