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July 29, 2020

You’ve Got Control: Plan Document Best Practices

Blog photo – July_2

What if there was a way to get control over your healthcare spend, without sacrificing the coverage you want? What you’re looking for is a better alternative to a traditional, high fixed cost insurance plan.

Paying an insurance premium every month without any control over the benefits or price for services not only sounds like a bad deal – it is a bad deal. Traditional, high fixed cost insured plans are a one-size only “solution”. At Roundstone, we offer a benefit plan strategy that puts you in control and places a priority on realizing value when purchasing health care.

The Roundstone Plan Document

Not all plan documents are created equal! There are a few basic tenets that a Roundstone plan focuses on to make sure that your transition to a self-funded plan is quick, easy, and smooth, while keeping you in charge of the benefits provided to your employees. These are the guiding principles when forming your Plan Document. If being in control of your healthcare plan is putting you in the driver’s seat, the Plan Document is your car keys. It’s a powerful tool that makes your plan go, and keeps you in control.

Roundstone’s plan document drafting process leads to a quicker and easier implementation- a straightforward guide to create a comprehensive plan that covers everything you need on your terms. Our form ensures that you’ll include the benefits you want without forgetting anything.

Written in clear, plain language your Plan Document ensures you know exactly what you’re implementing- this improves communication, reduces read time, and makes it easy for employees to understand..

Your Plan clearly explains employee financial obligations, so it’s easy to understand how payment to medical providers is determined, and how to make sure incurred charges are covered.

A comprehensive pre-certification list ensures coverage of employee benefits before major expenses are incurred by ensuring medical necessity. An effective pre-certification process also ensures the Plan is protected from the expenditure of unnecessary and/or unauthorized expenses.

A well-defined eligibility section includes exact criteria for Employee and Dependent’s eligibility, as well as how coverage is determined under FMLA/leave of absence, and enrollment periods.  Clearly-defined terms like Spouse, Domestic Partner (if covered), Child, and Dependent further clarifies your Plan’s eligibility.

Cost containment programs are the premium gasoline and high performance oil in your Plan Document car that ensure you get the most for your money. Roundstone’s team of Cost Saving Investigators (CSI Team) reviews your Plan Document annually to make recommendations that can help lower costs. Eligible plans also have access to monthly reporting through the CSI Dashboard to track your own costs and see trends in your spending that could benefit from a revision to your plan language.

Precisely-defined coverage terms and exclusions to prevent employee confusion or providers from manipulating a definition to inflate costs is one of the many straightforward plan document terms Roundstone delivers in its Plan Document resource.

Incentives and penalties to encourage member access and participation in available programs and improve member compliance while ensuring members receive quality care is another proven approach for finding value in health care.

Automated, Online Document Execution

Roundstone is also now offering online binding with automated execution. Instead of scanning or faxing paperwork that might be missing a signature, you’re in control of a streamlined, totally online process to get the right signatures in the right places.

It’s foolproof- you can only submit the binding requirements if you’ve done it correctly, so no need to check and double-check stacks of paperwork. One of our Regional Practice Leaders recently received an email from an advisor, asking us to double-check the work. “I’m afraid I missed something,” they said, “it was way too easy.” Of course, with Roundstone’s online, automated binding process, the advisor had nothing to worry about as the documents could only be submitted if they were complete.

Making the switch to a self-funding is easier than you think- you’re in control every step of the way. Roundstone’s Plan Document process places your objectives first while making its creation turnkey. Want to take back control of your benefits? Rev your engines, contact us, and let’s get started!

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