Harness the
Power of Data

to control benefits and risk program costs

Employee benefits are one of your biggest cost drivers. You’ve tried cost sharing and implementing health and wellness initiatives, yet costs continue to rise.

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Employees can’t shoulder any more of the burden. In some cases, they’re postponing treatments—they just can’t afford them. If their conditions worsen without proper care, you could actually be increasing your healthcare costs through emergency room visits and hospital stays. And that doesn’t even take into account how your workers’ compensation and disability costs or employee productivity are being impacted.

Gain Clarity Through Data Analytics

You use data to make strategic business decisions every day. But you don’t demand the same level of data insight from your benefits and risk programs. That’s why you aren’t able to significantly impact program costs.

Different vendors house your data—health, pharmacy, workers’ compensation, disability, etc.—in separate silos. You get static, quarterly or annual reports that don’t offer much insight. Your advisors have to manually go through the data, which is expensive, time intensive, and could result in erroneous interpretations. You are unable to see how changes to one program impact another, and you can’t perform any other type of detailed analysis.

To make sustainable changes that control your costs and improve employee health outcomes, you need to integrate all of your benefits and risk program data in a single, secure platform. Once your data is integrated and validated, you will have the visibility and clarity you need to make informed decisions about the quality and efficacy of your benefits and risk programs.

The platform should automatically analyze your data and provide instant access to automated alerts that prioritize your issues, showing you where to focus your efforts first. A best in class solution allows you to securely collaborate and engage with your advisor within the platform to ensure that your data is secure.

What Data Should You Assess?

The more data you integrate, the more insight you will glean. To keep the data current, you should schedule at least monthly data feeds. And to identify trends, you should start with at least three years of historical data.

At a minimum, you should assess:

The total amount you spend on healthcare, and how that cost is trending. You need the following data to perform an accurate assessment:

The health of your population

Enrollment and eligibility data and trends

Wellness engagement and program participation rates and trends

Absence management data and trends

With integrated access to timely data, you get answers to your questions in minutes rather than waiting days or weeks. Innovu offers the most scalable solution and analytics support to give you the insight you need to transform your benefits and risk programs.

Let Innovu harness the power of your data to empower you to make data driven decisions about your benefits and risk programs.

Real time insight

to make informed benefits and risk program decisions

Most data analytics solutions on the market today provide static reports that focus only on medical and pharmacy data. Some even rely on data that is two years old.

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To make impactful decisions about your benefits and risk programs, you need real time insight. Your data needs to be current and accessible. For most types of data, you should schedule at least monthly data feeds. Timely data is key to driving actionable insight.

Innovu encourages you to schedule at least monthly data feeds.

Integrate Your Data

You need to integrate all of your benefits and risk program data into a single, secure platform so you can get a 360-degree view of your population. If your data isn’t integrated, you aren’t able to see program correlations or uncover root causes of why issues are occurring.

Innovu doesn’t limit the number of data sources we collect for you.

Analyze Data Automatically

To reduce the time needed to discover actionable insight and decrease your chance of missing critical information, your solution should provide automatic analysis of your data. This gives you instant access to actionable insight you can use to make strategic decisions about your benefits and risk programs.

Innovu generates reports instantly to give you actionable insight to make informed, data driven decisions.

Prioritize Issues

With so much data available, you might not know where to start. You may waste resources on interventions that have little impact because of static reports showing you only part of the picture.

Innovu’s IntelligentAnalysis shows you where to look first.

Explore Your Data

You should have access to your data so you or your benefit advisor can mine it for answers to your questions and uncover why issues are occurring in your population. With real-time data across all of your programs, you get actionable insight to make data driven decisions.

Innovu allows you and your advisor to mine the data to identify root causes of issues impacting your benefits and risk programs.

Engage with Experts

You aren’t an analytics expert. Having a team of analytics experts to help you understand your data and identify problem areas would make your programs even more successful. Secure collaboration with our analytics and your advisors is built right into the platform.

Innovu’s benefits and risk experts, healthcare analysts, and business specialists engage with you and your data to get you the actionable insight you need.

Innovu empowers you to use timely data across all of your programs to make informed business decisions.

Data Transparency

In Benefit and Retirement Plans

It’s important for every business to have access to timely, transparent data—especially in regard to employee benefits plans. Not only will you have insight to provide your employees the best plans with such access, you are protecting yourself from possible legal headaches in the future.

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Consider the following.

The Department of Labor (DOL) oversees businesses’ employee benefit plans. Under the Employee Retirement Income Security Act of 1974 (ERISA), you are responsible for acting in your employees’ best financial interest when selecting your plans, how your plans are set up, and how they are administered. In other words, you are legally required to act as a fiduciary for your plan’s beneficiaries. Non-compliance with these requirements can result in fines, penalties, and lawsuits, depending on the violation.1

What Are Your Fiduciary Responsibilities?

