Medical & Rx

Medical & Rx

Overview

Drawing upon decades of knowledge and experience, Vertus professionals will undertake a fact-based, deep-dive assessment of your current program and how well it meets your needs and cost parameters. Operating as an extension of your team, we are focused on negotiating with carriers on your behalf to achieve the best possible group health insurance plan for your organization.

Based on our assessment, we will work with you to implement a medical insurance program that meets your employees’ needs, leveraging our strong relationships with carriers to help identify possible savings opportunities.

Vertus consultants act as extensions of your risk management and HR teams. We begin with in-depth, strategic discussions to achieve a complete picture of your business, your objectives and your employees. We develop a multi-year strategy to manage your benefit programs and costs. We negotiate with top-tier insurance carriers and vendors to achieve the best possible terms and services. We assure ongoing compliance with ERISA and all other mandatory filings. And we employ experience and creativity in formulating optimal, long-term financial arrangements to ensure cost-effective, sustainable programs.

  • Plan design analysis
    • Benefit review and recommendations
    • Certificate review
    • Policy review
    • Structure
  • Financial review
    • Pricing review
    • Underwriting
    • IBNR
  • Proposal development and marketing
  • Claim audits
  • Benchmarking
  • Ongoing account management and reporting

How we Help

Drawing upon decades of knowledge and experience, Vertus professionals will undertake a fact-based, deep-dive assessment of your current program and how well it meets your needs and cost parameters. Operating as an extension of your team, we are focused on negotiating with carriers on your behalf to achieve the best possible group health insurance plan for your organization.

Based on our assessment, we will work with you to implement a medical insurance program that meets your employees’ needs, leveraging our strong relationships with carriers to help identify possible savings opportunities.

What we Provide

Vertus consultants act as extensions of your risk management and HR teams. We begin with in-depth, strategic discussions to achieve a complete picture of your business, your objectives and your employees. We develop a multi-year strategy to manage your benefit programs and costs. We negotiate with top-tier insurance carriers and vendors to achieve the best possible terms and services. We assure ongoing compliance with ERISA and all other mandatory filings. And we employ experience and creativity in formulating optimal, long-term financial arrangements to ensure cost-effective, sustainable programs.

  • Plan design analysis
    • Benefit review and recommendations
    • Certificate review
    • Policy review
    • Structure
  • Financial review
    • Pricing review
    • Underwriting
    • IBNR
  • Proposal development and marketing
  • Claim audits
  • Benchmarking
  • Ongoing account management and reporting

Problem

For companies in every industry, profitable growth is exciting, energizing and emblematic of successful business strategies. But growth also brings challenges, such as finding and onboarding the right talent to maintain momentum. Riding a wave of success, a professional temporary services provider experienced a
120-percent increase in headcount between 2012 and 2016. One result was a significant increase in the cost of the benefit program underwritten by their current provider. In addition, the company was experiencing ongoing errors generated by an enrollment platform that often mismatched employees and their benefit choices. It was time to interview some new employee benefits talent.

Solution

Experiencing significant premium increases, the client turned to Vertus for an independent review of the underwriting assumptions driving their costs. Vertus reviewed the firm’s coverages and revealed a possible 10-percent savings even with the current program. Impressed, the client chose Vertus as its new Broker of Record, after which further technical underwriting generated an additional 10 – 12% each year in medial cost savings over what would have been the renewal program with the prior broker. Vertus also worked with the client and their payroll processor to reduce processing errors, ensuring smooth running of the onboarding platform with zero errors going forward.

For companies in every industry, profitable growth is exciting, energizing and emblematic of successful business strategies. But growth also brings challenges, such as finding and onboarding the right talent to maintain momentum. Riding a wave of success, a professional temporary services provider experienced a
120-percent increase in headcount between 2012 and 2016. One result was a significant increase in the cost of the benefit program underwritten by their current provider. In addition, the company was experiencing ongoing errors generated by an enrollment platform that often mismatched employees and their benefit choices. It was time to interview some new employee benefits talent.

Experiencing significant premium increases, the client turned to Vertus for an independent review of the underwriting assumptions driving their costs. Vertus reviewed the firm’s coverages and revealed a possible 10-percent savings even with the current program. Impressed, the client chose Vertus as its new Broker of Record, after which further technical underwriting generated an additional 10 – 12% each year in medial cost savings over what would have been the renewal program with the prior broker. Vertus also worked with the client and their payroll processor to reduce processing errors, ensuring smooth running of the onboarding platform with zero errors going forward.

21% reduction in
medical costs

7% reduction in
dental costs with
improved access

No reduction in
employee benefits

Enrollment platform
audit and
improvement