The RiskVantage Algorithm can be a point of differentiation and a key part of your value proposition. As health benefit costs continue to escalate, employer clients are increasingly looking to their broker advisors to bring new, innovate solutions to the table. Alternate forms of funding including fully and partial self-funding along with retrospective and other alternate forms of insured rating are becoming increasingly popular.
One size does not fit all. Most brokers are equipped to create a self-funded plan for their client yet very few are equipped to perform the in-depth analysis needed to determine if self-funding is the right choice for a given employer. It is not in the best interest of either the broker or their client to place the employer in a self-funded plan if it is not the right fit for that employer. If costs spin out of control the employer will find their alternatives unappealing and the relationship with the broker can be irreparably damaged. With the limited amount of information available even the best prepared and best intentioned brokers are unable to conduct an analysis that truly sheds any insight on the future expectation of plan expenses for small to mid-sized groups. For small to mid-sized groups, reviewing past claims data, demographics and industry codes fail to provide reliable predictive value.
RiskVantage can equip brokers with a tool that other brokers in their market cannot. The RiskVantage Algorithm can differentiate a broker from their competitors who lack the expertise and tools to provide real insight to their clients.
The RiskVantage team has used their extensive experience leading underwriting and analytics departments of large health plans to develop a set of factors that will allow us to look behind the curtain and shed light on the characteristics of the group that matter in predicting future health care expenses. RiskVantage will spend time with your client to get to know about the unique attributes of your group. Typically, the RiskVantage team will spend 1 to 1 ½ hours with the employer to conduct an informal interview and collect pertinent facts from the employer. This interview can be conducted in person or via phone at the employer’s convenience. Commonly, a human resource manager or financial officer of the employer can readily answer the questions or easily retrieve the data. Additionally, RiskVantage will request an enhanced census that contains some additional data elements not normally included in the census routinely provided to carriers but can be completed with little difficulty.
The data collected will be utilized to score the client on 42 different attributes to assess their unique risk profile. RiskVantage looks to provide a long term indicator to ensure that self-funding is viable option for the employer in the long run.
The 42 attributes evaluated break down into these six main categories of risk:
• Employer stability
• Employee composition
• Plan administration
• Employee benefits
• Approach to wellness
• Benefit utilization
An easy to understand report will be supplied to the broker. It will indicate if the employer is a fit for self-funding and will illustrate how the group compares to other employers in each of the six main categories. RiskVantage will also provide recommendations of changes that the employer can make to mitigate their risk. RiskVantage is able to provide a response within 3 business days of collecting all the information.
Don’t you owe it to your clients to make a small investment with RiskVantage to gather as much information as possible to inform them when making their plan decisions? It will improve the odds of guiding the client to their best possible solution for a sustainable long term plan.
RiskVantage is available to contract with brokers to utilize the RiskVantage algorithm on a client by client basis. RiskVantage also is willing to develop an exclusive arrangement with a broker in a given geographic area.
Other Services:
RiskVantage team has extensive experience leading the actuarial, underwriting and informatics areas of large insurance carriers. In addition to the risk evaluation services using the RiskVantage Algorithm, our team has the expertise to provide the following additional consultative services:
- Negotiation of plan premiums with carriers based on a detailed review of the carrier rating formula
- Recommendations for plan design changes to drive optimal utilization of services
- Obtain stop loss quotes from various carriers
- Analysis of third party administrator discounts and fees
- Incurred but not paid (IBNR) estimates, premium equivalents and other projections
- Formation of Trusts, Consortiums, PEO’s, Captives and Private Exchanges including risk selection of participants.
- Ongoing maintenance of such Trusts, Consortiums, PEO’s, and Captives including relative pricing of participating entities based on difference in prospective risk profile.
Please see the additional tabs for more information on the topic of Trusts, Consortiums, Captives and PEOs.
