Eureka!! - 11 Primary Strategies

The Ongoing Employer Group Health and Benefit Challenge

For decades, small to medium sized Employers and Employees have been                          forced to pay for an inefficient and opaque Healthcare System controlled                                 by self-interested Insurance Cos, PEOs, Brokers, PBMs, and others whose                               focus is only on generating more profit.

How does Eureka!! Overcome the Challenge of Reducing Costs?
We are founded to Empower Employers with 50 to 250 Employees to regain control over the Cost of Employee Health Plans and other Benefits by implementing Unbundled, Innovative, Cost-Saving Systemic Changes based on our 17 integrated, coordinated Strategies demanding radical transparency and vigilant compliance delivered by Best-Class Professional Vendors aggregated under the Eureka!! umbrella for each Customized Employer Group Health and Benefit Plan.

The Following 11 Eureka!! Cost-Saving Strategies are our Primary Unbundled Cost-Saving Starting Points! Note - We also offer 6 additional strategies we'll post in the future that can be added at a later time for additional savings!

Introduction - As your Aggregator and Coordinator of the Strategies, Eureka!! carefully Vets, Selects and Manages Best-of-Class Providers of required Plans, Programs &/or Services to generate 20% to 40% or more Net Savings on Health Plans and other Employee Benefits while delivering Better Benefits and Employee Satisfaction.

Take a look at the 11 Strategies:
1)Level Self-Funded Plans - Unbundled with 80% to 100% reimbursement of surpluses.
     Explained - An unbundled, level-funded health plan offers small to mid-sized Employers the predictable monthly budgeting of a traditional fully-insured plan with the cost-savings and transparency of self-funding. Instead of buying a packaged product from a single insurance carrier, Eureka!! "Unbundles" the plan by selecting separate, independent affiliates for the Third-Party Administration (TPA), Network Access, and StopLoss Insurance.
2) Defined Contribution - The Employer Budgets the Company’s Contributions to the Health Plan and other Specific Employee Benefits. This is a realistic alternative to reluctantly accepting the Broker/Insurance Provider’s self-interested proposals of insurance to be paid by the Employer.
     Explained - The Employer avoids the volatile costs of traditional group plans by providing Employees with a fixed dollar allowance This strategy allows small to mid-sized Employers to control their benefits budget predictability, eliminate administrative overhead, and offer diverse, customizable coverage options that appeal to a diverse workforce.
3) TPA - Third Party Administration - The Operational Engine of an Unbundled Level Self-Funded Plan.
Explained - The TPA reviews, audits, and pays medical plans, pharmacy and other bills based on the specific rules of the Employer’s plan. In addition, the TPA provides Customer Service: ID cards, member portal management, and call-centers/concierge services operations which your Employees use for their benefits questions.
4) Stop-Loss Insurance - Protecting the Level Self-Funded Plan from Catastrophic Claims.
Explained - Stop-loss coverage is the financial safety-net that protects a level-funded plan from the costs of catastrophic medical claims made against the Fund. It caps the Employer's financial liability at a predetermined, predictable maximum.
5) RBP - Reference Based Pricing - Setting a Cap on what the Plan will pay Providers for Medical Services.
Explained - RBP is a cost-containment strategy where a Level Self-Funded Health Plan pays medical providers, by contract, using an objective, public benchmark-most commonly a percentage of Medicare Reimbursement Rates. Legal Representation controls Balanced Billing attempts.
6) PBM Oversight - The strategy of monitoring, controlling, and actively auditing how prescription drug benefits are managed.
Explained - Prescription drug costs typically consume 20% to 25% of the Employer’s entire healthcare spend. When Employers "carve out" the pharmacy benefit, PBM oversight is what prevents the Employer’s Fund from being overcharged for medications.
7) Menu Building - Affordably meeting Employer’s and Employee’s Needs and Budgets.
Explained - Eureka!! assists Employers to mix and match different health options alongside ancillary benefits creating a Customized Menu to control corporate costs as Employees personalize their options.
8) Aggregator & Coordinator - Vetting and Overseeing the Carefully selected Professional for each of the Strategies/Solutions.
Explained - Eureka!! acts as an outsourced corporate benefits department. We leverage technology and industry partnerships to bundle, streamline, and manage all the moving pieces of the Employer’s unbundled, Level Self-Funded health plan and voluntary/worksite benefits.
9) State & Federal Compliance, Reporting & Legal Oversight - Compliance and Reporting is the foundation of a Level Self-Funded Plan. Skilled legal representation is critical because an unbundled levelfunded plan converts your business into a federal health insurance provider.
Explained - When Employers switch from a fully insured plan to a Level Self-Funded Plan, the company shifts from being a mere "buyer" of insurance to a Plan Sponsor and a Named Fiduciary under federal law including ERISA. Compliance ensures that Employers fulfill the legal responsibilities while protecting their business from penalties. Legal Oversight includes controlling attempts at “Balanced Billing”.
10) ECED - Education, Communication, Enrollment & Data Management - Shifting from a fully
insured plan to an unbundled, Level Self-Funded Plan completely changes the Employee healthcare experience.
Explained - A well-planned Employee Education, Communication, Enrollment and Data Management strategy with Employee and Management Team “buy-in” is absolutely critical to optimizing savings while gaining Employee Satisfaction with Better Benefits most often resulting in Enhanced Retention Rates.
11) Oversight/Coordination, Ongoing Service, Optimizing Satisfaction and Concierge Services -
Plan oversight/coordination and concierge services are absolutely essential to the implementation of CostSaving Strategies.
Explained - With central oversight and an Efficient Concierge Service, the Plan becomes a smoothrunning operation for the Employer’s Management Team and HR.

We invite you to better understand Eureka!!’s turnkey platform of Strategies for delivering Cost-Savings of 20% to 40% or More for Employers with 50 to 250 Employees - while providing Employees Better Benefits.
          Note - Eureka!! will provide substantial ongoing Referral Income for those introducing Qualified Employer Prospects - with 50 to 250 Employees - who become Eureka!! Clients. If you are interested and Insurance Licensed, please request information about this exciting, lucrative opportunity?

                    Let’s talk - Philip W Eide, President     .     phil@vestabp.com
                                   Text, Call, or Email...Mobile: 216.577.5579