Segal Company

Innovative Plan Design Strategy and Analysis

Effective plan design is the key to providing high quality, cost-effective health care to multi-employer benefit plan members. Segal has extensive experience in the design and redesign of all health benefit plans, including medical, dental, prescription drug, vision, short- and long-term disability, life, accidental death and dismemberment and flexible benefits.

Segal has developed multiple strategies for designing plan rules such as rules of eligibility and waiting period, coordination of benefits, and participant cost sharing. We model the cost impact before a plan is changed (e.g. from a 100% reimbursement to 20% coinsurance), so we can predict with accuracy how much the change will save a fund.

We use a number of strategies to enhance the health plans of our multi-employer clients. These include:

  • Participant cost sharing and contribution strategies
  • Multiple plan offerings/options
  • Opt-out incentives
  • High-cost claim management
  • Exclusions and limitations
  • Eligibility rules (for active participant and retiree health coverage)
  • Plan design review