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Rutherfoord’s solution to rising health care costs is our Health & Welfare Consulting practice. It’s the cornerstone of our benefits practice because we see it as the most effective way to deliver savings to our clients while also assisting with increased employee satisfaction and productivity.
Our services and solutions include:
- Underwriting Projections
- Underwriting Audits
- Provider Network Discount Analysis
- RX Quest
- Vendor Solutions
- Open Enrollment Management and Fulfillment
- Data Analysis and Reporting
- Escalated Claims Resolution
- Member Advocacy Services
- Benchmarking Studies, Multi-source Benchmarking
- Strategic Planning
- Network Analysis and Development
- International Benefits
Underwriting Projections – Rutherfoord has a staff of underwriters who will review your plans independently from the insurance companies, which gives us added leverage to negotiate your policy renewals.
Underwriting Audits - Typically, Rutherfoord significantly reduces clients’ premiums because we review your plan using the expertise of our Medical Director. He looks at your group’s clinical history, ensuring the underwriters consider the health status of your entire population when they set your rates. Contact Us to learn about our Clinical Premium Audit Service.
Provider Network Discount Analysis - Shopping for the right program for your employees can be difficult, frustrating and haphazard. You can request information on a potential vendor's underlying cost structure, but often they are unable to provide specifics because of contract limitations. Or, you can get the answers you need and then you choose a program that ends up costing you more than planned or budgeted for.
We have a solution that has saved companies like Georgia Pacific, Coke and Mohawk as much as $1,000 per employee per year! Contact us to find out more.
RX Quest - Choosing Pharmacy Benefit Management (PBM) services by looking at commonly quoted fees, discounts, and rebates shows you only part of the picture, which explains why many organizations pay more for prescription benefits than they need to.
RxQuest compares different PBM programs using all the variables that affect your prescription program costs, such as drug mix both now and projected into the future. With this more comprehensive approach, you can be confident that you’ve found the best pricing for your prescription program. Contact Us to see an example of the savings one client experienced through RxQuest.
Vendor Solutions – When you need the right fit for your benefits programs Rutherfoord’s professionals will apply their knowledge of markets and vendors to negotiate on your behalf and place your coverage with the right vendor.
We provide vendor solutions for:
- Health
- Dental
- Vision
- Life
- Disability
- Employee Assistance Programs
- COBRA
- Flexible Spending Accounts
- Health Savings Accounts
- Health Reimbursement Accounts
- Voluntary Benefits
- Online Enrollment Systems
Open Enrollment Management and Fulfillment – Our goal is to make this entire process seamless for you. With our resources and experience, we develop customized plan booklets with your logo, which outline the benefits program. We can include magnets & key fobs with important contact information, and most importantly, we make sure your employees have their ID cards in hand by the effective date of the new policy.
Data Analysis and Reporting – At Rutherfoord, we think you should always know how your plan is running. We hold quarterly claims review meetings with all clients which include a combination of the insurance company’s reporting as well as summaries and reports from our data warehouse. Through this approach, your team at Rutherfoord provides you with ongoing advice and solutions to help manage your claims expenses.
Escalated Claims Resolution - When one of your employees has a claim, they will have their own Health Advocate, a registered nurse, to help navigate the healthcare claims process.
In addition, our Medical Director works with the insurance company’s Medical Directors to represent your needs and to resolve issues as they arise. This also expedites the approval process.
Member Advocacy Services - Think of Health Advocate as a medical concierge service for all your employees and their families. Whether its health coaching or assistance navigating the increasingly complicated health care system, Health Advocate provides the following services:
- Personal Health Advocate—a registered nurse with medical director support that’s assigned to each member
- Clinical services—from finding the best doctors & hospitals to researching complex medical conditions and the latest treatments, Health Advocate saves employees and their families time and assures them top quality care
- Administrative services—corrects mistakes, navigates insurance company procedures and processes and resolves claims issues
- Health coaching—prepares employees and their family members to be informed, active participants in their health care
- Information and Service Support—assistance with eldercare, complex conditions, informed decision making, wellness services, and other special service needs
Benchmarking Studies, Multi-source Benchmarking - Staying competitive with benefits in your market space is very important with regards to retention and recruiting. We provide benchmarking from multiple sources as well performing benchmarking studies specific to the client.
Strategic Planning – Rutherfoord focuses on 3-5 year goals with their clients in a customized approach focusing on the following areas:
- Approach: Plan and process management.
- Analysis: Goal setting, needs assessment/benchmarking.
- Strategic Planning: 3- 5 year strategy.
- Tactical Management: 12 month plan fitting the strategy.
- Implementation: enrollment, employee education, ongoing support.
- Renewal Planning: plan performance analysis, trend review and design-update.
Network Analysis and Development – We contract with TPAs or commercial insurance companies to evaluate networks for disruption with providers and facilities. While cost is always important, it cannot be at the expense of access to providers for your employees. We ensure that there are no gaps in coverage or access, which helps you save money while providing high quality, accessible services to your employees and their families.
International Benefits – Rutherfoord has the resources to fit the needs of multinational companies.
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