In addition to medical and ancillary insurance administration, many employers find value in our advisory services and experience in medical management solutions.
With your business strategy and objectives in mind, a customized self-funded employee benefits plan is designed. The plan design may include a consumer directed high deductible health plan (HDHP) or traditional copay plan. Other considerations include cost sharing, pharmacy benefits, network and past utilization.
Using the power of data, you can view and analyze plan and network utilization. With ad hoc and custom reporting, it allows you to receive recommendations on plan design, wellness initiatives and more – with the overall goal to reduce the cost of health care and employer financial risk.
We are dedicated to helping employers navigate the complex and changing regulatory landscape. There can be a significant impact on how employee benefit plans are designed and administered to ensure compliance with ERISA, COBRA and HIPAA. Being well versed in ERISA and Federal and State requirements, employers can focus on the operation of their organization knowing the compliance details are managed and adhered to.
Stop loss coverage protects employers (plan sponsors) against catastrophic losses due to high health claim expense. This coverage is often in place to help manage financial risk. Health Choices partners with carriers that advise and provide both specific and aggregate coverage.
The enrollment process during annual and special enrollment should be seamless and intuitive. Health Choices works with several technology platforms that provide a seamless benefits management and enrollment experience.
Grown out of a successful provider system, Health Choices has built its services around a proven medical management model. It’s designed by medical providers who know that sustainable health care begins with directing people to the right care, at the right time, in the right setting.
Experienced contracting professionals are available to develop a provider panel that meets employer needs through thoughtful analysis and a sound credentialing process.
Whether your employees’ health risks are minimal (lower cost) or significant (higher cost), we can impact their outcomes by guiding them through their episodes of care — resulting in cost savings and better quality of life.
Employees have access to registered nurses and support staff who use physician approved protocols to guide employees to the appropriate care; calls become a part of the employees’ medical records for care continuity.
Certified health coaches guide employees into healthy, sustainable behavior change. Programs are personalized and range from lifestyle coaching to basic health management.
By managing employee health issues through the use of case managers, we provide ongoing consultation and review of available treatment options that result in your employees understanding and receiving appropriate care options.
For individuals with chronic conditions such as diabetes and hypertension, and those with complex diseases, we provide education and coordination of services to minimize complications and manage high-cost care. We collaborate with providers to develop a care plan that helps employees meet their goals and live more fully.
By encouraging the highest quality of care, in the right setting from the most appropriate provider, we seek to avoid over-use and under-use of medical services by making decisions based on evidence-based guidelines.
* Services provided by registered nurses who operate under the direction of a Health Choices Chief Medical Officer.
Organizations that add Health Choices medical management services save an average of 15% over organizations solely using benefit administration services.
Let us show you the savings of adding medical management services.
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