The Fedeli Group will assist in managing employer/employee costs while meeting your company's financial, security and services goals/objectives.  This includes but is not limited to:

• Review/analysis of all health insurance plan information on an ongoing basis and participation with your company in quarterly or semi-annual (or more frequently as needed) vendor and/or senior management meetings to discuss review and analysis of:

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  • Claims/premium analysis by plan
  • Normative analysis
  • Trend analysis
  • Large claims study
  • Network utilization
  • Provider discounts
  • YTD performance guarantee results
  • Vendor service issues
  • Industry updates

• Consultant/broker is expected to provide claims/premium financial analysis reports and presentation of this information to your company on a quarterly basis with recommendation/suggestions, etc.

• Review/analysis of annual insurance renewals for medical, RX, dental, vision, life and disability coverages with all vendors.  Also, conduct renewal/analysis of retrospective and prospective costs and prepare/present in formalized presentation format with Human Resources staff to your company senior management of renewal information – this includes but is not limited to:

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  • Meetings with respective vendors to negotiate fair and equitable renewal position for your company.
  • Evaluation of current funding arrangements, including pooling level, margin and trend numbers, stop loss coverages, projected claims estimations/calculations for the following plan year and making appropriate recommendations, if applicable.
  • Preparation and presentation of summary reports (annually, semi-annually or as needed) to your company and their senior management that will identify potential plan modifications, if appropriate, and the final renewal position.
  • If applicable, monitor the implementation of plan changes along with your company.
  • Review and monitor the completion of any financial documents & communication pieces for the plans.

• Evaluation of carrier’s effectiveness in management of claims costs – presentation on PPO usage, large claims cost containment, fraudulent claims processes/procedures, provider certification processes/procedures, etc.  This also includes analysis of utilization patterns to determine areas of potential abuse for wellness and recommendation of other interaction with your company personnel to bring costs down.

• Identification of trends in costs and funding for different plans and how they may meet your company’s needs/culture both present and future.