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 need...no more...no less...followed by solutions.
Program Evaluation and Audit- 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.
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 Postemployment/Preretirement Benefits (formet FAS 106) & FAS 112
- GASB Valuations
- Actuarial Equivalences, Actuarial Certifications, Second Opinions, Other
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 worksite 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!
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 worksite 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!
- 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
However, claim audit studiesclearly show this is not the case.For example, Craford claim audits have typically yielded savings/recoveriesworth 3 to 5 times the costs of the audit.Our audits have also identified sustained cost-saving opportunities for throughprocess and administrative efficiency improvements and resolution of root-causeissues.
For most clients, the objectivesof 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 coveredunder an employer's health insurance plan typically do not meet the eligibilityrequirements to participate on the sponsor's plan. The cost impact is significantand the result is higher costs for the plan sponsor and higher premium costs and/orreduced benefits for employees and their eligible dependents.
Historically, employers were unwilling or reluctant tochallenge the removal of ineligible dependents at the risk of upsetting theiremployees. However, the environment has changed considerably over the last 5-10years and employers are stepping up their efforts to identify and removeineligible dependents from their plans and step-up more rigorous measures toconfirm eligibility during the enrollment process.
Craford can help tailor a comprehensive and inexpensive eligibilityverification 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
- 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
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.
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.
