Risk & Pharmacy Management

RISK MANAGEMENT/STOP LOSS INSURANCE

STRATeBEN has a seasoned underwriting staff dedicated to matching the correct risk management tools to your organization’s risk tolerance. Our proprietary reporting tools allow us to evaluate a multitude of options prior to selection, which gives our client’s peace of mind knowing they have the correct risk coverage. Our underwriters also employ our prospective Clinical Management tools to evaluate the ongoing costs of a group plan, and they use these as leverage in their negotiations with stop loss carriers. Additionally, these tools aide by demonstrating to the stop loss carriers the active health care management our Clinical Management team conducts in order to protect all constituents' interests in the self funded environment. 

RISK MANAGEMENT CAPABILITIES: 

• Coverage requirements
• Specific deductible evaluations
• Aggregate insurance and attachment factors evaluations
• Prescription Drug cost risk management
• Transplant review and large claim risk shifting
• "Laser" evaluations and recommendations
• Disclosure Assistance

PHARMACY BENEFIT MANAGEMENT REVIEW:

STRATeBEN has experience evaluating and building prescription drug plans. As plan sponsors now know, one of the key drivers of the alarming increase in health plan costs is Prescription Drug expenses. It requires an unique skill to evaluate PBM effectiveness and negotiate the best possible arrangements for a particular plan. In addition, a more sophisticated approach to benefit plan design will position plan sponsors for long-term survival.

PHARMACY BENEFIT MANAGEMENT CAPABILITIES:

• Deliver sophisticated reporting tools
  • Evaluate the effect of Rx expenses on the plan 
  • Integrate Rx information as a key indicator of potential large claimant identification
  • Negotiate effective Rx arrangements
• Hold Rx Partners to strict Performance Metrics
  • Service
  • Savings
  • Claim Payment accuracy