Risk & Pharmacy Management
Stop-Loss & Risk Management
For self-funded employers, effective risk management requires more than purchasing stop-loss insurance.
StrateBen evaluates an employer's claims experience, emerging risk, financial objectives and risk tolerance to develop an appropriate stop-loss strategy. We analyze contract structures and alternative funding approaches and work with clients to evaluate both the cost of coverage and the financial exposure retained by the plan.
Stop-Loss & Risk Management Capabilities
- Specific deductible analysis
- Aggregate coverage and attachment-point evaluation
- Contract-basis evaluation
- Large claimant and emerging-risk analysis
- Laser evaluation and negotiation support
- Disclosure support
- Renewal modeling
- Alternative risk-management strategies
- Stop-loss carrier and contract evaluation
Pharmacy Benefit Management
Prescription drug spending has become one of the most important components of health plan management.
StrateBen helps employers evaluate the financial and clinical performance of their pharmacy benefit program. Our approach examines not simply pharmacy pricing, but the complete economics of the PBM arrangement and its effect on the overall health plan.
Pharmacy Management Capabilities
- PBM contract evaluation and market review
- Pharmacy cost and utilization analysis
- Specialty drug analysis
- Formulary and plan-design evaluation
- Rebate and financial guarantee analysis
- Performance guarantee evaluation
- Integration of pharmacy and medical claims data
- Identification of emerging high-cost claimants
- Ongoing PBM performance measurement
- Evaluation of strategies for high-cost and specialty medications