Lower Health Care Costs. Optimum Health Outcomes.
AIA, Alera Group is a true health care solutions company, pushing back on decades of the status quo and bringing a new train of thought to the current mentality where employers simply accept rising health care costs. Together with our clients, we are changing tactics to curb health insurance costs and provide better health outcomes for their employees. We know health care is one of the top areas of expense and financial risk for employers and the benefits package you offer to your employees is a critical strategic tool to recruit and retain the right people for your organization. Our talented team members are experts in navigating the complex and changing world of employee health and benefits that are right for you. We have compiled innovative solutions that improve health care affordability and deliver optimum health outcomes, all while strengthening your organizational and employee well-being.
Our Approach to Strategic Benefits Planning
We become your expert health-benefit consultant with financial transparency. It is our mission to be on top of new market trends and put these innovative strategies in front of our clients. Through our GameCHANGER© portfolio of solutions, we will greatly improve your benefit plans, increase your employee appreciation, and have a long-term positive financial impact. You do not have to hope for or settle for merely a "less bad" rate increase each year. Reducing health care costs while improving the quality of care and well-being for your people IS possible!
Below is a Sampling of Our Services as a Full-Service Health Solutions Company (Click the + button on any service for further explanation):
Health care plan design and cost matter! Your business and corporate culture are unique, so rather than choosing the typical health care plan renewal or a one-size-fits-all solution, we take a multi‐year strategic planning approach to your plan design. Our continuous and unparalleled feedback of detailed metrics, plan analytics, direct vendor negotiations, payment strategies, and our GameChanger© solutions help us focus on lowering your overall costs and improving the health and well-being of your most valuable asset— your people.
Taking the right approach to plan funding will have a direct impact on costs and your opportunity for reducing expenses. We work with our clients to evaluate every possible funding approach. Our unique health care solutions can be found within a variety of base designs such as:
- Participating and non-participating contracts
- Minimum and level funding
- Self-insured with stop loss insurance
Our AIA, Alera Group executive consultants along with our award-winning tools will help you determine the best approach and employee benefit solutions that are beneficial and consistent with your corporate culture. Call or email us today for a free consultation!
Pharmacy costs are one of the fastest growing expenses for self-funded employers, especially as high-priced pharmaceutical drugs continue to enter the pipeline. Recent insight reports project that by 2020, specialty drug costs are expected to reach 50% of overall drug spend. Compounding rising pharmacy costs, is a lack of clear transparency in the pharmacy industry, leaving employers questioning the validity of their pharmacy relationships and contracts.
AIA, Alera Group, is committed to aiding self-funded employers in identifying transparent and best-in-class pharmacy solutions to reduce costs. We take a neutral approach, working to distinguish pharmacy partners that have your best interests in mind. Based on a mix of utilization and bench-marking data and your unique needs, we will help you choose the right pharmacy partner, whether a carrier, PBM (Pharmacy Benefits Manager), or coalition arrangement. Our aim is to ensure that you have the expertise available to make the best decisions.
Our consulting expertise includes:
- Rx Opportunity Assessments
- Program Management and Communication Strategies
- Plan Design Strategy and Bench-marking Analysis
- Plan Performance Reviews
- Pharmacy Partner Selections
We do it for you! Our expert development of actuarial, underwriting, and financial deliverables within our analytical portfolio serves as one of the foundational points to the unique level of sophistication we are able to continually deliver to you as a client. We have received distinctive acknowledgement from regional and national health care representatives as having a “best in class” analytical portfolio. Gaining a deep understanding of your health care and benefit data enables us to help you make the best decisions, saving you time and cost.
Some of our capabilities include:
- Experience Report: Provides dashboard of all relevant plan performance measures.
- Financial Settlement Summary Report: Calculates carrier retention and profitability.
- Trend Report by Relationship: Models medical and prescription drug claims by employee, spouse, and dependent to analyze the plan performance by relationship.
- Claim Lag Analysis: Forecasts the monthly Incurred but Not Reported (IBNR) claims amounts to allow us to present claims on an incurred basis and calculate reserves.
In addition to the standard portfolio, there are also has a vast array of client-specific tailored analyses that include:
- Patient Utilization Report: Assesses the actual financial impact of benefit modifications.
- Cash Flow Analysis: Examines the advantages of alternative financial arrangements.
- Comparison of Funding Mechanisms: Illustrates the true costs associated with different financial arrangements.
