Self-insured health plans present opportunities for cost savings and customization, but they also demand that plan sponsors shoulder increased responsibilities, necessitating expertise in various domains. These encompass financial management, vendor oversight, regulatory compliance, cost control, and data security.
Self-Insured Health Plans – How We Help
Our team of health plan advisors have worked with plan sponsors from medium to jumbo health plans for more than 3 decades to help them address these responsibilities through a comprehensive suite of services and technology designed to mitigate operational and compliance risk. This includes everything from Fiduciary Oversight of plan Sponsor’s health plan, claims audits, to cyber risk assessments.
Types of Plans We Evaluate
- Medical
- Mental Health
- Prescription Drug
- Dental
- Vision
- Disability
- Health FSA
- Other Ancillary Plans
Advisory Services
We leverage technology, data analytics and digital solutions to provide actionable insights to our clients for better decision making.
- Risk Assessments
- Claims Audits
- 100% Electronic Claims Review
- Operational Reviews
- Focused Claims Audits
- Statistical Claims Audits
- Manufacturer Rebate Audits
- Compliance Audits
- HIPAA Assessments
- Litigation Services
- General Healthcare Administration Consulting
- Education and Training
- Cybersecurity Risk Assessments
- ASO Contract Reviews
- Third-Party Vendor Assessments
- Eligibility Process Reviews
+0K
From Plans with 2K to over 600K participants
Success Stories: How Our Services Helped Transform Businesses
Case Study: Elevating Healthcare Claim Payment Accuracy
Learn how Withum helped a prominent national multiemployer plan sponsor recover $2.1 million in rightfully owed funds.
Learn MoreCase Study: Achieving Financial Stability Through Healthcare Claims Administration Review
Learn how Withum helped improve financial stability and uncovered issues in stop loss administration, leading to successful resolutions through strategic negotiation.
Learn MoreClient Testimonials
Collaborating with Withum proved instrumental in addressing our health plan's challenges. We were experiencing unexplained cost increases that raised concerns among our stakeholders. Withum not only helped us uncover the underlying reasons for these increases but also identified significant errors in the processing of our stop-loss coverage. Their expertise, meticulous approach, and dedication to delivering concrete results have positioned Withum as an invaluable partner. We appreciate their insights and highly recommend their services to any plan sponsor seeking clarity in the administration of their health plan.
Large privately held company
Contact Us
For more information or to discuss your business needs, contact Withum’s Self-Insured Health Plan Advisory Services Team.
Leadership
Featured Insights
Elevating Vendor Oversight: The Crucial Role of Performance Guarantees
In the realm of plan sponsor vendor oversight, the pivotal role of well-defined, mutually agreed-upon contractual performance guarantees (PGs) cannot be overstated. These guarantees, when intricately tied to key performance […]
Unveiling the Impact of Auto Adjudication Rates on Insurance Claims Processing
Understanding your insurance carrier’s auto adjudication rate can offer valuable insights into the efficiency of their third-party claims processing. Have you ever inquired about your auto adjudication rate and compared […]
The Significance of an Administrative Manual in Effectively Managing Employee Health Plans
Within the context of employee health plans, the partnership between a plan sponsor and its administrator holds paramount importance in ensuring seamless operations and prudent management of plan assets. To […]