Advanced Benefit Consulting (ABC)

Continuous inflation and the Great Resignation have prompted employers to offer the best possible benefits programs, particularly related to health insurance. The most cost-effective way to provide this is self-funding, as it allows employers to design health plans from the ground up. They can focus on every employee’s and their family’s requirements.

“That’s what we do every day at Advanced Benefit Consulting,” says Dorothy M. Cociu, president of Advanced Benefit Consulting (ABC). “We are self-funding and plan design experts with decades of experience. Our top-tier managerial staff ensures everything works well for the employer and their employees.”

ABC walks employers through every step. It starts with a blank piece of paper and provides employers with many options to design the best self-funded benefits plans.

For instance, ABC can provide a lower benefit option to meet ACA affordability and provide savings for employees who may not need a gold or platinum-level plan. This gives them the option to enroll in the ancillary coverages they need. It can also design creative cost-containment provisions within the plan.

Creating a Win-Win Situation

ABC alters the traditional ‘take what they give you’ approach of carriers.

The firm focuses on forming strong relationships with carriers, whether in the fully insured or the stop-loss space, to provide the best fit and creative options to employers and their covered dependents. Carriers are given proper information about what their clients are looking for, the claims experience and utilization trends, and ways to keep costs down to create a win-win for themselves and the employer.

“Just looking at the billing statement and arguing for lower rates do not work in today’s market. You have to understand why claims experience is trending in one direction or another to create the best benefits program,” says Cociu. “For every client, whether employer or employee, education is key. If carriers see that we educate employers and their dependents about cost-containment options, they are more willing to work with us.”

For instance, ABC has a self-insured client that uses reference-based pricing. The plan was financially successful, but a small group of employees was not satisfied , and were vocal to top management about it.

Although ABC originally recommended a PPO physician/professional services network with an RBP hospital/facility arrangement, the employer decided to take the plunge and move into full RBP for all services. To reduce the noise from providers and plan participants, ABC asked the client if they could take another look at adding a physician/professional service network, as some employees were highlighting their inability to find providers.

We Can Put In As Much Or As Little Cost Containment As Is Needed And Wanted, But Today, We See Employers Wanting To Give Employees The Best Possible Coverage, But Finding A Way To Keep Expenses Low

After the employer client agreed to allow ABC to look into the matter, they realized that many of the issues were on the physician/professional services side.

“After running provider disruption reports, we found an excellent network choice for them. We also felt that if we could add to the facility/hospital RBP an advance step at the time of pre-authorization that they could perhaps prevent or reduce some of the hospital/facility issues,” says Cociu.

ABC custom-designed an early-step solution by investing significant time and effort, which worked.

In the past open enrollment period, the employees were delighted to have a network and told ABC that most of their physicians were in the network. This made the HR department and the executives happy as well. The client could keep RBP for the hospitals and facilities and make the participant experience better with a well-known network that doctor’s offices knew and accepted. And their “extra step” pre-service helped with the hospital/facility side greatly, and reduced facility noise and balance billing issues.

Combining Old-Fashioned Caring and Customer Service

The biggest contributor to ABC’s success is its incessant endeavor to become a leader in this space through continuous improvement. Its mission is to provide superior products and customer service to employers and their employees with insights, education, innovation, knowledge, and compassion.

Striving to meet and exceed client expectations, ABC sets a standard of excellence by combining old-fashioned caring and customer service with employer needs in a technological world.

ABC has successfully infused its values and goals into every team member. Every employee—from senior management to client-facing executives and account service team members—leaves no stone unturned to achieve excellence. They keep themselves updated on market trends and constantly evaluate and readjust plans to ensure optimal outcomes for clients.

“What lies ahead is the ability to adapt, change, and find solutions,” says Cociu. “With creativity, knowledge, and analysis, as well as continuous client education and compliance assistance, we can provide our clients with what they need, now and in the future. We don’t really package products. Whenever we can, we offer customized solutions for each employer and will continue to do so.”

Going forward, ABC will continue to provide education to clients in all forms, including monthly webinars, seminars, workshops and training, and custom and generic educational videos. The goal is to help businesses adapt to legislative and regulatory changes and market conditions.

Today, providing employee benefits is critical for every employer to win the talent war and avoid regulatory complications. But many perceive it to be a resource-intensive process and believe it can negatively impact their business's bottom line. What they lack is proper guidance and knowledge regarding the intricacies in benefits space. A partner like Advanced Benefit Consulting can do wonders in this regard. It is equipped with the right resources to guide clients through all stages and show empathy and compassion in everything it does. This will certainly cement its position as the preferred partner for organizations that plan to offer self-funded employee benefit plans, as well as groups who may not want to self-fund, but want the creativity and expertise of a benefits partner to help them meet and exceed their benefit goals.