Benefit Design
Introduction
The Benefit Design Modeler allows you to Forecast the cost and utilization impact of changes in current health plan designs, and Model the likely cost and utilization pattern of new health plan designs.
The benefit design modeler allows you to:
a) Forecast the cost and utilization impact of changes in current health plan designs, and
b) Model the likely cost and utilization pattern of new health plan designs.
These models may incorporate demand-side assumptions about the shift of employee enrollment across benefit plans. To support these capabilities, users may choose from a number of forecasting / rating methodologies:
- Manual rating
- Experience rating
- Blended rating
Features
- Manual and Blended Rating
To support manual rating and blended rating, the CKM system incorporates standard actuarial approaches to medical and prescription drug cost trend rates, to area adjustment factors (3 digit zip or SMSA), stop loss options, and so on.
The CKM system is able to import details of plan design such as tier structures, benefit coverages, network offerings, and exclusions/limitations from computerized procurement systems. By importing rather than entering plan design details, the user may focus upon elements of change rather than documentation of existing provisions.
- Experience and Blended Rating
To support experience rating and blended rating approaches, the benefit design modeler relies upon the data mining capability of the CKM system. The CKM analytic engine assembles and organizes appropriate retrospective data from within the data warehouse to populate the historical component of the rating model.
Benefits
There are many benefits in use of the BDM modeling program.
- Efficient and timely preparation of plan designs.
- Prospective benefit design model creation in minutes.
- Actuarially sound benefit design.