Last September, Franklin-based Bowers & Associates Inc. unleashed its Health Plan Evaluator, which is the first tool in its niche that embeds actual claims information, regardless of whom the claims administrators are.
The Health Plan Evaluator is a Web-based tool that provides each employee of an organization a portal to determine which health plan option best suits the employee’s needs, based on a set of criteria.
Actual claims information is evaluated to see which plan option makes the most sense for each employee, given the available plan design provisions for co-pays, deductibles and co-insurance.
“We do this by loading each of the employer’s medical and prescription drug plan designs into this tool for the employee and applying sophisticated modeling algorithms to determine the employee’s cost share under each option,” said Scott Weltz, senior vice president of analytics and tools.
Actual premiums also are considered. Premiums often depend on a number of variables. This customized analysis makes it easier for the employee to make a decision about which plan will be the most effective.
“The real value to this tool is that it provides the employee with a customized answer the second they log on,” Weltz said. “A small percentage of employees will want to do ‘what-if?’ testing by determining which option is best if they increase/decrease their utilization of certain services.”
Such additional testing is accommodated on the Web site, Weltz said.
Bowers & Associates was founded in 1990 to help employers and employees navigate, coordinate and negotiate the complicated and ever-changing health care system. Today, the company has 50 employees and clients such as Children’s Hospital of Wisconsin.
The hospital, which has about 3,500 employees, uses the software. About 43 percent of the hospital’s employees who opted to take
health care coverage used the Health Plan Evaluator.
“We found that both our lean PPO option and HSA high-deductible health plan saw an enrollment increase of more than 16 percent,” said Staci Benz, benefits manager at Children’s Hospital and Health System.
“The Health Plan Evaluator made it possible for us to provide our employees with an easy and personalized way to evaluate the four plan options offered to them, while giving us the ability to drive migration into plan designs that are simply more sustainable over the long run,” Benz said.
Address: 9779 S. Franklin Drive, Suite 300, Franklin
Web Site: www.bowersa.com
Industry: Software development
Innovations: Employee health plan evaluation tool.
