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Data Needed to provide analysis: Below is the data request list for us to do a full analysis of your Health and Welfare Benefits Programs with benchmarking. We have highlighted what is most important in BLUE.
Medical and Pharmacy (PBM) Data Request:
Current Medical & Pharmacy contract
Current Employee Premium Contribution Levels by plan and coverage tier
Current Premium and/or Fully-insured equivalent (phantom) rates
Last two years of premium rate history and/or administrative and stop loss fees
Last two years of monthly claims experience (include enrollment by month, if possible)
Last two years of High Dollar claim experience, if available
Last two years of claim utilization reports (medical and pharmacy
Rebate History for two years (if you have it)
Copy of current Benefit Summary, Summary Plan Descriptions
General Data Request:
Copy of Employee Communication Package
Copy of any Open Enrollment Presentations and Materials
Employee Census (template attached) of total eligible; indicate if waived coverage) – no names or PHI. This will allow us to evaluate based on age gender and those waiving vs taking coverage to compare to the benchmarks.
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