Innovative Software Solutions For Pricing, Analysis & Design Of Healthcare Plans

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Cutting Edge Applications for Analysis & Design of Health Care Plans

About Us

Claros Analytics is an actuarial software firm that develops cutting edge software for pricing and analysis of risk in health care plans and health care systems.

Actuarial Advisor, our health benefits rating manual, is used by underwriters, carriers, reinsurers, and consulting actuaries.

The Health Benefits Consulting Suite applications are used by benefits advisors, consultants, TPAs and plan sponsors to credibly model health plan design changes, the risk-reward dynamics of stop loss, and experience-based projection of claims.

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Health Benefits Consulting Suite

Comprised of three applications for employee benefits professionals who want powerful, credible, and easy to use tools that deepen and expand their consulting capabilities for their client’s health benefits plans.

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Actuarial Assistant

Detailed modelling of health plan design; allows for side by side comparisons of benefit designs and circumstances. Graphically shows the impact of changes and potentially mitigate losses.

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  • Values multiple plan changes (plan design, provider network, demographics & stop-loss levels)

  • Produces quick answers and sophisticated analysis

  • Provides details on drivers of change

  • Determines the impact of plan and population changes

  • Simulations: See the impact of adding aggregating specific corridors or health savings accounts to a plan

 

Risk Decision Support

Sophisticated analysis of the risk/reward tradeoffs in stop-loss structures. Provides employer ample information to properly evaluate the opportunity to move to self-funded plan. Enables a user to provide a detailed comparison of stop-loss structures.

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  • Evaluates the fully insured to self-funded decision

  • Locates the risk structure that meets a group’s tolerance level

  • Graphically displays and scores current or proposed risk scenarios versus various other options, illustrating the relative differences in expected return and capital at risk

  • Graphic display makes plan dynamics easy to visualize

  • Runs and tests multiple stop loss scenarios to find the optimal outcome

 

Experience & Migration

Robust experience analysis based on a consistent and actuarially sound methodology; simulation of employee enrollment in plans based on the group’s experience; set budget rates with analysis and predictive modelling of employee migration between plans.

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  • Values multiple plan changes (plan design, provider network, demographics & stop-loss levels)

  • Produces quick answers and sophisticated analysis

  • Provides details on drivers of change

  • Determines the impact of plan and population changes

  • Simulations: See the impact of adding aggregating specific corridors or health savings accounts to a plan

 

Our products give the following clients the most accurate information to help them make decisions

Health Plan Advisors, Administrators and Plan Sponsors

Cutting edge capabilities bring you a competitive advantage.

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Managed Care Providers

Customized solutions for risk pricing and contracting negotiation.

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Underwriters, Carriers and Reinsurers

Industry-leading first dollar and stop-loss rating manual.

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Our Services

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Software Solutions

Our software solutions are built on a robust healthcare claims database. The database underlying our model represents medical and pharmacy claims data of more than $100 billion in charges, on more than 10 million commercial, nationwide member lives.

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Consulting Services

Consulting services are available through our partner, Windsor Strategy Partners; a strategic actuarial consulting firm dedicated to helping healthcare clients maintain and grow their businesses. Services include product pricing, model building and data analysis, underwriting, strategic planning and business strategy.

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Strategic Partners

We align ourselves with strategic partners who focus on the challenges and opportunities that influence your business across the healthcare domain.

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