Our commitment is to provide benefit plans that significantly reduce annual benefit costs while increasing employee satisfaction. As an industry leader, we serve as a comprehensive employee health benefits resource. 90 Degree Benefits provides everything from actuarial consulting to benefit management and the highest quality claims administration.
90 Degree Benefits is a comprehensive benefit resource group with unmatched expertise in:
- Health Benefit Plan Design
- Actuarial & Risk Services
- Benefit Compliance
- Rx Cost Control
- Fully insured products
- Rx consulting
- Claim fiduciary & co-fiduciary services
- Claim audit & fraud-abuse programs
Traditional Self-Funded Plans
90 Degree Benefits offers traditional self-funded plans designed to meet each employer’s unique business and member needs. Second sentence can now be removed. Employer’s work with 90 Degree Benefits to create health plans that meet their specific business and member needs. While complete claims administration and reporting is included in all of our self-funded plans, the benefits themselves can be tailored to meet the employer’s unique needs, such as:
- Provider Networks
- Medical Benefits
- Rx Benefits
- Dental & Vision Coverage
- Care Management
- Direct Primary Care
Level funding is a hybrid between traditional self-funded and fully insured plans. Employers pay a fixed monthly cost for medical expenses, like they would in a fully insured plan, but are able to retain 100% of any unused funds at the end of the plan year. Level funding is ideal for employers who enjoy the stability of a fully insured plan but also want to take advantage of savings opportunities that result from self-funding.
Proactive Reference Based Pricing
Proactive Reference Based Pricing (Proactive RBP) is a pricing methodology based on a framework from a third party, usually Medicare. It is a way to establish a reasonable amount an employee benefit plan will pay health providers for medical or prescription services in a group benefit plan.
90 Degree Benefits creates and administers Proactive RBP plans for employers across the country. Our clients typically save from 25% to more than 50% of their health benefit costs. Our program’s success is based on Direct Facility Agreements, Patient Advocacy and Rx Watchdog.
Direct Facility Agreements
90 Degree Benefits contracts with local facilities that are willing to accept a reasonable multiple of Medicare that ensures savings to the plan before members receive care. Once established, members can then receive care at these facilities with no out-of-pocket facility expenses and avoid balance billing.
Employers, employees, and hospitals all benefit from Direct Facility Agreements. The agreements allow employers to offer lower out of pocket costs to employees and keep care in the local community
90 Degree Benefits’ Patient Advocates actively help plan members minimize their health care costs, while receiving the care they need. Patient Advocates focus on supporting and empowering members through dedicated patient and health advocacy programs designed to help employees and their families navigate the healthcare maze.
Our advocates use cost comparison tools, quality evaluation tools, beneﬁt guides and other services to help patients when they need to make important care decisions. the financial benefits of using Proactive Reference Based Pricing.
Patient Advocates help ensure there is no balance billing and reduce costs for the members and the plan — a win-win for everyone involved.
Our Patient Advocates help patients:
- Navigate our on line pricing tools to determine the best combination of price and quality for procedures
- Locate providers in their area
- Understand and reduce medical bills
- Initiate cash pricing deals that could save members money on expensive procedures
Rx Watchdog protects your company from rising prescription drug costs. Rx WatchDog saves groups 25% to 30% or more off their prescription costs. Members will be better informed about pharmacy options and services, empowering them to make educated prescription decisions.
With 90 Degree Benefit’s Proactive RBP, employers know exactly what they’re getting:
- No excessive fees
- Plans expertly designed to mitigate balance billing
- Strong partnerships with providers
- Zero out-of-pocket for members at Safe Harbor Facilities
- Member education – not provider litigation
Direct Primary Care
Health needs to happen 24/7 – so should your care
90 Degree Benefits offers a revolutionary Direct Primary Care (DPC) solution that cuts through the complexity of healthcare, improving the quality of care received and generating savings for employers and members. This program eliminates medical care barriers. DPC is not telemedicine—it is a form of concierge medicine that enables 24/7 patient access to the full range of comprehensive primary services including routine care, regular checkups, preventive care, and care coordination.
The Direct Primary Care Advantage with 90 Degree Benefits
Through effective engagement, quality and price transparency, patients begin acting more as consumers, shopping for healthcare services as they would for other products. This is a complete shift from traditional services administered through networks, where the total cost is a seldom consideration.
Our proactive concierge services are member focused and serve to guide patients through the complex healthcare system. 90 Degree Benefits delivers a platform that acts as a safe-haven environment for patients within self-funded employer populations, giving them high quality care in a manner that is cost- effective for both the employer and the employee.
90 Degree Benefits DPC solution provides extensive concierge medical services and care, including:
- Preventive Medicine
- Men’s & Women’s Health
- Children & Seniors
- Chronic Disease Management
- Healthy Lifestyle Management
Minimum Essential Coverage Plans
Minimum Essential Coverage (MEC) plans allow companies to cost-effectively provide employees with health plan coverage required under the Affordable Care Act (ACA). Employees get access to preventive care and other programs that encourage wellness, while companies avoid paying costly tax penalties for non-compliance.
Considering the significant financial impact of the Affordable Care Act (ACA), employers can no longer afford not to have a benefit compliance strategy. Benefits are important, but understanding the ramifications of offering, or not offering, benefits is what will protect an employer from unnecessary penalty exposure. In order to develop a proper strategy, employers need to understand critical points about the Affordable Care Act such as those listed below.
The MEC plans are designed to do the following:
- Eliminate the 4980H(a) Employer Shared Responsibility penalty
- Reduce exposure to the 4980H(b) penalty
- Eliminate the significant penalty for not reporting
- Provide MEC so enrolled employee’s do not incur a penalty while providing an opportunity for family units to do the same
- Consolidate the compliance services and reporting requirements onto a single cloud-based employee benefit management platform
With pharmacy costs rising at an astonishing rate, it’s time for a new way to protect your self-funded plan. Rx Watchdog is our Pharmacy Cost Management Program that delivers efficient and effective pharmacy cost containment to employers of all sizes. With Rx Watchdog, groups save 25% to 30% or more of their prescription costs.
