While some employers have a professionally trained HR team. Some don’t. No matter your level of sophistication, everyone needs help. We provide HR / benefit administrators with proactive advice, tools, and resources to manage your programs and stay compliant…allowing your HR team to focus on people management.
Staying current can be a daunting task with the ongoing changes in the compliance landscape brought on by the Affordable Care Act. Our goal is to provide you with information to keep you current along with resources you can access to stay compliant.
A fully-insured health plan works for many organizations, however, it isn't always the best answer. You’re always paying for last year’s claims with current premiums, you don't get actionable data, plan design flexibility is limited and changing carriers to save money causes disruption.
We help you evaluate, design and implement alternative financing solutions that won’t sacrifice employee care, morale, out-of-pocket spending or your bottom line.
An HRA enables an employer to purchase a High Deductible Health Plan and reimburse expenses below the purchased plan’s deductible. This keeps premium costs low, while offering a high level of benefits.
A Level Funding arrangement enables employers to benefit from the regular and predictable cost of a fully insured plan and benefit from some of the flexibility of a self-funded plan without the uncertainty of fluctuating claims costs that comes with self-funding. If claims are less than the amount deposited to the claim-fund, the employer gets a refund of claim-fund surplus. If claims are more than expected, the employer is not asked to provide additional funds for the bad claim year. Employers get more claims utilization data and because these are ERISA plans, they don’t need to comply with certain state and ACA benefit mandates.
In comparison to a fully-insured health plan, where for a fixed monthly premium all or most of the risk is with the carrier, in a self-funded plan, the risk is on the employer or plan sponsor (although most of the risk is transferred to the stop-loss policy). A third-party administrator (TPA) provides administrative services, and a stop-loss policy is purchased to reduce employer claims liability.
The employer pays administrative fees, stop-loss insurance premiums and actual claims up to a pre-determined threshold. Specific stop-loss coverage is purchased to limit the plan’s financial exposure on any one individual; Aggregate stop-loss coverage is purchased to protect against a higher than average frequency of claims for all eligible plan members combined within the group.
Self-funding is not right for every company. There are advantages and disadvantages. However, the arrangement does allow employers to gain control, have access to data, and deploy cost-containment strategies that improve employee care and actually bend the cost curve.
Many employees believe their medical insurance alone will cover all health-related situations, so they don’t plan for or understand the impact these costs can have on daily life. We help you offer a wide range of traditional and supplemental benefits, along with the education as to how they work together to provide your employees with a solid foundation of protection that enables them to be better health care consumers.
Insurance is complex. Our goal is to help your employees understand how your plans works so they value the program being offered.
At Miller Wolf Associates, we provide accurate answers to employee questions and pride ourselves on timely resolution of complex problems.
One wellness solution does not work for all. In fact, the very definition of a “wellness program” can vary depending upon who you ask. Using claims data in collaboration with our wellness vendor partners, we develop population health management strategies that match corporate culture and management’s engagement in the program. We work with you to design a long-term strategy to improve company morale, reduce absenteeism and ultimately drive down plan cost.
Employees care about financial well-being and they want access to education and great programs where they work.