Health Benefits 2018-09-21T12:58:40+00:00

Health Benefits Consulting Suite

Claros Analytics HBC Suite is 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.

Our HBCS applications provide plan sponsors and their advisors with powerful tools to model the impact of plan changes, identify the risk/reward profile of alternative self-funded plan structures, and calculate a group’s projected claims experience.

Health Benefits Chart

Cutting Edge Applications for Analysis & Design of Health Care Plans

Actuarial Assistant (AA)

Innovative Analysis of Plan Cost Dynamics


Compare, Evaluate, Analyze & Customize Plan Options for Your Clients

By comparing two plans side by side and allowing for customization, Actuarial Assistant can provide quick answers, and also has the ability to perform a sophisticated analysis. To aid in evaluating plans and potential changes, the dollar impact of each decision is illustrated in real time, in the context of the user experience.

Actuarial Assistant is updated annually and has the ability to archive plans and scenarios for later recall and modification.

Key Features

Actuarial Assistant (AA), Claros Analytics’ medical and Rx plan relative value solution, enables users to perform sophisticated analysis efficiently.

  • 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

Experience & Migration Predictive (EM)

Robust Experience Analysis


Put Predictive Modeling to Work for Your Clients

By utilizing up to three years of claims, our predictive solution normalizes data for large claims and adjusts annually for changes in demographics, plan design and other factors. This solution’s migration algorithm can predict where plan participants are likely to enroll given past benefit decisions and simulated future requirements. Claros’ Predictive Modeling can also anticipate participant cost sharing and contributions, allowing benefits managers to complete the annual budgeting process.

Experience/Migration Predictive (EM) is updated annually and has the ability to archive plans and scenarios for later recall and modification.

Key Features

Experience/Migration Predictive (EM) enables users to execute traditional experience projections and budget rate developments, and offers a predictive twist.

  • Utilizes up to three years of past claims to develop the expected medical and Rx costs for a plan
  • Adjusts each year for demographics and plan changes
  • Forecasts the employee migration for up to six current plans into a new mix of plans for the next year
  • Creates budget/funding rates for the following year’s plans
  • Demonstrates scenarios where a change of plan may cost more than expected

Risk Decision Support (RD)

Sophisticated Illustration of Stop Loss Risk/Reward Profiles


Analyze and Make Recommendations on the Best Risk Structure for Your Client

Help your client make an educated decision as to whether the group should self-fund or stay fully insured. With this solution, advisors can evaluate a group’s risk in terms of capital at risk, return on capital at risk, and the likelihood of beating a fully insured (riskless) benchmark. The solution will also find the risk structure that meets the group’s risk tolerance level. The solution will also present a visualization of the relative risk/reward profile of different self-funded structures.

If a group is currently self-funded, Risk Decision Support can also evaluate the appropriate specific deductible level, and whether an aggregating specific corridor should be used based on the group’s risk tolerance level.

Risk Decision Support is updated annually and has the ability to archive plans and scenarios for later recall and modification.

Key Features

Risk Decision Support (RD) enables users to evaluate whether or not a group should move from a fully insured to a self-funded plan. If the group is currently self-funded, different risk structures within self-funding can also be explored.

  • 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

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

Underwriters, Carriers
and Reinsurers

Man on Cell Phone at Computer

Health Plan Advisors, Administrators and Plan Sponsors

Person handing insurance card to doctor

Managed Care

Stethoscope on table


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