- Claims Re-Pricing Analysis: Depicts the network “discount” differential between each carrier under evaluation.
- Charges vs. Discounts Summary: Determines the achieved level of network discounting.
- Advanced Rate Projection: Provides an early estimate of the carrier renewal action based on our deep understanding of the carrier-specific underwriting methodologies.
- Longitudinal Renewal Analysis: Evaluates the appropriateness and reasonability of the carrier renewal action relative to current and historical actuarial considerations.
- Assessment of Renewal Options: Illustrates the best financial outcomes across multiple-year offers according to the most likely scenarios.
- High Claimant Sensitivity Analysis: Projects the financial and ongoing impact of each high claimant.
We also have partnership services that deliver actuarial attestation or certification. Our source warehouses more than $19.0 billion in claims data for over 3.0 million commercial, nationwide member lives. We can provide quick answers or a sophisticated analysis of the value of plan changes, such as plan design, provider network, demographics, and stop loss levels. In addition, by utilizing up to three years of past claims, we can forecast the expected plan costs, predict employee migration, create budget equivalent rates, and test various employee contribution strategies for their impact on plan cost.
The bottom line is our consultative approach combined with our unparalleled data analytics helps you make optimum benefit decisions, setting up your organization for success and ahead of others.
We want to help you preserve the most valuable asset of your organization; your employees! Employers continue to face challenges with recruiting, engaging and retaining talent. Today, leaders must be more consciously aware of their influence in engaging employees and molding their company’s organizational culture. Your organization has a unique culture that exists because of the relationships, organizational design, and foundational tenets that inherently hold it together. Recognizing all of this, our aim is to help you engage, support and retain those valuable employees and inspire a workplace culture that allows employees to thrive.
AIA, Alera Group, believes in the philosophy that there is no “one size fits all” approach in designing a well-being program. We feel the greatest opportunity to engage employees exists with a “whole-person” approach focused on each of the six interconnected elements of well-being:
We will work with you to develop a cohesive strategy that aligns your employee’s well-being needs with the goals of your organization to build a distinguished workplace culture promoting employee productivity and retention.
Our Capabilities Include:
- Well-being and Culture Consulting
- Needs Assessment
- Data Review
- Strategy Development
- Thought Leadership
- Training and Education
- Vendor Evaluation & Selection Support
Now more than ever, employers are looking for ways to automate important areas of Human Resources including applicant tracking, on-boarding, payroll, employee benefits administration and ACA reporting, and performance management. With the HR Technology marketplace becoming more complex, it is a real challenge for even the most advanced HR professionals to stay current, especially with the addition of needing to understand and apply the Affordable Care Act requirements.
AIA, Alera Group is a Center of Excellence for HR Technology and Benefits Administration. As a Center of Excellence, we are looked to as a subject-matter expert for our Alera partner firms and their clients as well as our own. Finding the right technology solution at the right price for your specific company is not a simple task. Every vendor believes they have the right system. As your trusted advisor, we’re here to help you find the solution that makes the most sense for your needs, not to sell you on one vendor’s system. We continually research the market to find the latest, and best, solutions to reduce your benefits administration cost and improve efficiency.
Our in-house expertise coupled with our trusted technology consulting partners deliver different, and better thinking on the solution that’s right for you. As a result, your HR staff will experience a better outcome in improved efficiency, creating the opportunity to focus on strategic issues rather than administrative tasks.
We can help you with HR/Benefits Technology Solutions including:
- Technology Gap Audits
- HR Technology decision support for vendor selection and implementation of HCM Modules including full employee life cycle (“hire to retire”) applications such as:
- Applicant Tracking Software
- On-boarding Software
- Payroll Administration Technology
- Time & Attendance
- Performance Management
- HR Technology Vendor Issue Support with Key Vendor Contacts (e.g., ADP, Ultimate and Paylocity)
- Benefits Administration support on preferred platforms (e.g., Employee Navigator, bswift, PlanSource, Businessolver)
Staying in compliance with ever-changing state and federal employee benefit regulations can be a monumental task for your business. If not properly attended to, it can set your organization back financially with tens of thousands of dollars in fines and penalties. We are strongly committed to assisting and helping our clients navigate this difficult landscape. Our highly experienced compliance team works closely with your AIA, Alera Group account team to provide compliance support/services that will minimize or eliminate your risk and give you peace of mind so you can concentrate on your organization’s mission and growth.
