Anatomy of a rate renewal

Article Abstract:

Many benefits practicioners view insurance rate renewals with reservation because of their perception that they are complicated. However, the rate increase formula which underlies rate renewals is deceptively simple. The formula is composed of six components: experience base, reserve change, trend, administrative expense, claim fluctuation margin and enrollment adjustment. Rate renewal is simply a logical progression of estimating the future based on past activity.

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How to choose the best vendor for processing claims

Article Abstract:

Benefit managers tend to disregard cost-reduction measures associated with the manner of processing and payment ofhealth care claims. These managers also think that health care program evaluation relies heavily on fixed costs. The belief that variable costs are insignificant is faulty because processing of claims involves numerous variables. Benefit managers are advised to use performance measurements as guides in the selection of cost-effective programs.

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Managing prescription drug costs

Article Abstract:

Prescription drug costs have increased by 15.4% annually since 1990. They represent a big portion of total medical costs. Employers are being forced to seek adopt more effective prescription drug management. Organizations must diligently determine the appropriate managed pharmacy benefits for themselves. The history of prescription drug costs and the description of a prescription drug managed care model are presented.

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