Health and Welfare Consulting Services

Craford Benefit Consultants creates client value through the implementation of cost-effective employee benefits programs. We partner with our clients to provide them with the most market-competitive group health plans available. Craford specializes in providing benefit consulting and technology solutions to administer those programs that ultimately enable our clients to focus on their critical business needs.

There is a noticeable gap in offering benefit solutions. On one end of the spectrum it is possible to be “over consulted,” seeing little benefit from the extra time and money spent. The other end of the spectrum is being simply offered a benefit “plan or package” which could be a cookie-cutter solution not offering the firm the best available options for their needs. Craford Benefit Consultants has always balanced this approach by offering the consulting services our clients less...followed by solutions.

Program Evaluation and Audit

It is essential that your benefits program be aligned with your overall business strategy, which is why Craford initiates every new client relationship with a thorough evaluation of your current program. We conduct a comprehensive audit of existing plans to pinpoint areas where changes may be warranted. We assess your current plan design to determine the potential impact of adding new plan options, and we establish realistic budgets corresponding with your long-term financial objectives. Once the program evaluation and audit are complete, we are prepared to create a benefits program tailored to your needs.

Strategy Development

Together with our clients we will collaborate to develop a strategy for the coming year and 3 – 5 years in the future. Craford will provide industry intelligence, updates on health care trends and hot topics, and help determine which tactics, interventions, and design changes fit within the clients philosophy and strategy. We will ensure you have current and comprehensive information, and will provide information within the context of your organization’s culture and your program results. We will model the financial impact of any proposed changes, and develop preliminary assessments of the employee and administrative implications. In addition, we will develop calendars and project plans for the work to be completed in the upcoming year.

  • A historical study of demographics, claims experience, and prior benefit election practices.
  • A detailed evaluation of each proposed change to the benefit program including costs, communication needs, and impact to existing contracts and administrative practices.
  • Design of a systematic implementation plan to ensure a smooth and accurate transition.

Actuarial and Underwriting Services

Health care spending is no longer solely in the realm of HR – the Chief Financial Officer and other members of the finance department are now taking an active role in managing this expense. We monitor budgets on a monthly basis and adjust accrual rates when necessary – not simply once a year.
In addition to continuous monitoring of the budget, we provide the following services, tailored according to your needs:

  • Plan Design, Renewals, Funding Rates, Costs Allocations, Contribution Strategies
  • Cash Flows and Plan Performance Assessments
  • Health Claim Liabilities: Unpaid Claims, IBNR, and other
  • Plan Termination and Terminal Liability Calculations
  • Trend and Claim Cost Analysis (Aggregate and Components)
  • Budget Projections/Forecasts - Accruals, Expenses, Premiums, Claims, Stop Loss
  • Provider Network Discount and Carrier Pricing Financial Analysis
  • Mergers and Acquisitions Impact Analysis
  • Retiree Drug Subsidy (RDS) Actuarial Equivalence Attestation
  • FASB ASC 715 for Post-employment/Pre-retirement Benefits (former FAS 106) & FAS 112
  • GASB Valuations
  • Actuarial Equivalences, Actuarial Certifications, Second Opinions, Other

Health, Absence and Productivity Management

Employers typically spend an amount equal to14%–16% of their payroll on employees’ time away from work. 82% of employers have never calculated leave administration cost. Of the 18% who have, the median cost of leave administration is $12.00 per employee, per month. A recent CCH survey reported 66% of employees take sick time off to deal with personal or family issues (i.e., there is no illness involved). Of these, the vast majority admit that they call work at the last minute claiming a personal illness.

Businesses’ direct payments toward absence programs only represent the tip of the iceberg, however. Indirect costs such as temporary labor or overtime expense, reduced productivity, increased defect rates, and more drive the indirect cost of unplanned absences up to 200%-400% of direct costs.

Viewing absence as an Enterprise Risk drives demand for credible metrics and to optimize absence management. An effective, comprehensive absence management program will reduce direct and indirect program costs, but should also mitigate risk by evaluating and addressing root causes of absence. The actual results organizations see vary dramatically, but typical results would see savings equal to 2%-4% of payroll.

Craford consultants can assist you in designing, implementing, and managing a comprehensive absence management program that maximizes ROI. Call us to discuss!

Health & Productivity

The U.S. approach of employer-provided health insurance and occupational health/disability insurance has created an environment that literally demands employer involvement in employee healthcare. Many employers, however, have taken the approach that by improving employee health – as opposed to simply treating illness or injury – they can improve employee productivity and corporate profitability. Significant research, innovation, and early successes have given momentum to the "health improvement" movement.

Employers who have embraced employee health improvement understand that such initiatives do not just improve productivity and profitability. By improving the state of employees’ health, employers can also:

  • Improve the employees’ quality of life
  • Help employees to avoid disabling injury
  • Reduce the incidence and severity of workplace accidents

Actual ROI varies, but a recent summary of 42 independent US studies (with a total of 537,319 employees who participated in work site health promotion programs for an average of 3.6 years) indicates the following results:

  • Employee absenteeism decreased 30.3%
  • Per capita healthcare costs decreased 21.8%
  • Average program ROI of 5.6 to 1

Craford consultants can assist you in designing, implementing, and managing a comprehensive health improvement program that maximizes ROI. Call us to discuss!

