Our service team is continuously cross-training with the objective being any AVI Tribal representative having the ability to assist you on a day-to-day basis. Our philosophy is over-servicing. Some clients require a very high level of service, contact and communication. Others prefer to be more self-sufficient. We assume each client requires the highest possible level of service and product.
We believe that a great way to judge the success of any broker/consultant is to look at a track record. Many of our clients wish to remain confidential, while others prefer to advocate on our behalf. We are often called in to assist in repairing broken self-funded plans through a referral.
“I would highly recommend Steven (AVI Companies) for any enterprise looking to improve their cost/benefit ratios on their insurance policies. Steven is an expert and his results far exceed his peers in the industry.” – Robert Kennedy, CEO Susanville Indian Rancheria Corporation
Our unique background in underwriting, coupled with our proven track record of success with Tribal entities gives our clients the assurance that AVI Tribal is the very best in the industry.
We take a very hands-on approach for service. Our team prefers to lead Open Enrollment meetings and be available for one-on-one enrollments with employees that may not be comfortable communicating all of their health insurance concerns with a representative of your HR department. Not only does this free up time and alleviate some of the pressure of Open Enrollment for HR, but it also avoids potential HIPAA and other compliance issues. Every communication between our staff and our client is logged, tracked and filed once completed.
Claims processes vary from carrier to carrier, which is why we have a staff member dedicated to handling employee claim issues. Whether it is a pharmacy refusing to refill a hydrocodone prescription or a hospital trying to provide less than acceptable services, our staff has the ability to push claims issues through the system and get the Rx filled. We continue to push for employees to make absolutely sure that we have exhausted every avenue possible to provide employees the very best benefits.
Additional Benefits
Being recognized as a leader in the Tribal marketplace, AVI Tribal is directly appointed with all vendors/carriers that represent a viable product. We only do business with the best vendors which represent the strongest networks, products and rates. With a national presence, we are constantly researching the viability of particular carriers in different geographic areas for our clients. One of the biggest mistakes an employer can make is taking on a self-funded plan with an under-informed broker/consultant. As a Tribal environment continues to grow and add employees and facilities, the overall effectiveness of the benefit package is reviewed more frequently. Upon reaching a certain size or premium amount, most firms will elect to go self-funded with a less expensive network, not realizing network has a direct financial impact on the employer through claims. We take the additional time to run self-funded feasibility reports, financial impact reports and network reports that give our clients and executives a much more thorough review of the market.
Our team is uniquely qualified in self-funding. Steve Trott, the lead consultant at AVI Tribal came from a leading carrier, where he served as a lead underwriter on large self-funded accounts. His experience and understanding of the market is unparalleled. Steve was the lead underwriter on one of the first large Native American entities to seek medical insurance, and has since become recognized as an expert in the Tribal space. We make a point to hire industry leaders coming from carriers for both account management and underwriting.
Most organizations over 500 employees start to seriously consider self-funding. The three major challenges companies this size will typically experience will be a broker/consultant that is less informed on self-funding. This can create a position of weakness for both the broker and the employer. Every vendor/carrier, without fail will take advantage of an under-informed consultant by passing on additional costs.
Another major challenge is the administration of the health plan. Sometimes larger self-funded employers will adjust specific deductibles in order to contain cost when the health plan itself can be analyzed and tweaked in certain areas to have a positive effect on claims. We analyze all utilization patterns and constantly report findings along with recommendations. The third most common challenge we will recognize within a self-funded plan is communication. If employees, HR or managers/directors are under-informed or not completely educated on the intricacies of self-funding, the plan will fail. Communication on all levels is incredibly important to us. We use many different tools to increase communication, which will be discussed below.
For our self-funded accounts, we typically begin the process of renewal about 6-7 months in advance of the actual effective date. We use a process called “snapshotting.” This process is the most important part of the renewal process because it essentially describes your group to an underwriter. If we snapshot claims at the correct time each year, we ensure that the data and information is accurate, concise, complete and showing the very best data to carriers/vendors. If a broker/consultant snapshots a group at the wrong time of year, claims may be skewed in a poor light or utilization may be artificially good.