Plan Document Tips

By the Numbers: Eligibility Audits

Eligibility Audits By the Numbers Article

Written by Book Chrobak, Health Analytics Manager     Many of us read about the importance of the plan document language in last month’s By the Numbers. Eligibility is an important part of a strong plan document and is the topic of our CSI bulletin this month. Employers are the […]

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Not all Group Health Plans are Created Equal

Group Health Plans Blog Article

At Roundstone, we believe in a proactive approach to cost containment and plan language. Precise language which strictly states available coverage and full compliance to the terms required for coverage, combined with an administrator committed to the protection of the plan, are essential to controlling future costs. To assist employers […]

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By the Numbers: Plan Documents

Plan Documents By the Numbers Blog Article

By Book Chrobak, Health Analytics Manager     Switching to self-funding health benefits allows employers to take control of their costs, design their benefit coverages, and understand their healthcare spend. The plan document is the “formal, written, legal statement listing the provisions of the insurance plan.” It is the instrument […]

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Education & Transparency: The Keys to RBP

Keys to RBP

Employers are continually looking for ways to control medical costs. This is especially true for self-insured employers. One strategy that has emerged is the implementation of Referenced-Based Pricing (RBP).   With RBP, the employer sets a maximum reimbursement tied to a particular benchmark. The amount that providers bill is arbitrary […]

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7 Secrets to Finding a TPA that Fits Your Needs


Matt Monda, Chief Operating Officer     At its most basic, self-funding is a mechanism an employer uses to pay for its employees’ health care costs. But it’s also an investment in controlling a major cost of doing business. The employer relies on three consultants to deliver a return on […]

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