Please find below a link to BAN’s Legal Alert on Notice 2020-76, which extends the deadline to provide
About Plan Analysts
We know this business
We know we have to deliver in order for our clients to be successful
This is what we do
As the pressure of rising health costs and governmental regulations squeeze the bottom line, finding an advisor with the right experience is essential to achieving your mission, now and in the future. We have the right team of experts with the experience to navigate these disruptive times and bring common sense approaches to complex issues.
Who We Are
Employee Benefits leader for over 35 years
North Florida Benefit Advisors Network Partner
Sole focus on Employee Benefits
Expertise – full spectrum of skills
130 years combined relevant industry experience
Multi-thousand life, Multi- location, Self-funded
Multiple Plan design and multiple division platforms
Effective communication with employees
Plan sustainability – cost control, Reporting
Flexibility, IT interface and support, Administration support
Employee Handbooks & Communication Tools
Our Commitment – to be Your Trusted Partner
Long term relationship strategy & history
CBO – Chief Benefits Officer mentality and performance
Delivering national resources with local service
Top 10 National Benefits Organization
Representing 10,000 employers
3.5+ million covered employees
$20 Billion in annual healthcare spend
Nationally recognized experts
Compliance, Communications, Medical, Actuarial, Wellness, DM, Audits, Rx, HDH/CDH, Self-funded, Retirement, Executive, Voluntary Benefits
Independently owned, Member directed, Collaborative organization
Entrepreneurial & Professional
Preferred Vendor Relationships
National Wiki based robust information sharing and collaboration system
Preferred Relationships: Carriers, Data Analytics, Wellness/Health Management
Save through PAHM (Plan Analysts Health Management)!
Detect and Reduce UNKNOWN High-risk medical conditions or even eliminate them. PAHM nurses also help members with KNOWN medical conditions.
What this means to you:
- Employees are less likely to have those time bomb claims
- Some large/shock claims are headed off as risks are uncovered and reduced
- Employees know what to do to better manage their condition and their lives
- Employees like their one on one relationships with real Nurses and respond
- You receive reports giving evidence of progress being made and proof of “what didn’t happen”
The advantage to you:
- Significant claim reduction
- More productive employees and lower absenteeism and related effects
- Employees save costs and perhaps lives/quality of life
- 90%+ participation using our effective and strong incentives
- Impact your health plan cost by effectively targeting large health risk through PAHM, or plan analysts health management
- Preventing ONE or FEW large claims can have a major impact to your spend and your employees lives
- Identify health problems and behavioral risk factors that influence health status, development and implementation of highly effective, targeted health prevention activities
- Shows the employer “what didn’t happen” and it’s value
- Reduces costs of surgery through pre & post-acute care coaching
- No employer net cost – costs are covered up front by non-participants and ongoing savings are demonstrated through the advanced accrual model analytics (not “ROI”)
How it works:
- Health Risk Management – Bio-metric Screenings
- Reveal unknown health conditions
- Reporting – Members are confidentially contacted about issues potentially seriously affecting their health
- Nurse Manager Coaching (RN) – One to one monthly calls following Prochaska’s behavior modification model for successful Disease Management
- Healthier employees
- Lower cost to your Health Plan
- Increase in productivity
$543,900 Savings for Lung Transplant Candidate:
48 year-old spouse participated in annual screening in August 2019. Identified through annual screening as morbidly obese, poorly managed blood pressure, GERD, and COPD.
Timing was everything in this case. Member not on shock claim list, not a high claimant yet – but the annual health screening put her on PAHM’s radar. Nurse care management outreach indicated that the member was having serious health issues which put her at high risk for hospitalization and her doctor put her on the transplant list. She is diagnosed with high blood pressure, COPD, morbidly obese. Member reported that her Pulmonologist put her on the transplant list as her lung capacity was not improving. Her nurse worked with her to follow-up with her physician, participate in pulmonary rehabilitation, compliance with COPD medications and to lose weight. Nurse Care Manager motivated her to exercise and work on breathing exercises. As of December 2019 her doctor took her off the transplant list. She has lost 23 pounds, compliant with her medications, and is committed to continuing exercise and to lose weight.
$226,550 Savings for Pancreatitis and Intestinal Surgery:
Plan Paid ICU and Hospital Stay, $34,512
Potential Savings: $226,550 (Plan Paid)
(Avoided Sepsis infection/extended hospitalization and nursing home recovery)
50-60-year-old male employee participating in annual health screenings and nurse care management since August 2019. Poorly managed cholesterol, blood pressure and diabetes. Member also now being followed due to being diagnosed with prostate cancer. Recent hospitalization for pancreatitis and intestinal surgery without complications.
This could have been MUCH worse! This member has been working with his nurse since August 2019 to improve managing high cholesterol, high blood pressure and diabetes. He is also obese with a BMI of 34.7. He has begun making dietary changes, losing weight, and becoming more compliant with medications. In the meantime, he was diagnosed and being treated for prostate cancer.
During his May nurse care management call he was complaining about diarrhea and noted that he had it for 3 weeks. He said he thought it was getting better and that it was just a virus. His nurse immediately advised him that a virus does not last 3 weeks and that this could be signs of a much more serious condition. She advised him to immediately contact his doctor.
His nurse learned during the recent June nurse care management call, that he followed her advice and his physician instructed him to immediately go to the emergency room. He was diagnosed with pancreatitis and due to bowel obstruction, required surgery to remove a portion of his small bowel. The member spent several days in the hospital on antibiotics before he was able to undergo surgery. He has recovered well without infection or any complications from surgery. His doctor advised him that if he had waited any longer, he would have resulted in sepsis which is a chain reaction in the body causing tissue damage, organ failure and often death. This member avoided a lengthy hospital stay and nursing home recovery. The member was also instructed on proper diet following intestinal surgery. He was very thankful that his nurse was attentive and responsive to his health concerns and helped him understand the need to immediately contact his physician.
Potential Savings: $226,550 -actual claim paid by Company ABC Health Plan for another member’s sepsis hospitalization and nursing home recovery.