Employee Health & Benefits Consulting

Employee Health & Benefits Consulting

Managing Your Risk, and Maximizing Your Return

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Our teams offer a comprehensive, data-driven approach to your employee benefits program.

  • How We Help

    Our commitment to our clients is total. Our teams ensure that each client receives every resource required to provide quality results across all service areas. Our team of experts supports each client through the following process:

    Discovery: Understanding Your Business Your Goals, Your Culture, Your Benefits & Your Budget

    Deep Data Dive: Claims, utilization, accurate costs, market benchmarks and predictive analytics to set baselines and construct strategy. We provide benchmarking for employer-specific plan data against normative and industry-specific data.

    Insights: Proprietary tools like the Total Opportunity Matrix (TOM) Strategic Forecast Model (SFM) and Planning and Analytics for Total Health (PATH) are used to guide recommendations.

    Actions: Change management through end-to-end support of implementation of the strategic recommendations.

    Measurement: Tracking of success targets, vendor and performance and overall plan financials presented in easy-to-understand reports and metrics.

    Optimization: Refinement of strategies to achieve optimal outcomes and engagement.

  • What We Provide

    Strategic Initiatives and Planning: We hold focused discussions to understand the full picture of your business environment to develop a multi-year strategy that uses basic and advanced tactics to manage your benefits programs and your costs.

    Forensic Financial Underwriting: Using data from carriers’ wellbeing, disease and care management program, our underwriters provide informative and actionable evaluations minimizing exposure to unforeseen and unpredicted financial risk. We have deep technical, financial and underwriting expertise that allows us to provide our clients with the most effective financial arrangements.

    Vendor Management: We operate as an extension of your team, negotiating on your behalf to achieve the best possible terms for all your benefits program vendors, and then provide support throughout the implementation process and ongoing services, continually seeking opportunities for improvement and enhanced services.

    Annual Renewal Management: Yearly re-evaluation of your programs and plans resulting in customized recommendation for the most effective approach for plan renewals.

    Compliance: Our National Compliance Center of Excellence provides a comprehensive set of legislative awareness and coaching communications and services for each client. Support includes an annual compliance audit encompassing a review of all ERISA plan documents for employer-sponsored benefits plans, a review of each client’s Section 125 Summary Annual Report and the preparation of signature-ready Form 5500 filings for health and welfare benefits plans.

    Client Service: Trion recognizes the need to deliver the best value for our customers. Our client service philosophy is built around a dedicated client team structure, which is the foundation of our business model. Each of our clients is assigned a team of professionals with individually defined roles and responsibilities whose skills and experience match our clients consulting and administration requirements. Your dedicated Client Service Manager supports the day-to-day activity including:

    • Enrollment management
    • Monitoring and filing stop-loss claims
    • Escalating and resolving claims issues, and
    • Supporting employee education efforts through premium in-scope communications.

    Wellbeing Solutions: Wellness/wellbeing and health management strategies are a critical part of a benefits program management. We have a structured framework to help design and implement your wellness (wellbeing) program and to reflect the alignment of the program with overall benefits and business objectives. The framework leverages our consulting expertise in data analysis and strategic planning and also our consulting strength in vendor selection and management, plan/vendor implementation, and employee communications. We know the vendor marketplace well and most importantly, we have experience in achieving wellbeing program savings and employee health-improvement goals for clients.

    Worksite Health: Trion has extensive experience collaborating with hundreds of employers to develop and implement worksite health centers – and our clients have found worksite health to be a ‘game changer’ for improving population health, enhancing their brands as employers of choice, and managing health and improving productivity.

    Stop Loss Center of Excellence: We offer a dedicated team who is laser-focused on providing the most competitive pricing and contractual terms possible to manage risk and control costs with top-tier carriers. Each year, our team negotiates on your behalf to secure preferred terms such as clinical trial coverage and defined rate caps in order to help our self-funded clients manage risk and limit liability.

    Voluntary Benefits: Employee-paid supplemental health and benefits programs have become more valuable to the current workforce and we endeavor to assist in deploying the correct options with the least amount of administrative burden possible. Our teams include experts specializing in these plan types who understand how to design programs and supporting communications specific to each client’s unique culture and demographics.

  • Case Studies

    A 1300-life group in the banking industry asked us to help develop a multi-year benefit budget that accurately depicts annual cost increases.

    The Challenge

    Sr. HR Officer was not pleased with their reactionary planning to annual benefit cost increases. The group did not feel that they had the right tools to project future benefits costs. HR team was tasked by finance to develop a multiyear benefit budget.

    The Solution

    Trion obtained the banks benefit data and loaded our Strategic Forecast Model. Trion and banking group agreed on certain trend assumptions. Trion and banking group determined the target employer annual cost change. A formal 5 year pro-forma of costs and the funding gap were developed.

    The Result

    The client was able to see the different cost reduction strategies available to them. Client could observe (real time) the cost impact of each potential strategic change. Based on these findings, the client developed their strategic plan and used this data to populate their long term benefits budget.

    A 2500-life municipality received a claim review showing a single claim in excess of $1.2 million.

    The Situation

    At time of review the employee was working for a subsidiary of the specific employer. Current stop loss contract had a $1.2 million laser on the member. Client was looking at an exposure of $850,000.

    The Solution

    Utilize a data warehouse solution to analyze case details, to include the member’s clinical profile. Confirm the condition, prognosis, and risk of future claim expenses with member’s physician. Gather insight from stop loss vendor to understand methodology.

    The Result

    After careful analysis and through direct communication with the stop loss vendor, Trion was able to eliminate the laser and reduce the client’s exposure. How did we negotiate it? Data controllership and clinical resources support our detailed analysis making the result the clear choice.

    A new client was notified by the Department of Labor (DOL) that it failed an audit that occurred the prior year. Our objective was to help provide a response to address the DOL’s concerns.

    The Challenge

    One of the DOL’s conclusions from the audit was that the Plan had failed to provide an ERISA-compliant summary plan description (SPD) because it failed to disclose certain information.

    The Solution

    Our legal team prepared a document to supplement the carrier’s document, making it an ERISA-compliant SPD, which the client distributed to participants.

    The Result

    The DOL determined that since appropriate corrective action was taken with respect to the violations contained in its previous letter, it would take no further action regarding the matter.