Publications

Superior Healthcare at Reasonable Costs

By Jeffrey S. Reisel, Geller Group Ltd

In recent months, increasing numbers of human resource managers and corporate controllers have begun meeting with health care consultants to review the health care marketplace, to identify options that can provide comparable or superior service and coverage at a reasonable cost. These consultants, who are paid a fee rather than a commission, are called upon to improve the quality and range of the employers benefits plans without increasing health care costs.

Managed health care provided through health maintenance organizations (HMOs) have reduced the quality of health care and have limited the access to health care providers, in favor of reducing health care costs. Human resource managers have considered self funding their health care benefits in order to improve quality control and the realization of benefit claims.

Employers have chosen to self-fund their health care benefits to reduce costs, custom design their benefits, eliminate state premium taxes, and offer a preferred provider network without a so-called gate-keeper. These plans limit corporate liability by utilizing specialized stop-loss insurance contracts.

An independent fee-for-service consultant can help an employer deal with the more complex legal and administrative issues involved in the conversion to a self-funded health plan. Consultants help design the benefits program, assist in hiring a third party administrator, negotiate stop-loss insurance contracts and research the various preferred provider networks.

A consultant helps an employer comply with the various Federal laws that govern a benefit plan including, but not limited to, the Americans with Disabilities Act, the Family and Medical Leave Act, the Consolidated Omnibus Budget Reconciliation Act and the Health Insurance Portability and Accountability Act. Unlike fully insured plans provided through private insurance carriers, self-funded plans may not discriminate in favor of highly compensated employees by offering these employees a higher level of reimbursement.

Self-funding a health plan permits the employer to actively manage the cost and quality of its health benefits. A consultant may provide a cost-effective alternative to improve the quality and range of an employers health coverage without an increase in corporate costs, utilizing private carriers, managed care programs, preferred provider arrangements and self-insurance.

Geller Group Ltd.

Geller Group Ltd. is an employee benefits consulting firm providing integrated solutions and cost effective relationships for middle market companies. Jeffrey S. Reisel, Director of Welfare Benefits Consulting Services, offers 18 years of experience designing and servicing benefit plans. Mr. Reisel earned his Chartered Life Underwriter and Chartered Financial Consultant Designations from the American College.

New York, NY 212-268-5700
Mr. Reisel direct: 212-655-0364