Our evidence-based approach and quantitative results impact bottom lines. Taking a forensic approach to data analysis, we negotiate vigorously with carriers on your behalf to achieve the best possible financial terms.
Pacific Resources provides significant expertise in all aspects of financial underwriting of Life, Accident (AD&D), Disability, Dental and Voluntary Benefits programs. We understand the cost drivers, claim patterns and expense loads associated with these programs. Our financial models develop accurate loss ratios and claim picks, identify the true cost of the programs and assist us in negotiating the most favorable terms and conditions. Our deep understanding of the entire financial snapshot of Life, Accident (AD&D), Disability, Dental and Voluntary Benefits products affords our clients the most competitively priced programs in the industry.
Due to our exposure to the vast spectrum of funding methods, we are able to evaluate our clients’ current arrangements as well as determine more viable and cost effective funding solutions. Our cost analysis includes factors such as loss ratio development, claim picks, targeted market pricing and review of FAS 106 and 112 liability.
Retiree exposure, including those for closed groups, can represent a significant FAS liability for many employers. We conduct comprehensive reviews of our clients’ retiree liability and determine the best course of action to help mitigate employer costs. In the case of a buy-out, the liability is transferred to an insured contract through a one-time premium payment, thereby removing the employer’s FAS liability.
As with the retiree FAS liability review, we also perform the same evaluation of self-funded Long Term Disability liability. We coordinate the carrier’s takeover of the liability and ensure that the process is seamless and all but invisible to the claimants.
As Long Term Disability claims age, they typically move into "Stable and Mature" units within the managing carrier/TPA. The claim is often only touched on an annual basis, through a very cursory review. LTD Redevelopment looks at claims on an individual level with a fresh, unbiased review to uncover termination potential, possible settlement, re-employment, overpayment recovery and SSDI changes. The financial outcomes of this review can lead to substantial LTD reserve reductions, collateral FAS 112 reserve reductions, reduced monthly benefit payments and future service cost reduction.
Part of our overall objective is to eliminate any surprises at renewal. We monitor ongoing plan performance by conducting frequent, in-depth experience reviews. Our renewal negotiations begin early in the renewal cycle, affording additional time to understand ongoing claims experience and trends. This allows us to extrapolate immature or less revealed experience and ensure our clients get the most favorable renewal position possible.
The financials associated with any Life, Accident (AD&D), Disability or Dental plan are not completely illustrated by a carrier’s experience summary. While premiums, paid claims and outstanding reserves represent major components of a plan’s performance, items such as IBNR calculation, reserving methodology, tolerable loss ratio analysis and Social Security Disability Award rates and processes can have substantial impacts on a plan's overall health and performance. We thoroughly review every aspect of our clients’ plan financials, going back several years, to determine the true financial health of the plans. We then benchmark the results to the current financial environment.
Pacific Resources has extensive experience in reviewing claim and reserve data for Life, Disability, Accident (AD&D) and Voluntary Benefits programs, and in using this data to find opportunities to create better risk pools and control costs for our clients. Our underwriting expertise sets us apart from our competition. We do a very deep analysis focusing on the diagnostic distribution of claims, demographics, and incidence and severity trends in order to make recommendations and negotiate the very best deal for our clients. We know the intricacies of the reserving models used in the industry, and use that knowledge to ensure that accurate disability claim reserves are used for our clients’ programs. In addition, we ensure fair IBNR and premium waiver reserves are used in prospective pricing, and we perform retrospective reviews to accurately price plan alternatives. We bring everything together to create innovative solutions as well as the most competitively priced programs in the industry.
Due to the size of our clients, we recognize that rates and plan designs have to be negotiated and finalized far in advance of the renewal date. In anticipation of the upcoming renewal, we provide our clients with a complete understanding of their plan’s experience at each quarterly meeting so that any renewal position will not be a surprise. This enables us to have early discussions regarding the expected renewal position so we can develop a strategy for the renewal, which may include the release of an RFP to test the market. Our goal through our renewal negotiations is to ensure that our clients’ rates and fees are priced appropriately and competitively so the plan has long term rate stability.
In addition to auditing a credible sampling of Life, Accident (AD&D), Disability and Dental claims for plan design administration, performance and service level, claim payment, and financial and coding accuracy, our auditors and account staff meet with the claims team to fully understand roles, responsibilities, intervention points, and frequency and availability of clinical resources. We work with the carrier and our client to ensure that best-in-class processes are implemented and that claims are paid correctly and in a timely manner.
"I appreciated the outstanding work Pacific Resources put into the RFP effort. Pacific Resources has performed exceptionally well in my opinion and I am grateful for the opportunity to have worked with them. I consider the selection of and the work product produced by Pacific Resources to be some of the real highlights of my work supporting the Benefits team.”