Page 25 - Upstream Rehabilitation
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Sample three-year strategic plan
2020 (current) 2021 2022 2022
• Medical self-insured • Assess and recalibrate stop-loss risk • Implement copay/coinsurance • Mandate COE facilities and providers
• Rx self-insured transfer strategy differentials for using COE facilities for designated services
Purchasing eficiency • Stop-loss reinsurance • Reassess self-insured TPA/PBM and designated high quality
terms and provider network(s) providers
• Broad national PPO network • Implement telemedicine service • Adopt local narrow network options • Consider ACO plans/networks by
• Mandatory Rx mail-order for • Validate effectiveness of Rx where available market where proven cost effective
Healthcare delivery maintenance medications mandatory mail-order and adjust as
needed
• EE annual discounts: • Continue biometric testing • Continue biometric testing • Continue biometric testing
− $40 per month for completing • Add spouses to biometric testing • Implement outcomes-based • Continue outcomes-based
Health and risk improvement health evaluation and biometric contribution differentials based on contribution differentials based on
screening health risk factors health risk factors
− 73% employee participation
• 1.38 covered dependents per • Amnesty dependent audit • Engage third party for dependent
covered employee • Assess and recalibrate employee eligibility audit
Eligibility management • 300 estimated covered spouses contributions for adding spouses as
• 4-tier contributions needed to mitigate risk exposure
• HDHP/HSA option • Eliminated HSA seed and require • Reduce dental plan subsidy to 50% • Only offer one medical plan option
− 78% coverage value employee contributions to receive • Reinvest savings into medical plan that is HSA qualiied
• PPP option any XYZ Company match • Make dental plan 100% employee
Participant experience − 80% coverage value • Start process of implementing a paid
• ABC Company total medical plan deined contribution strategy; cost
premium subsidy at 70%; total cost neutral to XYZ Company regardless
subsidy at 57% of plan elected by employee
Upstream Rehabilitation — Lockton Total Rewards Practice overview 25 Lockton Companies
2020 (current) 2021 2022 2022
• Medical self-insured • Assess and recalibrate stop-loss risk • Implement copay/coinsurance • Mandate COE facilities and providers
• Rx self-insured transfer strategy differentials for using COE facilities for designated services
Purchasing eficiency • Stop-loss reinsurance • Reassess self-insured TPA/PBM and designated high quality
terms and provider network(s) providers
• Broad national PPO network • Implement telemedicine service • Adopt local narrow network options • Consider ACO plans/networks by
• Mandatory Rx mail-order for • Validate effectiveness of Rx where available market where proven cost effective
Healthcare delivery maintenance medications mandatory mail-order and adjust as
needed
• EE annual discounts: • Continue biometric testing • Continue biometric testing • Continue biometric testing
− $40 per month for completing • Add spouses to biometric testing • Implement outcomes-based • Continue outcomes-based
Health and risk improvement health evaluation and biometric contribution differentials based on contribution differentials based on
screening health risk factors health risk factors
− 73% employee participation
• 1.38 covered dependents per • Amnesty dependent audit • Engage third party for dependent
covered employee • Assess and recalibrate employee eligibility audit
Eligibility management • 300 estimated covered spouses contributions for adding spouses as
• 4-tier contributions needed to mitigate risk exposure
• HDHP/HSA option • Eliminated HSA seed and require • Reduce dental plan subsidy to 50% • Only offer one medical plan option
− 78% coverage value employee contributions to receive • Reinvest savings into medical plan that is HSA qualiied
• PPP option any XYZ Company match • Make dental plan 100% employee
Participant experience − 80% coverage value • Start process of implementing a paid
• ABC Company total medical plan deined contribution strategy; cost
premium subsidy at 70%; total cost neutral to XYZ Company regardless
subsidy at 57% of plan elected by employee
Upstream Rehabilitation — Lockton Total Rewards Practice overview 25 Lockton Companies
