Financial Management & Underwriting
CME assists in developing the right strategy based on your actual cost drivers and utilization patterns. Our underwriting team offers you thorough tracking and reviewing of claims experience and provides a comprehensive analysis of utilization data.
With CME, you will acquire the expertise you need in evaluating funding arrangements in the following areas:
– Demographic Rating
– Prospective Experience Rating
– Retrospective Experience Rating
– Delayed Premium
– Minimum Premium
– Partially Self-Funded
– Self-Funded
CME can offer an all-inclusive evaluation of pertinent factors to determine the best funding options for you based on your group size, demographic factors, type of plan(s), and enrollment by family status. For self-funded clients, CME will:
– Review necessity of stop-loss insurance and determine appropriate level and type of stop-loss based on strategy and risk tolerance
– Project future costs based on current claims experience
– Develop conventional equivalent rates and COBRA rates
– Determine actuarial differentials for plan design changes
We help to determine your risk tolerance and assist you in selecting the most practical funding arrangement!
CME can routinely track your claims utilization. We can also supply you with regular reports projecting your claims and utilization measures from which we can complete an analysis to indicate the unique risks of your group.
At CME, we realize the need to focus on the future, and we understand the extensive scale of resources required to conduct plan accounting in-house. That is why CME can offer you the additional support needed to resolve and eliminate your current financial management issues and can concurrently provide assistance to successfully perform plan accounting.
CME has the knowledge and know-how to sift through your firm’s abundant amount of cost and utilization data in order to reveal the exact trends and service categories that are causing benefit costs to rise. We fully analyze your current benefits plan to uncover the systemic influences that are causing your plan costs to increase. After all influences are identified, we will develop a plan that employs the right strategies to resolve your cost and utilization concerns.
Let our knowledgeable, experienced underwriters work on your side. Researching healthcare cost and utilization trends and applying the appropriate factors to your claims experience in order to estimate future cost is a part of what we do every day.
Our professional underwriting team may be able to provide you with renewal estimations. We feel that it is necessary for you to receive a renewal estimation not only during the infamous “renewal period,” but also at other points depending on your status and funding arrangements. This is also an excellent tool in the rate negotiation process.
CME provides an all-inclusive set of renewal management services. Key components of CME’s renewal management services aim to:
– Provide comprehensive marketplace analysis of carriers and/or other plans
– Incorporate your relevant data into an electronic document with extensive templates for responses
– Create and manage a timeline to allow sufficient time for you to make necessary decisions and implement any changes
– Supply detailed analysis of top carrier proposals
– Compare plans, costs, network access, network payment arrangements and discounts, and disruption analysis
– Organize vendor finalist presentations
– Ensure that the implementation process is structured and well thought-out
As part of your self-funded plan management, we can provide you with an estimate of your incurred but not reported (IBNR) claims liability. This analysis can be completed at various frequencies to meet your needs.
Our contribution modeling helps to illustrate the potential impact on plan enrollment and rating considerations using different contribution scenarios. This key service involves the development of alternative contribution strategies to allocate costs between your company and its employees.
Our goal is to quantify the financial impact of contribution changes for both your company and its employees. Possible contribution techniques can include:
– Core/Buy-Up Option
– Defined Contribution Methodology
– Length of Service
– Percentage of Salary
– Opt-Out/Waiver Credits
– Spousal Eligibility/Surcharge
– Tobacco Surcharge
– Various Contribution Considerations
We analyze all renewals and proposals with respect to actual utilization, experience, and trend. Renewals and proposals will be re-priced for competitiveness by a skilled underwriting team. Negotiations with vendors will be conducted in order to secure favorable pricing. All negotiations will be documented so you can see the impact that CME has made on your behalf.
In addition, CME will estimate projected costs for all plans and develop corresponding rates, while evaluating the accuracy and relevance of your current plan expenses and assumptions.