Self-funded.org

How to be an effective fiduciary.
How to design and evaluate your ASA.
How to be compliant with the CAA, 2021: GCPCA, vendor compensation disclosures, mental health parity disclosure, and pharmacy disclosure.
How to select the right employee benefits consultant.
How to select the right TPA and PBM--it's usually a good idea to shop for each separately.
How to contractually ensure your TPA will give you access to your claims in the optimal format.
How to pipeline, parse, and warehouse claims.
How to analyze claims.
How to select an independent 3rd party auditor for claims review.
How to access and utilize price transparency data.
How to compare and contrast payer networks for network adequacy and price competitiveness.
How to identify high value care (quality / price).
How to identify high cost providers and steer members away from them.
How to contract directly with providers.
How to help direct contract providers manage your member pool's health.
How to decide if joining an employer coalition is right for you and which one/s to join.
How to steer members to high value care, including direct contracts.
How to steer members to the appropriate acuity of care setting.
How to identify members in need of additional help before they become high cost claimants.
How to get targeted help (health coaches, dieticians, nutritionists, psychiatrists) for members in need.
How to select and continuously measure point solutions.
How to incorporate second opinions on costly and/or questionable surgeries.
How to communicate plan information to members in real time.
How to ensure only eligible members are receiving your plan's benefits.
How to take advantage of 501(r) (hospital charity care) discounts for eligible members.
How to track member satisfaction with providers and treatments.
How to track and optimize prior authorizations and step therapies.
How to help members find the drugs they need at the cheapest price available.
How to evaluate formulary quality.
How to identify cost-effective drug alternatives where available.
How to get transparency out of your PBM.
How to utilize cost plus pharmacies.
How to utilize discount card prices.
How to track rebate dollars on a per script basis.
How to carve out specialty drugs.
How to expand your formulary using direct contracts.
How to strategically utilize copay accumulators and maximizers.
How to think holistically about your medical and pharmacy expenses.
How to incorporate State Pharmaceutical Assistance Programs (SPAPs) and Patient Assistance Programs (PAPs) for eligible members.
How to track member satisfaction with drugs and DME and report respective side effects to the FDA.

How to be an effective fiduciary.

How to design and evaluate your ASA.

How to be compliant with the CAA, 2021: GCPCA, vendor compensation disclosures, mental health parity disclosure, and pharmacy disclosure.

How to select the right employee benefits consultant.

How to select the right TPA and PBM--it's usually a good idea to shop for each separately.

How to contractually ensure your TPA will give you access to your claims in the optimal format.

How to pipeline, parse, and warehouse claims.

How to analyze claims.

How to select an independent 3rd party auditor for claims review.

How to access and utilize price transparency data.

How to compare and contrast payer networks for network adequacy and price competitiveness.

How to identify high value care (quality / price).

How to identify high cost providers and steer members away from them.

How to contract directly with providers.

How to help direct contract providers manage your member pool's health.

How to decide if joining an employer coalition is right for you and which one/s to join.

How to steer members to high value care, including direct contracts.

How to steer members to the appropriate acuity of care setting.

How to identify members in need of additional help before they become high cost claimants.

How to get targeted help (health coaches, dieticians, nutritionists, psychiatrists) for members in need.

How to select and continuously measure point solutions.

How to incorporate second opinions on costly and/or questionable surgeries.

How to communicate plan information to members in real time.

How to ensure only eligible members are receiving your plan's benefits.

How to take advantage of 501(r) (hospital charity care) discounts for eligible members.

How to track member satisfaction with providers and treatments.

How to track and optimize prior authorizations and step therapies.

How to help members find the drugs they need at the cheapest price available.

How to evaluate formulary quality.

How to identify cost-effective drug alternatives where available.

How to get transparency out of your PBM.

How to utilize cost plus pharmacies.

How to utilize discount card prices.

How to track rebate dollars on a per script basis.

How to carve out specialty drugs.

How to expand your formulary using direct contracts.

How to strategically utilize copay accumulators and maximizers.

How to think holistically about your medical and pharmacy expenses.

How to incorporate State Pharmaceutical Assistance Programs (SPAPs) and Patient Assistance Programs (PAPs) for eligible members.

How to track member satisfaction with drugs and DME and report respective side effects to the FDA.