Understanding Occupational vs Non-occupational Health Insurance

Our team specializes in the analysis of PEO client pools to better design occupational and non-occupational health insurance and workers’ compensation programs. We are a consultative broker who specializes in the PEO model. We provide guidance and expertise on how to implement pricing models in order to properly manage commercial health insurance and workers’ compensation placements on behalf of our PEO and traditional clientele. We work closely with actuaries to better understand what is meaningful in order to make occupational and non-occupational healthcare pricing more predictable by relating the outcomes of each line of insurance. Our systems manage pricing of masters, small group reform, carve-outs, multiple coordinated and client-based policies all on one platform.

While it is only logical that there are correlations between occupational and non-occupational healthcare delivery, the technology has not been in place to illuminate it. Utilizing the data vault built by our sister company RiskMD, we are able to ingest the PEO loss information of any client company written by any workers’ compensation or health insurance carrier in an effort to understand pricing, profitability and direction. Meaningful areas such as pharmaceutical usage, length of disability per causation and double-billings of medical treatments can now be understood by month. Additionally, we believe in benchmarking and data analysis on an as received basis with the intervals being far quicker in order to make outcomes more predictable and actionable data more available.

Additionally, we are always looking to explore new technologies and processes to reduce the spend for health and workers’ compensation insurance. Our team levers recent technologies such as TeleDoc and Wellness Platforms to bring in better outcomes. Pharmaceutical spend is strictly monitored and PBM and 340B programs utilized as warranted. We watch every penny spent in the delivery of heath and workers’ compensation insurance.