Rx Watchdog Includes:
- Key Pharmacy Benefit Manager Partnerships
- Care Management Expertise
- Specialty Rx Management
- Comprehensive Administration
- Clinical Management Integration
- Rebate Administration
- Rx Reference Based Pricing
- Capitated Drug Plan
- Reporting & Analytics
90 Degree Benefits Care Management is provided by Medical Helpline, bringing together Patient Advocacy, Utilization Management, and Case Management. While members are always welcome to call regarding their specific health episodes, our team proactively reaches out to them first to get informed of potential issues. This integrated health management approach provides a collaborative process for assessment, planning, facilitation, care coordination, evaluation, and advocacy all in a single service.
Medical Helpline Clients Experience:
- Improved member health
- More engaged and informed members
- Streamlined levels of care
- Member and Employer savings
Your Complete Benefit Administration Solution
EASI streamlines the entire benefit administration, compliance, enrollment and employee communication processes so that it is as efficient and painless as possible. EASI is powered by bswift and is designed with the “non-technical” user in mind. As a result, it is intuitive and easy-to-use for employees, HR managers and administrators alike.
EASI’s cloud-based technology makes online enrollment simple and speedy for employers. Designed to address compliance and enrollment needs from one easy-to-use platform, EASI simplifies employers’ compliance needs by creating a single outlet for all employee benefit and human HR necessities.
EASI provides continual compliance management and analysis of healthcare reform impacts an employer’s business, including potential strategies for optimizing employer-sponsored health benefits and minimizing taxes and fees.
EASI Employee Portal
EASI is also a portal for employees to access all required documents, forms and brochures — 24/7 from any device. When employees have access to the documents they need, anytime and anywhere, HR Managers and administrators have more time to focus on other vital tasks.
EASI is quickly and easily configurable and available on-demand, with integrated text and email communications capabilities, to meet the evolving needs of businesses.
Compliance mandates and updates can leave employers feeling unsure and wondering, “Is my business protected? Are my employees?” With compliance services from 90 Degree Benefits, organizations can go about business as usual with the knowledge that a team of experts is keeping their health plan up-to-date and fully compliant.
With extensive experience in benefit and risk consulting and administration, we are experts in compliance for employers of all kinds. We place an emphasis on health and welfare compliance with ERISA and have a number of benefit attorneys on staff, as well as a dedicated, trained compliance team to ensure timely and comprehensive plan compliance.
90 Degree Benefits alerts clients as soon as regulatory changes occur. Our compliance team is fully engaged at both the federal and state regulatory level, bringing employers an added layer of confidence that their business is protected in today’s ever-changing healthcare landscape. In addition, 90 Degree Benefits’ compliance attorneys are dedicated to plan document generation, regulatory and ACA review, and amendments to ensure your plan is in compliance.
Medical Expense Reimbursement Plan (MERP)
Our Medical Expense Reimbursement Plan (MERP) allows for large businesses, municipalities, and government agencies to reduce the cost of employee health care benefits. This voluntary program reimburses employees, spouses, and their eligible dependents for eligible out-of-pocket medical care expenses incurred under an alternate group medical coverage. Through this customized program, we can reduce an employer’s healthcare costs while maintaining or improving health benefits for employees, saving employers 5% to 15% on overall medical plan expenses.
Ancillary Coverage Options
From plan creation to administration and to everything in between, Entrust provides a full suite of services for whatever an employer needs. Our ancillary coverage options allow employers to build in additional layers of protection and financial security, both for the plan itself and for members.
Some of our ancillary coverage options include:
Accident Indemnity - Hospital Indemnity - Critical Illness - Short Term Disability
Back Office Services
Entrust offers comprehensive back office support services to carriers and third party administrators. A partial listing of such services is below:
- Preparation of Plan documents
- Back Office Services
- Eligibility maintenance
- Claim processing
- Explanation of Benefits and Explanation of Payments
- Appeals management
- Claims customer service
- Member and Provider Claims Portal
- Claims audit
- Claims reporting
- Claim Adjudication
- Benefits Administration Solution: EASI
- Online enrollment
- Change Management: Adds, terms
- Account Management
- Rx Watchdog
- Pre-Underwriting and Stop-loss Shopping
- Compliance Services
- Plan Integration, Contracting, & Eligibility with PBMs
- Claim Portal, Dashboard & Mobile App for Members, Employers, and Providers
- Customized Group Structuring and Plan Build
- Data extract for Data Warehouse and Rx reporting
- Bi-Weekly Check Runs on claim activity, with check verification services as needed
- Accounting and Trust Accounting Services
- Case management, UR, Advocacy
- Direct Primary Care integration
Fully Insured Products
90 Degree Benefits offers a full suite of fully insured products. Our products allow employers to build in additional layers of protection and financial security, both for the plan itself and for members.
- Accident Indemnity
- Hospital Indemnity
- Critical Illness
- Short Term Disability
- Long Term Disability
- Group Life Insurance
Health Benefit Plans
At 90 Degree Benefits, we believe the right health plan does more than just provide benefits — it takes your business in the right direction. Offerings range from traditional self-funded solutions to complete reference based options. Each plan is built to address the specific savings and coverage needs of an employer, helping organizations go further with their health plan than ever before.
Our health benefit plans include Proactive Reference Based Pricing, Traditional Self-Funded, Level-Funded and Minimum Essential Coverage plans and a full suite of Fully Insured options.
We have a plan for you!