As previously stated, employers and advisors are required by law to act in the best financial interest of their plans’ beneficiaries, and to monitor the plan’s administration with adequate knowledge. This obligation is not limited only to pensions and 401(k)s—employers and plan sponsors must meet the same fiduciary duty when it comes to healthcare benefits and other employee benefit plans.

Ideally, a prudent administrator would ask questions such as:

This high focus on fiduciary responsibility may lead you to believe that ERISA violations are the result of plan administrators who put their interests before the beneficiaries’ interests. However, this is usually not the case. Most violations are due to errors in administering the plans, which includes monitoring performance of the plans in terms of cost, quality, and efficacy.

A $50,000 Mistake Caught by Prudent Monitoring of Plan Performance

As the saying goes, “ignorance of law excuses no one.” ERISA violations are no exception. Due to the complexity of benefit and retirement plans, some companies don’t have the resources to monitor these plans in line with their fiduciary obligations. In addition, a large majority of companies don’t have access to the detailed data their plans generate—this lack of access prevents companies from verifying that plan funds are being spent as beneficially as possible. Without your company’s detailed healthcare and benefits data and the ability to analyze it, you won’t be able to easily identify areas for improvement or derive a more detailed understanding of your medical, prescription, workers’ compensation, and other benefit plans. You also won’t know if the root of the problem lies with the healthcare provider.

Here’s a case of note: in August of 2016, a self-funded employer with more than 40,000 covered lives in Western Pennsylvania integrated its data with Innovu. Automatic analysis identified end stage renal disease (ESRD) as one of the client’s top two costliest chronic conditions.

Innovu’s benefits experts knew that Medicare becomes the primary payer for ESRD patients 30 months after diagnoses, so they dug deeper to see if our client was paying for claims that Medicare should have been paying. We discovered that our client continued to pay for services for a claimant after the 30-month eligibility period had passed.

We alerted the client and their benefits advisor to the issue. We then provided the advisor with the claimant’s name and information needed to approach the carrier. In the end, the carrier issued a reimbursement check for $49,600 to Innovu’s client.

In the above case, it was the employer’s responsibility to recognize that they were overpaying for their medical claims. Without Innovu’s services, this mistake would have cost them nearly $50,000 in unnecessary expenses that could be better applied to delivering new programs or containing costs to minimize future insurance cost increases.

Demand Your Data

As an employer or advisor, it’s your fiduciary responsibility to monitor whether plan funds are being spent in the most beneficial manner on an ongoing basis. What can you do to ensure that your company is complying with ERISA and—more importantly—ensure that your beneficiaries are not overpaying for their plans?

First and foremost, you and your advisors must have unfettered access to your plan’s detailed data. This access gives you the foundation to develop the insight to proactively identify and take action where your plan may not be running in the best interest of your beneficiaries. You will also be able to identify and mitigate risks in your plan by leveraging the knowledge and experience of your advisors who now have better access to your critical data across all programs.

However, accessing your data is not as easy as it sounds.

You might not be allowed to see your own data due to restrictive provisions in an administrative services only (ASO) agreement with your plan administrator. Furthermore, your business associates are typically required to sign non-disclosure or confidentiality agreements (NDAs) before they can access your data on your behalf. These NDAs limit how the data can be used, including prohibitions against data aggregation and the combination of provider and financial fields. Without access to and the use of your data, you are prevented from improving your beneficiaries’ access to better benefits; you also are not able to easily identify and mitigate your plan’s risk. Your limited access to data hinders you from carrying out your legal responsibilities as defined under ERISA.

In order to best comply with ERISA and effectively improve your employees’ access to better healthcare and benefit plans, you must demand data transparency. In other words, you must ensure that you have unrestricted access to your detailed data. To accomplish this, you should include broad data access provisions in your requests for proposals and in any ASO agreements. Establishing ownership and access to your own data are critical elements in making sure that your plans are being administered in the best interests of your beneficiaries.

Let Innovu Empower You

Data transparency puts you in control of your program costs by allowing you to monitor and maximize your program assets—all of which will lessen the chance of hefty fines due to fiduciary mismanagement. Let Innovu empower you through better data access with our EmployerLens solutions.

EmployerLens helps you meet your fiduciary responsibility by enabling you and your advisors to access your data, monitor performance, and address changes in trends that could be missed. Our solutions effectively allow you to make strategic decisions that affect the cost, efficacy, and quality of your benefit and risk programs.

You can learn more on the EmployerLens product page.