Cost is an important consideration when planning any change in benefit plan design, as plan redesigns can have a significant fiscal impact on a heath fund.
Segal’s cost modeling experts and tools enable trustees to make informed decisions about their plans. Segal can:
- Evaluate the immediate financial effects of a plan design change
- Predict future utilization patterns and estimate changes in claims costs
- Determine change or impact to member out-of-pocket expenses
- Provide multi-year estimates of plan sponsor costs
- Identify trends in the market and benchmark plan features to industry peers
We have extensive experience in assisting clients modeling both plan sponsor expenses and the member out-of-pocket cost of any plan design or coverage changes. Our knowledge allows trustees to make decisions that maintain the long-term sustainability of their plans. Through our ongoing work on plan design, cost sharing, vendor negotiation, and contract management, we help our clients understand the current and future costs of their benefit programs with the objective of best meeting the needs participants and the overall management of the plan.
We also help trustees communicate plan changes to their participants. It is important for participants to understand how to best use their benefits.
Cost Modeling and Health Care Reform
Trustees must address both the challenge of spiraling health care costs and compliance with the Affordable Care Act (ACA), also known as Health Care Reform. The ACA is expected to change health care economics by reshaping the health insurance marketplace. Trustees need to consider both direct and indirect ACA implications on the benefits plan as well as participants. Segal can help trustees assess costs resulting from ACA compliance, including surcharges, exchanges, and subsidies.