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Benefits Strategy Equals the Right Plan and Price

The technology industry in Pittsburgh competes for talent. A significant employee retention and attraction tool is a best-in-class benefits program. With the right strategy, you can achieve the quality plan of coverages, network and support services without blowing the funding and your budget.

The PTC Corporate Coverage Group (PTC CCG) team can develop a strategy that delivers great customer service throughout the year, detailed reports, competitive premiums, personalized open enrollment and ongoing administration services that your HR team appreciates.

However, whether you are a start-up enterprise, a small employer, or one that is large or spans various geographies, managing the cost of employee benefits is what your CFO monitors closely and your investors demand. Regardless of your size or tenure in business, one strategy that is proven successful is to understand the health and wellness of your population and how to reduce the emerging medical claims.

So, how can the PTC CCG team help you to control the claims costs of your benefits program? One traditional answer to that question is to implement a wellness program, including education and resources in the areas of tobacco cessation, weight loss, healthy eating and exercise. These are great employee benefits, but they don’t substantially lower the premium and other costs.

In order to drive down quantifiable benefits costs that are sustainable, the strategy must include a risk management program.

“You can achieve the quality plan of coverages, network and support services without blowing the funding and your budget.”

The medical claims of your plan participants are the most significant factor impacting the cost of insurance premiums. However, rather than focusing on past medical claims, it is more effective to understand the risk factors that will lead to the upcoming, or emerging, medical claims. In other words, learn from each individual participant what exactly is needed to reduce costs, or even mitigate the claim from ever occurring.

Developing the risk management strategy is customized based on the size of the employer group and the type of insurance program. Small employer groups don’t have access to the claims information. Fully insured insurance programs only receive aggregate claims information. These examples require a different risk management strategy compared to a large employer that has a self-insured or reference-based pricing program.

A way to lower emerging claims costs and improve employee health is to engage PTC CCG’s Population Health Management program. The program engages employees and their family members personally, identifies health risk factors confidentially and supports participants individually to improve health, choose the most effective courses of treatment (or action), and lower out-of-pocket costs.

We also offer cost transparency tools to help participants make smart choices. This is a great tool for all employers, and effective for the small employer (typically fewer than 25 insured employees), and those small employers with fewer than 50 employees who are fully insured and don’t receive individual claims data from insurance companies. Our cost transparency tool is online and available 24/7 so that individuals can research the cost of medical services by zip code, before they choose the facility with cost and convenience in mind. Educating individuals to compare costs of medical services is empowering and lowers out-of-pocket and claims costs.

Another service PTC CCG offers is an independent bi-metric screening of the employees and participating dependents. When people complete the bio-metric screenings, the service provides independent health coaches to work directly with the plan participants to improve identified health conditions.  The screenings and health coaching are “one-on-one” and confidential. And the Population Health Management software will frequently produce reports for the employer to illustrate the emerging claims, report on health coaching results and specifically how the strategy is stabilizing or lowering the plan costs.

The difference between Population Health Management from a traditional Wellness Program is the ability to measure results from actual data. Having the risk management software and services alongside a focused wellness program, is powerful and most effective.

PTC member employers using a strategic approach to employee benefits can effect big change and be empowered to negotiate the plan of benefits and related costs. For your talent pool and valued employees, you will have set yourself apart from the competition.

To continue the dialogue, call PTC Corporate Coverage Group 1-855-717-2864 and ask for Michael Galardini.