Health Insurance Captives

We customize captive health plans aligned specifically to the needs of select brokers and their clients. Captive Solutions & Options 

Health Claim Audit Service

An analysis of recently adjudicated claims can result in payment adjustments and significant recoveries of money. Comprehensive algorithms provide the data needed to compare numerous areas, including care delivered with care that should have been delivered and billed charges with amount paid. Discrepancies are then adjusted and collected from corresponding providers. 

Data Management & Transformation

Powerful analysis tool that incorporates all health claims and plan structure into one comprehensive system, allowing employers and health plans to dissect and understand true costs and their causes. By fully understanding health plan data, plan sponsors are better equipped to dynamically analyze current and proposed plan design changes to see their effect on costs and plan usage, as well as determining the most effective strategies moving forward. 

Health Improvement & Risk Reduction

A proven approach that provides employees, spouses and retirees the information and tools they need to determine where they may be at risk from a health perspective and the most effective ways to reduce those risks.

Powered by The Gideon System™ participant data is processed at a level that not only analyzes and stratifies their health risk in multiple clinical categories, but allows them to see and understand what strategies will help them the most. Participants are then able to take action through best practice strategies and programs to improve their health and reduce their risk.

PBM Selection & Management

Savings of 10%-18% off pharmaceutical drug costs using a proprietary procurement and management tool that not only assures you select the best PBM, but also tracks and enforces contractual compliance by the PBM. By representing and working directly for you and not a PBM, guarantees are negotiated on the front end, performance is validated continuously across the plan year, and non-performance by PBM’s are identified, fixed and money returned to you if guarantees are not met.