Health Plan Evaluator
(Available in Summer 2007)
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.
- Customized quality information (coming in 2008). Each employee’s claims data can be very telling. The data often indicates which conditions the employee and their family have and whether they are receiving care as regularly as they should. If desired, we can monitor that information and provide “soft” reminders and educational information on the website that are customized to a given employee’s healthcare needs.