Our team’s expertise include:
- The Patient Protection and Affordable Care Act (PPACA or ACA)
- The Employee Retirement Income Security Act of 1974 (ERISA)
- Internal Revenue Codes (IRC) related to employee benefits, including 125, §105, §106, §129:
- Consumer Driven Healthcare
- Medicare D and secondary payer rules
- Account-based plans (Health Reimbursement Accounts (HRAs), Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs)
Our standard compliance services include:
- In-house compliance team support to respond to specific employee-benefit related compliance questions
- Monthly Compliance Alerts
- Legislative updates or new, emerging or changing laws that impact employer-sponsored health and welfare plans
- Access to webinars and educational series (typically held by ERISA attorneys and industry experts)
- On-line human resources self-service tool
- Review of plan documentation for ERISA and IRC compliance purposes (applicable to group health plans)
- Insurance carrier and third-party administrator contract reviews
- Comprehensive onboarding Compliance Assessment (gauges employee benefits compliance adherence)
- Data collection of required information for the Annual Form 5500, associated Schedules and summary annual report (SAR)
- ACA compliance support, including assistance with:
- Market reform provisions and implications for employer-sponsored plans
- Understanding related fees; PCORI, Transitional Reinsurance Program (TRP) fee
- Employment mandate compliance support
- Minimum essential coverage (MEC) minimum value (MV), and affordability considerations
- General guidance related to IRS information reporting requirements
- Participant notice preparation and assistance with common notices imposed on group health plans (ex. Medicare D notice of creditable coverage, HIPAA privacy notice, etc.)
- Annual HIPAA training
- “Smart” compliance portal – proprietary employee benefits for enhanced compliance support
- Creation of new plan documents or substantial updates to existing documents, summary plan descriptions (SPDs), summary of material modifications (SMMs)
- Preparing “signature-ready “welfare plan annual Form 5500 and SARs, delinquent and amended Form 5500 filings
- Compliance related audits (outside of initial onboarding compliance assessment)
- Customized client specific training for client workforce
- IRS information reporting assistance (1094-C and 1095-C); data collection and providing data to vendor transmitting the forms
- Other compliance related services not included in our standard services
AIA, Alera Group is also positioned to help clients with other compliance related areas including non-discrimination testing, COBRA administration, and human resources consultancy services.
Helping employees and their families understand, utilize and appreciate the programs is essential to. Whether the goal is to engage in wellness programs, steer employees into the most cost-effective plans, or clearly explain changes, effective employee communication is critical to the success and appreciation of every program. The best plan strategy and design will fail if employees are not engaged.
AIA, Alera Group considers our client's and their staff preferred means of communication, and we may recommend different approaches to maximize effectiveness for each group. We believe it is our obligation to help employees manage the complexity of the health care system and to make informed decisions that are in the best interests of their families. We take the position that health care communication is often a “call to action” where success is defined by employees making informed decisions.
Common communications include:
- Targeted enrollment and new hire materials
- Newsletters, benefit guide, benefits-at-a-glance, election forms, posters, payroll stuffers, flyers, PowerPoint presentations
- Mobile apps
- HTML email announcements
- Content, messages and ideas for in-house publications
- Onsite employee meetings
- Web-based employee meetings
- Online company benefit portal
- Ongoing relevant and timely employee benefit / wellness education newsletters
- Topic-specific communication campaigns tied to your overall benefits strategy, such as wellness programs
- Employee benefit statements / total compensation statements, and
- Employee satisfaction surveys
Our AIA, Alera Group Insurance and Risk Solutions Department is a dedicated team that specializes in employer-paid and/or voluntary ancillary and worksite benefits. Our team’s sole focus is on analyzing your current coverage and making value-added recommendations to enhance your employees’ piece of mind and experience. We will review your employee demographics, coverage levels, and premium cost while obtaining competitive quotes from our extensive carrier-partner relationships. Our goal is to provide you with the benefits your employees need, when they are needed most--during loss or disability, all while partnering you with the right carrier for the most competitive cost.
Some of our value-added expertise includes:
- Group Term Life Insurance
- Group Short and Long Term Disability
- Supplemental Medical Products
- Critical Illness
- Hospital Indemnity
- Individual and Executive
- Life Insurance
- Identity Theft Protection
- Pet Insurance