Covenant Services Group - Summary of Programs
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Covenant Services Group offers a comprehensive healthcare risk management program, aiming to reduce healthcare costs for employer groups through advanced strategies and technology. Their services include health risk management, lifestyle programs, and integrated care solutions, providing clients with multiple year cost guarantees and potential reimbursement benefits. The group emphasizes control over healthcare expenses, aiming for significant savings while maintaining quality coverage.
Covenant Services Group - Summary of Programs
- 1. The Covenant Services Group factors and fixed costs. • Access Your Claims - With CovenantCare, you have access As a leading Third Party Administrator (TPA) since 1992, The Covenant to your own claims experience. This will allow you to Services Group concentration is to be more than just a claims processor manage your healthcare program. or even a claims manager, but to be a Healthcare Risk Manager. The • Health Risk Management - With CovenantCare, you will Covenant Services Group provides Health Benefits Risk Management have at your finger tips true risk management programs that Programs and Administration Services to over 100,000 member lives by allow you to control and direct the future outcomes of your harnessing the industry’s most powerful technology and applying sound plan. You will be able to reduce or eliminate the future fundamental healthcare strategies. Our global focus is to provide Health impact of claims. Risk Management solutions that will have a dramatic impact on the • Lower Maximum Cost - CovenantCare favorably resembles bottom line costs by providing techniques to eliminate exposure to risk a fully insured program. Similar to a fully insured plan, and reduce the cost impact of known risks. CovenantCare affords the client consistent monthly plan costs. Our commitment to the level of service we provide is best exemplified • No Lasers / Even At Renewal - A great advantage to by our name itself. We are honor bound, far beyond the stipulations of CovenantCare is that no “lasers” will be placed as a any paper contracts between us. We settle for no less than to exceed condition of renewal. Laser is a self-funded term where the your expectations. At Covenant, we believe and are committed to the stop-loss contract can carve out certain individuals due to following… “Covenant...More Than A Promise” high claims liability and apply larger stop-loss deductibles. • Client Funding is Capped / No More Cash Calls - With CovenantCare, the only monies the client is required to fund Uniquely Designed Healthcare Programs on a monthly basis are aggregate premium rates and aggregate claim factors. The CovenantCare Program will automatically and immediately fund any claims above the monthly funded equivalents. An Alternate Funded Healthcare Program • Potential for Reimbursement - Unlike a fully insured product, should actual claims come in lower than the The CovenantCare benefit program is an attractive self-funded attachment point at year-end, reimbursement is a alternative for employers and health plan sponsors with 25 to 200 possibility. This is not an option with a fully insured product. employee lives who are currently fully insured and want the advantages of self-funding but are hesitant to leave the safety of fixed premiums Covenant Advantage - A Multiple Year Guarantee and limited liability provided by fully insured medical plans. In essence, it provides a way to apply health risk management strategies to your During these volatile healthcare and economic times, the ability to benefit plan like large employer groups but with the same financial safe provide a multiple year cost guarantee to an employee benefit health harbors of fully insured programs. You will truly be able to take control plan is INVALUABLE. Covenant Advantage has been created to control of your healthcare benefit program. The benefits of choosing the rising healthcare costs and improve cash flow without sacrificing quality CovenantCare Alternate Funding Plan include the following: healthcare coverage. It allows employer groups the opportunity to have • Capping the Risk - Just like self-funded plan sponsor’s use a multiple year budget stabilization in operating their healthcare benefit of aggregate reinsurance to cap maximum liability, plan. CovenantCare also caps the risk based on expected claim
- 2. Covenant Advantage highlights: in reducing healthcare unit costs. Our risk management strategy will • Program marketed to partially self-funded employee pave the way to allow your organization to win the battle over rising benefit plans with 200 or more employee lives. healthcare costs. Listed below is a summary of our strategic programs: • Program will provide a multiple year cost guarantee of the employee benefit health plan costs. • Lifestyle Management - New legislation allows employer- • Employer groups must agree to implement the following sponsored health plans to provide results-based incentives Covenant Risk Management Strategies, which improve the for wellness. This program provides a unique way to assist overall management and costs of the health plan, in order in improving the health of employees through lifestyle to receive this guarantee. changes. Our lifestyle habits are responsible for over 71% ⇒ A Results Based Lifestyle Management Program of every claim dollar associated with our health plans. ⇒ An On-Site Primary Care Clinic Thus, by controlling these habits, savings will drop straight ⇒ Medical Advocate Program to the bottom line of an employer’s health plan. Under the • The multiple year rate guarantee maximizes the annual cost plan, a confidential health screening will take place to increase of the health plan to no greater than 8% per year. assess each employee’s basic health in the key areas of: We anticipate that the entire costs of the health plan will • Blood Pressure decrease. However, our reinsurance and administrative • Cholesterol (LDL) contracts guarantee the entire cost of the health plan to be • Body Mass Index (BMI) limited to 8% annually. • Tobacco/Nicotine Use Based on the number of these categories that are shown Covenant Administrators is…. to be acceptable, the employee will have higher or lower deductibles for the plan. Annually, each employee