Segal Company

Innovative Plan Design Strategy and Analysis

Effective plan design is the key to providing high-quality, cost-effective health care to your employees. Segal has extensive experience in the design and redesign of all health benefit plans, including medical, dental, prescription drug, vision, behavioral health, short- and long-term disability, life, accidental death and dismemberment and flexible benefits.

Segal has developed multiple strategies for designing plan rules such as rules of eligibility and waiting period, coordination of benefits, and participant cost sharing. We model the cost impact before a plan is changed (e.g., from a $10 copay to 20% coinsurance), so we can predict with accuracy how much the change will save your public sector entity.

We use a number of strategies to enhance the health plans of our public sector clients. These include:

  • Participant cost sharing and contribution strategies
  • Multiple plan offerings/options
  • Targeted inner-tier networks
  • Specialty carve-out networks
  • Opt-out incentives
  • High-cost claimant-case management
  • Chronic illness utilization management
  • Exclusions and limitations
  • Eligibility rules (for active participant and retiree health coverage)
  • Retiree VEBAs