Plan Development
Plan design and development is one of ClaimSecure’s key areas of expertise. Our consultative approach involves working together with our clients to develop a health benefit plan that is comprehensive, cost-effective, and easy to administer.
First Steps More Steps
We begin by working closely with each client to determine their health benefit plan requirements and objectives. Based on the results of this process, we provide recommendations as to the type of plan design that best addresses these needs:
- Administrative Services Only (ASO) Plans: ClaimSecure specializes in ASO plans – a cost-effective solution whereby plan sponsors pay only for actual claims submitted by members and dependants, plus a fixed administration fee.
- Traditional or Blended Plans: Working closely with a number of insurance partners, we also administer traditional insured group health benefit plans, as well as non-ASO elements of group benefits plans, such as Out of Country and Travel Assistance, and Stop Loss coverage.
Plan Details
Once the framework of our client’s plan is in place, we strategically customize it with the other specifically required elements, including:
- Pharmacy and dental provider network management.
- Vision preferred provider network.
- Specialized plan design options – such as sliding or tiered co-pay and annual deductibles, customized formulary creation and maintenance, varied dental fee guide options and grouping of dental categories with variable maximums, deductibles and time definitions, etc.
- Health Service Spending Accounts (HSSA).
- Comprehensive billing and invoicing system providing such features as: wallet certificates, monthly premium billing statements, claims management services, life and disability plan administration, and premium remittance.
- Flexible and actionable reporting package – including a suite of comprehensive printed reports, in-depth electronic reports, and user defined customized reports.