Risk Management

Increasing benefit utilization and controlling cost

Our consultative approach means we go beyond providing the right benefits and providers for your business. We are real-time risk managers, finding and implementing strategies and programs for ensuring that your benefits work within your tolerances for cost and risk while delivering value for your employees.

In addition to guiding you through self-funded plans, health reimbursement arrangements (HRA), wellness and disease management, our team puts tools and resources to work managing and reporting costs and performance.

On-staff medical underwriter
Claims analysis specialists
On-call actuarial firm
30 years of benefits underwriting experience

Part of managing risk is implementing strategies to make benefits more appealing and easier for employees to use. Our team makes it happen with modern benefit strategies that include:

High-touch disease management
Claims and coverage advocacy
Wellness programs
New plan designs, vendors or benefits

Health Benefits can be financed in numerous ways – health insurance alone or in combination with a Health Reimbursement Arrangement or with a partially self-funded approach, limiting exposure with stop-loss insurance. What you pay as an employer for health benefits is dependent on the health status of each individual; risk management is important for every company, no matter your size. If your organization has a self-funded arrangement or carries great financial (or legal) risk related to employee benefits, then eBen can help by bringing an innovative and proactive risk management strategy to manage short-term issues and bring long-term stability.

What Do Risk Management Programs Include?

Participant data is used to personalize each risk management program; all recommendations are shaped by a deeper understanding of your organization and employees. Primary services include brokerage and consulting for self-funding arrangements and compliance assessment. We will cover the general process below, although your experience may be a little different and uniquely based on your needs and goals.

Data Analytics and Analysis

Looking at your actual data determines the current and future state of your health plan. Health analytics reveal how your group is performing, identifies any unique risks and provides direction on how to mitigate their impact on future costs. Using a dedicated actuarial and underwriting team, we provide an honest assessment before going to market.

Best Fit Funding For Your Health Care Costs

We assist organizations with assessing their options and placing the right approach with the establishment of their long-term strategy and goals and cost-controlled solutions to help mitigate organizational risk.

Analyzing Your Long-Term Strategy and Goals

Risk management programs begin with a detailed assessment of your company. This includes an analysis of your long-term goals, the study of participant data to develop your risk management strategy, and data analysis and benchmarking to identify cost-effective solutions. We leverage our unique marketplace position to negotiate cost-controlled plan designs.

Risk Management Consulting

Risk management consultants are equipped to advise clients on how to control their costs, follow all applicable compliance regulations and laws, and handle current and potential problems with their company, especially as it pertains to human resources, employee benefits, and administrative concerns. We also provide brokerage services to help reduce insurance costs (and other costs) and mitigate your company’s overall financial risk.

Wellness & Disease Management Programs

Helping employees understand the state of their health is the first element of long-term risk management. Through health risk assessments, biometric screening, programs to encourage regular physicals, dental visits and group wide programs, we focus everyone’s attention on what is going on and may happen in the future.

But the highest costs in health care all relate to those with chronic medical costs. We bring unique products and services to our clients that have a proven history of helping reduce the cost of living with diabetes, high blood pressure or cholesterol, or serious back and other joint pain. There is no one-size-fits-all program for organizations – and our experienced consultants implement the right program for each client’s unique needs.

When Should I Consider A Risk Management Program For My Company?

Risk management programs are encouraged for any organization that has a self-funded insurance plan and subsequently assumes the financial risk for providing health insurance benefits to employees. Additionally, risk management programs are recommended for organizations that do not have internal compliance professionals that are tasked with staying up-to-date with all compliance measures related to human resources and employee benefits. If there is no one internally to be designated with these tasks, working to form a program is going to save you lots of extra work and headaches later. It is important to have a plan for risk, and we can assist you with creating a strategy that mitigates the financial risk of your organization.

Risk Management And Mitigation

eBen has vast experience in working on various funding approaches to health benefits, with special emphasis on working with traditional self-funded arrangements. This includes the following that has allowed our clients to take proactive measures on emerging risks as well as effectively evaluating current and future risks and their impact on fixed and claim costs:

In-House Case Management & Review

We have experienced team members who provide support for our clients’ specific cases and evaluate individuals who have exceeded certain project cost thresholds and target diagnoses. Our team offers a unique ability to intervene at early stages to understand the emerging claim(s) and what alternative risk methods might be employed. Our team has years of experience in working directly with provider, stop-loss carriers, actuaries and underwriters to provide the best perspective on what is really going on with each individual.

Our own Underwriter to Assess Risk and Equip Our Team for Battle with Carriers & Stop-Loss Markets

eBen has its own underwriter on staff which empowers our quoting process for the best understanding of risk and providing the right language and data to support our position. Our expertise is recognized in our industry and people who can “talk the talk” with other underwriters to help our clients get the best price for stop-loss and related services.

Health Care Specific Actuarial Services at the Ready

For 30 years, our view on the market and costs has been guided by Bernie Erickson and his team at Actuarial Strategies and Tactics, a Phoenix-based firm that is dedicated to working on health plans and related risks. Their expertise has allowed us to provide our clients an independent view on stop-loss markets, premiums and trends, network discounts, and product and service innovations that may reduce both specific deductibles as well as aggregate attachment and claims exposure. We have found this approach – an independent, dedicated firm – to be far more advantageous for our clients since we can prove an outside perspective as we negotiate with various markets and service providers.

Contact The Professional eBen Team Today To Get Started

Improve the long-term outlook of your company through risk mitigation with eBen. We enjoy helping clients identify and manage the risks their company faces. You can reach one of our risk professionals at eBen today by giving us a call or sending us a message.