Data Analytics, Reporting and Predictive Modeling

The power of data mining and predictive modeling is not just about real-time analytics or clean data. It’s about the business insight and professionals who understand what problems are likely to occur and how to solve those problems. Through our partnership with D2Hawkeye (D2H), Craford is able to turn our clients’ fragmented data into actionable information. Our clients are able to:

  • Identify emerging high risk members
  • Develop a long-term health care strategy
  • Recognize care management opportunities
  • Improve plan and benefit design
  • Measure vendor performance
  • Educate members and providers
  • Measure ROI of case management or disease management opportunities

Here at Craford, we focus on “bending the trend” of upward spiraling healthcare cost by applying evidence-based medical rules to the existing claims information coupled with heavy industry knowledge to elicit solid, actionable result

Claims and Dependent Audits

Employers are leaving "no stone un-turned" in finding ways to curb the soaring cost of providing health plan benefits. Health plan benefits are one their largest operating expenses. And for self-insured employers, you are paying your claims administrator a lot of money under the assumption that claims are being paid accurately and promptly.

However, claim audit studies clearly show this is not the case. For example, Craford claim audits have typically yielded savings/recoveries worth 3 to 5 times the costs of the audit.Our audits have also identified sustained cost-saving opportunities for through process and administrative efficiency improvements and resolution of root-cause issues.

For most clients, the objectives of a claims audit are:

  • Identify and recover overpaid claims
  • Measure the accuracy of claim payments - identifying and prioritizing costly administrative errors
  • Reduce claims expense and improve service through audit, control, and improvement of key administrative processes
  • Help plan sponsors measure how effectively their plan is being administered and to determine if their Third Party Administrator is operating within industry standards
  • Identify and address root-causes of errors and resolve to prevent them from occurring in the future

Studies show that as many as 10%-15% of dependents covered under an employer's health insurance plan typically do not meet the eligibility requirements to participate on the sponsor's plan. The cost impact is significant and the result is higher costs for the plan sponsor and higher premium costs and/or reduced benefits for employees and their eligible dependents.

Historically, employers were unwilling or reluctant to challenge the removal of ineligible dependents at the risk of upsetting their employees. However, the environment has changed considerably over the last 5-10 years and employers are stepping up their efforts to identify and remove ineligible dependents from their plans and step-up more rigorous measures to confirm eligibility during the enrollment process.

Craford can help tailor a comprehensive and inexpensive eligibility verification solution. Our approach typically involves:

  • Conduct a comprehensive, evidence-based audit of all participants covering dependents
  • Review plan documents and tighten up eligibility language to clearly define a "qualified dependent"
  • Implement an affidavit process into your dependent eligibility and open enrollment process requiring employees to attest their understanding of who is eligible to participate and enrolling anyone other than a qualified dependent would constitute fraud and intentional misrepresentation

Vendor Marketing and Negotiation

With more than 35 years in the benefits industry, Craford continues to build on an enduring legacy of trust. Our longstanding vendor relationships translate into powerful advantages for our clients. We have earned access to top decision makers in nearly every facet of the insurance industry. Our staff of professionals not only possesses in-depth knowledge of critical issues, we also have the communication skills required to articulate our client’s needs and negotiate for the optimum outcome. It's all part of our shared commitment to the values of respect and honesty, and our collaborative effort to deliver the results our clients deserve.

Compliance Support

Craford offers the following compliance services to all of our clients in partnership with Barran Liebman, our legal partner on compliance issues:

  • Quarterly newsletters detailing newly arising legal and legislative issues
  • Regular “alerts” which provide more detail on issues requiring action by our clients
  • Regular “updates” on newly arising issues occurring outside of our normal newsletter cycle
  • Annual compliance audits with detailed descriptions of each requirement
  • A year-end compliance update
  • Oversight of the development of plan documents and SPDs
  • Annual 5500 filings with SAR completion
  • A conduit to an ERISA attorney on contract with Craford for use by our clients

Communications and Change Management

Communicating company information is a critical task facing all organizations. Craford Benefit Consultants works with clients to develop and deliver progressive communication channels that promote a culture where all employees are informed of needed information. Various techniques are utilized including web-based systems, hard copy mailing and group communication presentations.

One of the top challenges facing our clients is managing change in their organizations. Craford Benefit Consultants offers progressive and hands on consulting in the areas of identifying those factors that lead companies to change. Organizational dynamics are reviewed and action plans are jointly developed to lead organizations through the defined stages of change management.

Day-to-Day Customer Service

Our philosophy is to value the importance of understanding our clients, their business, and the challenges they face. Through this understanding, we are better able to evaluate our client’s current programs and offer options that best suit their needs. We support full disclosure in all aspects of our relationships and ensure the highest quality by applying rigorous peer review and industry standards in the work we do. This allows us to forge a partnership with each client that grows as we mutually solve challenges related to your employee benefits program. The benefits are high quality work that exactly meets your needs, a full understanding of how we came to our recommendations and a strong partnership that fosters trust.

Craford has an experienced staff of consultants that rival all major consulting firms, yet we offer a level of flexibility that is unmatched by our competitors. We place significant focus on both internal and external compliance and quality, and have overall dedication to service that comfortably allows us to guarantee that we will meet each client’s needs.

Craford is all about identification and delivery of the best business-based solutions for each and every client, implemented in partnership with the client’s needs. We conduct regular client satisfaction visits with senior members of the firm and also conduct an annual client satisfaction survey to ensure we are doing the right things at the right time for our clients.

We take pride in offering a level of service that is unmatched in the industry. We balance our high service level with technical and financial expertise that ensures our clients are obtaining the best levels of coverage at the lowest price. We have developed a strong reputation as an aggressive, yet fair consulting firm. Mike Craford invests a significant amount of time meeting with senior level executives at the insurance companies, which translates into our clients getting the highest quality vendor support at all levels.

Government Services Expertise

Benefit programs offered by companies engaged in government contracting work offer a unique challenge to the employee benefits industry. Craford has extensive experience in working with both Service Contract Act and Davis-Bacon fringe benefit plans. Our creative approach focuses on maximizing the benefits offered to employees, while carefully addressing the significant regulatory requirements inherent in government contract employer plans