Health Insurance is complicated, but it shouldn't have to be. That's the realization we came to when founding PA Health Advocates. Over the years, as we have grown to serve our clients, we have realized that not only is it complicated, but Employers, Employees and HR aren't always on the same page about what is important. Adding to the confusion, brokers focus on the groups they work with as units of coverage, forgetting the people behind them. Our job is to recognize each stakeholders unique concerns and bring everyone to the table to make sure your programs run smoothly, and affordably with our breadth of partners and resources to manage any hiccups along the way.
Products and Services
For Employers
Health and Welfare Benefits
For employers, benefits become an opportunity to award your team beyond a paycheck. As a baseline, many employers, to remain competitive, must look beyond traditional offerings like medical, dental, vision, DI and life. Many employers have tuned into social determinants of health and providing welfare benefits like fitness, mental health, ID theft protection, leave, and corporate social initiatives. Building the right programs can retain top talent and attract new employees to your organization.
Business Guidance
Sometimes the difference between an average group broker and a confidant comes down to guidance beyond plan design. As a group we provide a Compliance Rx report to all businesses we serve. In addition, our guidance surrounds legal and compliance questions as well as event driven questions like business succession strategies, mergers and acquisitions impact on plans, buy sell agreements and executive retention strategies.
Data and Benchmarking
Four key responsibilities of management are planning, organizing, leading and controlling. To effectively work, data and analysis are necessary along all parts. Being members of SHRM, NAHU, CPBGH and other trade groups give us data on the standard practices of your competitors. Equally, our partners use rich reporting features available to you to help through all four of the responsibilities of your management.
Cost Controls
Benefits are a big decision that your team needs to be confident of. Across the board, cost is only one determining factor. With that said, under ERISA fiduciary guidelines, you are required to document your cost control measures. Whether it is annual RFP's, price negotiation, creative planning strategies, parts analysis (Plan Admin, PBM, etc.) or claims advocacy for out of pocket reductions, we, and our partners, can help.
For Employees
Health and Welfare Benefits
It is important to us that employees have a seat at the table. Whether physically, or through our advocacy, your business is a collective effort of your teams strengths. We want to make sure they are heard.
Products
- Medical Plans: Fully Insured, Partial Self Funded, Fully Self Funded, Level Funded
- Account Based Health Plans: FSA, HRA, HSA, ICHRA, QSEHRA, EBSHRA, DCFSA
- Ancillary Lines: Dental, Vision, AD&D, Life, Disability
- Voluntary/Company Paid: EAP, Wellness Incentives, FMLA+, Legal, ID Theft, Gap Coverage
- Retention Strategies: Tuition assistance, Dependent Care, Deferred Compensation 457 programs, Bonus strategies
- Life Events: Medicare transitioning, chronic diagnosis management, disability, family planning guidance
Employee Education
Effective employee education reduces work stress, plan administration friction, and plan admin overhead. We can provide payroll stuffers, bulletin board flyers and in-person/remote workshops on various topics.
Workshop Topics
- Plan summary overview
- Insurance Literacy
- Compliance
- Financial Literacy
- Family Planning
Technology
The easier your systems are to use, the less stress your employees have during medical emergencies and annual plan election.
Happy employees = happy HR.
Cost Controls
With our current partnership with AblePay your employees can see 13% discounts on medical claims and copays. We also partner with AllyHealth as a telemedicine provider to help remove out of pocket copays that your employees may be subject to for in person acute treatments.
For HR Teams
Health and Welfare Benefits
To employers benefits show a commitment to their employees, and to employees it's considered a lifeline to cover whatifs. To HR benefits can be a big thorn in yourside. Between payroll deductions, plan compliance, annual pricing of plans, carriers and vendors, there is alot to unpack. We are driven by two factors. 1. Reduce burdens 2. Increase literacy
Reducing HR Burdens
- Plan Design: With the competing goals of your management and rank and file team members, finding the right balance of quality coverage and affordable options is paramount
- Time: A more cost effective solution is useless if the administrative burden is amplified. We want to give you your time back. At the end of the day, you are your team's champion. If we can help you, you can help us help your employees.
- Money: There is an unlimited supply of vendors touting the newest and easiest solution to your needs. PEPM is thrown out left and right and adds up fast. Our job is to get you the right solutions without muddying your offerings and keeping your costs in check. Both from a resource perspective and plan design perspective we want to give you piece of mind.
Benefits Administration
Effective employee education reduces work stress, plan administration friction, and plan admin overhead. We can provide payroll stuffers, bulletin board flyers and in-person/remote workshops on various topics.
Plan Oversight
- Annual Enrollment: With a network of vendors, annual enrollment software is paramount. Regardless of your groups size, we use tools to leverage technology for enrollment.
- Plan Documents: Getting started with a vault of prevalent plan documents help ease the year round burden of questions. Our team will draft summary documents for your team and work with carriers to get SOB's in a timely fashion for enrollment and renewals.
- Onboarding/Offboarding: Looking for an HR tool to track onboarding (we like bambooHR) or an efficient process for adding new hires to your plan? You can be assured to get the answers you need, when you need them.
- Renewals: Outside of the renewal process we will review industry changes and recommendations for the upcoming enrollment period. If self funding we will take stock in your claims history to determine the best course of action for your new plan year.
- Claims Monitoring: Self funding analysis requires proactive claims administration and monitoring. Not only are we looking at timely payments, but also trends to determine if you are allocating enough or bullish/bearish on your stoploss programs.
Employee Engagement
In an article released by Sage|People in 2019, 14 HR experts cited the reasons why they loved their job. Interestingly, benefits RFP's were not listed by a single professional. How could that be? Well, for the most part, HR teams felt they made a difference and got to help people. After all, as one expert, Shally Steckerl, put it, "HR is the internal organs that give companies life." For HR teams that we partner with saving time and money, both at the company and HR level frees up those resources. That, combined with vetted partners like bambooHR help automate your processes and allow you to reallocate your time to educational initiatives and team building programs.
Benefits Compliance
"If you think compliance is expensive, try noncompliance" -Former U.S. Deputy Attorney Paul McNulty.
Starting with 2 employees, there are overarching compliance responsibilities. As you grow your employee base to 20, 50, 100 and so forth your oversight grows. You have responsibilities governed by agencies like EBSA, DOL, IRS, and CMS and policies related to ERISA, HIPAA, COBRA, FMLA, and HITECH. We can help with those.