WHAT YOU NEED
Integrated Health Plans
Franklin Health is a proprietary platform offering integrated level-funded health plans and consortiums. A Crumdale Partners program, Franklin Health supports innovative and proven cost-containment measures to reduce costs and create better experiences for employers and their employees.
This platform combines best-in-class components of an integrated health plan while offering dynamic and innovative solutions to achieve extraordinary results.
Franklin Health is available to all employers with at least 25 enrolled employees who are tired of double-digit renewal increases and see the advantages of buying into a multi-year approach designed to deliver savings, transparency, superior member experiences, and risk pooling.
Our transparent and innovative program is ideal for fully-insured groups looking for more renewal stability with a structured approach to self-funding and self-funded groups that are experiencing significant increases due to lack of claims control.
WHAT YOU NEED
Best-In-Class Integrated Health Plan
Franklin Health combines best-in-class components of an integrated health plan while offering dynamic and innovative solutions to achieve extraordinary results.
Innovative Approach: Five Core Components
- Active Claims Monitoring
- Member Advocacy & Support
- Independent TPAs
- Custom Rx Programs
- Group Purchasing Stop-Loss
Active Claims Monitoring
We offer protection from high-cost medical claims due to fraud, waste, or abuse with our active claims monitoring. Our expert clinicians and in-house pharmacists analyze claims, identify errors and implement improvements for savings through experienced claims negotiation.
- Expert clinician and pharmacist oversight
- Real-time claims analytics
- Cost-saving intervention
Member Advocacy & Support
To ensure clients get the most out of their benefits, we offer ongoing benefits navigation and HR support to improve utilization for employers and employees. We use technology-enabled tools with proprietary data analytics to navigate the best health options, improving member experiences.
- HR Support for employees to improve health benefits navigation
- Proprietary data analytics to find the best physicians
- Member concierge services to alleviate issues
- Strength of multiple networks and partners for competitive benefits and ensured coordination
- Fast and smooth implementations with 11 pre-built plan designs, SBCs and SPDs to streamline the process
- Stop-loss and active claims review and monitoring to protect against unexpected high costs of care
Group Purchasing Stop-Loss
Crumdale provides a strategic approach to underwriting so clients can leverage our global volume for access to leading rates, terms, and discounts. This type of underwriting also promotes long-term financial success by promoting strategic planning.
- Stop-loss leverage provides favorable discounts, terms, and conditions
- Pooled arrangements significantly decrease renewal volatility
- Allows for strategic planning around a long-term financing strategy
Custom Rx Programs
Our in-house pharmacy benefits team provides continuous high-cost claims management and high-cost drug support. Our proprietary PBM contracts include specialty drug management, alternative sourcing solutions, and pricing validation to identify and implement solutions to cut unnecessary costs.
- In-house pharmacists and PBM experts
- Continuous high-cost drug support
- Alternative sourcing for specialty drugs
Short-Term & Long-Term Support
- Short-Term & Long-Term Strategy: Renewal Expectations & Goals
- Quoting: Risk Analysis & Quote Delivery
- Implementation: Vendor Notification & Plan Build
- Ongoing Support: Claims Review & Risk Analysis
Partnering With Brokers
We take a collaborative and consultative approach when it comes to plan development but handle all of the fine details behind the scenes so you can focus on what you do best – managing clients.
Even After Signing
Our relationship doesn’t need to end when the contract closes. Let our health insurance experts provide ongoing HR support, benefit navigation, and education services, so employees get the most out of their insurance and benefits.