will be Your Health Benefits Risk Management Solution re-tested for their progress in these lifestyle categories. As their health categories improve, their deductible will reduce. This approach has proven very successful in Covenant’s Healthcare Risk Management Solutions multiple companies across America. The Covenant Services Group is leading the way in providing state-of- • On-Site Primary Care Clinic - This is a return to a more the-art initiatives that control and reduce the high cost of healthcare, traditional health strategy that is driven by several factors: while improving the quality of care. This comprehensive risk ⇒ Employer’s desire for greater risk management and management program is identified as CAST, “Covenant Applied Savings regulatory compliance. Techniques”. The sole purpose of CAST is to enable employer groups to ⇒ Case and Medical Management that improves not only control healthcare costs but to eliminate exposures to risk that effectiveness in the workplace. will eventually produce significant unwanted costs if not addressed. ⇒ Population Health and Absence Management Healthcare costs are based on a simple formula: With an on-site clinic, the improved access to primary care and pharmaceutical services improves an Unit Cost X Frequency = Total Claims Cost employer's ability to intervene and treat problems early, leading to a decrease in specialty care, emergency CAST’s Healthcare Risk Management Program will provide your room use, hospitalization and absence company with a comprehensive and seamless plan that will eliminate from work. exposures to risk by decreasing the frequency of high risk claims or potentially high risk opportunities. CAST will also have a positive impact
- 3. An employee can receive their primary care visits and healthcare today…. Access, Affordability, and prescriptions for a $0 Co-Pay. The “On-Site Clinic” will Convenience. TelaDoc can be used to treat problems such provide annual health risk assessments, coordinate care as Allergies, Bronchitis, Respiratory Infection, Rx Refill and serve as the Primary Care Physician for all covered (short term only), Sinusitis and Urinary Tract Infections. employees and dependents that choose this method of care. The savings generated by this delivery of care will • MEDInnovations (TC3) - is a suite of loss control and dramatically reduce the overall cost of the plan. decision support capabilities that will improve the management of medical risk. MEDInnovations works in the • The Medical Advocate Program (MAP) - will assist following arenas to improve cost outcomes for employer employees in receiving the highest quality and the most groups. efficient health care available. With a simple phone call, ⇒ Integrated Fraud & Abuse / Detection & Prevention the program uses an advocate nurse to guide and coach Suite employees through their episode of care to the higher ◊ Provide Match Program qualified physicians and the most cost effective facilities. ◊ Fraud Diagnostics ◊ Intelligent Fraud Analytics For employers who want to reduce and manage their sm ◊ TruClaim Code Edit Compliance medical costs, MAP provides a “transparent” solution ◊ Case File Investigations Unit through an extensive data base that profiles the quality of ⇒ Re-pricing Optimizers every specialist and the cost of every medical facility in the ◊ AccessPlus PPO United States. ◊ Provider R&C Negotiations • MEDai Predictive / Risk Analysis - is a prediction engine • MehraVista Health - specializes in solving employer’s that applies the right combination of today’s technology to behavior health costs and productivity problems. They correctly identify patients at risk and forecast future health offer a variety of custom designed products that allow you plan costs. This technology allows an employer to be to choose the program best suited to your company’s proactive in establishing proper programs that will manage needs. and alleviate health conditions before they become a strain ⇒ Behavioral Health Benefits Management - on healthcare costs. It will also identify gaps in care and assumes responsibility for all clinical and immediately recognize those individuals with the greatest administrative aspects of behavioral health care. impact potential from both a financial and a quality of life ⇒ Employer Assistance Program (EPA) - provides perspective. education and prevention as well as early intervention and solution-oriented counseling to • TelaDoc Medical Services - is a national network of employees with personal problems. licensed, board certified primary care physicians offering medical consultations via the telephone 24 hours a day, 7 days a week. TelaDoc consulting physicians treat illnesses that arise quickly and tend to run a brief course, typically 5- 10 days. Consulting physicians address acute, episodic, self- limited and minor illnesses as opposed to chronic conditions such as hypertension, epilepsy or diabetes. TelaDoc addresses three of the key challenges facing
- 4. What’s the bottom line on the bottom line? The Covenant CAST Risk Management Funnel of Savings Are you looking for savings and security? Then you have come to the right place. Our healthcare risk management programs will provide real bottom line savings. Based on our proven strategies, we can save you from 18% to 30% in the first year of coverage. You can see it illustrated with our funnel of savings. And this is not just a one-year proposition. Our strategies are engineered to continually have a positive effect on your healthcare budget year-after-year. Lifestyle Management Let the Covenant Services Group illustrate to you how we can provide 8% Savings 12% Savings a positive impact to your healthcare program by reducing costs and reducing the ever rising health care trend on your healthcare pro- gram, while not sacrificing quality to your employees. MEDInnovations MEDai “Covenant…..More Than a Promise” 3% Savings 5% Savings TelaDoc On-Site Clinic 3% Savings 7% Savings MehraVista MARYLAND NORTH CAROLINA SOUTH CAROLINA VIRGINIA Health Dean Holmes, CLU, RHU Regional Sales Director 4% Savings 6% Savings phone 919.605.9160 dholmes@covenantservicesgroup.com MAP CORPORATE OFFICE Covenant Services Group, LLC 1745 North Brown Road Suite 400 Lawrenceville, Georgia 30043 phone 678.258.8200 800.680.8728 fax 678.258.8298 18% - 30% Potential Claims Reduction www.covenantservicesgroup.com