Single Source Self-Funding™ from The Alliance

It’s a Simpler Way to Start Self-Funding

A Bright Idea for Self-Funding Health Benefits

Be a Hero to Your Mid-Sized Clients with Single Source Self-Funding

  • Single Source Self-Funding from The Alliance is the simpler way for brokers to successfully guide their clients (with 75 to 250 employees) from fully-insuring to self-funding their employee health benefits.
  • Self-funding provides your clients access to their data, control over their benefits and an opportunity to gain from their efforts to control costs.

Advantages of Single Source Self-Funding

Enhanced Cost Control

  • Broad network with competitive provider contracts
  • Steerage programs to high-value providers
  • QualityPath® from The Alliance
  • FocusHealth® from Auxiant
  • Opioid risk management program

Pre-Built Framework for Success

  • Broad network with competitive provider contracts
  • Steerage programs to high-value providers
    • QualityPath® from The Alliance
    • FocusHealth® from Auxiant
  • Opioid risk management program

Improved Coordination and Support

  • Less paperwork with centralized point of contact
  • Combined reporting packages with insights into cost drivers
  • Advice on new strategies and actions based on full knowledge of all aspects of your health benefits

Your Self-Funding Partners:

Medical Network Services Include:

  • Alliance Network Coverage

    Learn more about our network here.

    Membership in The Alliance cooperative with:

    • Broad primary network (The Alliance network) offering competitive savings to your client along with the ability to steer between systems to highest value providers.
    • Community of self-funded employers in your area.
    • Access to educational events focused on issues important to self-funded employers.
    • An opportunity for an annual dividend.
  • Wrap and secondary networks (selected by location of enrollees).
  • View our provider directory.
  • Major health systems in-network include:
    • Ascension Wisconsin
    • UW Health University Hospital & UW Health Children’s Hospital
    • SSM Health Care of Wisconsin / Dean Medical Group
    • Mercy Health System Corporation
    • Aspirus Network
    • Gundersen Health System
    • OSF Healthcare System
    • Agnesian HealthCare

Third Party Administrator (TPA) services include:

  • Medical claims adjudication and financial functions.
  • Compliance and regulatory support.
  • Summary Plan Description (SPD) consulting, design and creation from ERISA attorney coordinated with employee handbook review.
  • Advice on new responsibilities about self-funding employee benefits.
  • Broker, client and enrollee portals.

Pharmacy Benefit Manager (PBM) services include:

  • Prescription drug claim adjudication and financial functions.
  • Formulary management.
  • Pharmacy network management.
  • Specialty Drug Management including, but not limited to:
    • Prior authorization and limits on day supply and quantity.
    • Site of care optimization.
    • Exclusive specialty pharmacy (Serve You DirectRx).
  • Broker, client and enrollee portals.

Pre-built, optimized framework includes:

  • Value Based Benefit Design (VBBD) to improve outcomes for enrollees with diabetes and hypertension.
  • Coordinated language between medical, pharmacy and stop-loss coverage to protect your client against unintended claims exposure.
  • Flexibility for you and your client to choose the benefit design (including enrollee cost-share and maximum out-of-pocket limits) that best meets their needs.

Coordinated service and a simplified approach with:

  • TPA and PBM partners vetted by The Alliance for service and financial performance.
  • A single point for quoting, implementing and renewing, while retaining the advantages of expert vendor partners.
  • Reduced paperwork.
  • An enrollee communication plan, tailored to organizations new to self-funding.
  • Combined medical and prescription drug reporting with coordinated recommendations.
  • A single point of contact for enrollees. Facilitated connection through warm transfer or single sign-on functionality to other partners, if needed.
  • Freedom for brokers to determine their own fees or compensation.

Enhanced cost containment components:

  • TPA and PBM partners vetted by The Alliance for service and financial performance.
  • A single point for quoting, implementing and renewing, while retaining the advantages of expert vendor partners.
  • Reduced paperwork.
  • An enrollee communication plan, tailored to organizations new to self-funding.
  • Combined medical and prescription drug reporting with coordinated recommendations.
  • A single point of contact for enrollees. Facilitated connection through warm transfer or single sign-on functionality to other partners, if needed.
  • Freedom for brokers to determine their own fees or compensation.

Guide Your Clients to Self-Funding Success.

Request a quote or learn more here.

Contact Mike Roche, member services manager at 800.223.4139 x6645 or singlesource@the-alliance.org with any questions.

Pin It on Pinterest

Share This
group

Join our Broker Advisory Group for the Single Source Self-Funded Product

Thank you for joining the advisory group! The Alliance will contact you soon to provide additional information.