Common use of Medical Plan Management Clause in Contracts

Medical Plan Management. 1) Provide monthly and/or quarterly review and analysis of health benefit plan expenses including an analysis of claims data and summaries of claims, administrative and stop- loss expenses. 2) Provide analysis and review of loss ratio and claims history, and emerging utilization trends. 3) Conduct annual benchmarking in terms of health benefit plan design and premium contribution of city’s health plans against other comparable organizations on a national, regional, and local basis. 4) Evaluate plan financial performance and funding strategy. 5) Evaluate reserve status and requirements. 6) Assist in evaluating the effectiveness of the City’s wellness initiatives. 7) Assist in evaluating the efficiency of the administrative service provider’s performance and reporting and determination of ongoing reporting needs. 8) Provide actuarial certification for the City’s COBRA rates and provide actuarial attestation for the Medicare Part D subsidy should the City make application.

Medical Plan Management. 1) Provide monthly and/or quarterly review and analysis of health and dental benefit plan expenses including an analysis of claims data and summaries of claims, administrative and stop- stop-loss expenses. 2) Provide analysis and review of loss ratio and claims history, and emerging utilization trends. 3) Conduct annual benchmarking in terms of health benefit plan design and premium contribution of city’s health plans against other comparable organizations on a national, regional, and local basis. 4) Evaluate plan financial performance and funding strategy. 5) Evaluate reserve status and requirements. 6) Assist in evaluating the effectiveness of the City’s wellness initiatives. 7) Assist in evaluating the efficiency of the administrative service provider’s performance and reporting and determination of ongoing reporting needs. 8) Provide actuarial certification for the City’s COBRA rates and provide actuarial attestation for the Medicare Part D subsidy should the City make application.