Employer Groups & Broker Consulting

Data-driven guidance for employer groups and health insurance brokers.

For employer groups and health insurance brokers, optimizing coverage while minimizing financial risk is a difficult balancing act, made all the more difficult by the complexities of healthcare markets. Wakely is the intermediary you need to guide your decision making. We provide expert actuarial consulting and analysis for the brokerage community, multi-employer arrangements, and employers. Our in-depth knowledge of healthcare markets, unique analytical tools, and decades of experience lead our clients to data-driven solutions that balance the needs of all involved.

Our services for employer groups and brokers

This easy-to-understand but comprehensive report of current and projected experience is available for all major funding types. Our Renewal Evaluation report can also be customized to include any future changes to an employer’s plan offerings and strategy.

Wakely can provide detailed analysis and guidance regarding current and future benefit plan designs, including employee migration analysis. We also offer actuarial value attestations for Federal Minimum Value or Part D.

SIFA highlights the differences and risk considerations an employer can expect to see between fully-insured and self-insured funding arrangements. For employers considering a funding change, this report is essential for assessing the risk of each option.   

Wakely’s IBNP report uses industry-standard actuarial methodology and our proprietary model to provide estimates of outstanding claims liability, including analytics to facilitate decision-making and financial planning.

Using a Monte Carlo simulation, Wakely can assess an employer’s risk at various coverage levels for both specific and aggregate stop-loss, backed by Meritave Marketscan healthcare data. By adding employer-specific data and demographics, we also compare expected catastrophic claims to current experience, which helps evaluate the reasonableness of stop-loss premium rates. 

To assist employers with the estimation of COBRA rates, Wakely offers a top-to-bottom analysis of current premium equivalents and healthcare experience, with reasonableness and quality data checks.  

Wakely’s analytical depth and expertise can help brokers and employers with a detailed peer review of financial dashboards or other financial summary reports for accuracy and reasonableness.

Wakely can help brokers and employers compare premium contribution scenarios using experience from our own book of business, as well as publicly available employer health benefit surveys.

Wakely offers a comparison and feasibility analysis of claims experience, demographics, and risk characteristics to help employers evaluate benefit offerings during their M&A. Our actuarial analysis provides valuable insights on risk considerations between different populations. It also includes rate development for the upcoming plan year.

Wakely supports Multiple Employer Welfare Arrangement (MEWA), Association Health Plan (AHP), and Insurance Captive arrangements with rate development and ongoing monitoring. The Wakely team has significant experience with managing a portfolio of employer groups. We can assist you with:

  • Development of rating tools for new groups
  • Renewal block management and risk bucketing
  • Financial monitoring
  • Regulatory compliance
  • Overall strategy with top-line and bottom-line consideration

Wakely helps small and large group employers perform comparative analysis on the design and application of quantitative treatment limits (QTLs) on mental health or substance use disorder benefits, in compliance with the Consolidated Appropriations Act.

By helping brokers and employers evaluate the efficacy of third-party vendor solutions for cost containment or care management strategies, Wakely can assess the impact to an employer’s total healthcare costs.

Our products for employer groups and brokers

Wakely has developed these industry-leading products and tools, which empower our clients to make highly informed strategic decisions.

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Wakely ACA Database (WACA)

Contains the most robust and detailed ACA data available in the industry.

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Wakely Plan Valuation Model (WPVM)

Supports pricing, mental health parity compliance, cost and utilization analysis and more.

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Wakely Analytics Health Operations Optimization (WAHOO)

Helps payers and providers optimize financial performance with a complete package of services and tools.

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Wakely Affordable Care Act Competitive Analysis Tool (WACACAT)

Allows users to interactively explore market metrics.

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Wakely Risk Assessment (WRA)

Provides a transparent, open-code, high-performance risk assessment model.

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Wakely Medicare Repricing Analysis Tool (WMRAT)

Aids the comparison of payment rates across multiple lines of business, categories of service, geographic locations, and providers.

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We back your strategies with a wealth of data.

We back your strategies with a wealth of data.

Wakely consultants draw on a broad range of data sources to assist you in market analysis, benchmark development, strategy and more. Here are just a few:

  • Medicare 100% Research Identifiable File
  • Medicare Limited Data
  • Wakely Medicare Advantage Aggregate Client Data
  • Wakely ACA
  • Large Group Commercial Data

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Healthcare Industry Insights

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Michael CohenBy Michael Cohen
weekinwashington1
Michael CohenBy Michael Cohen