It's hard to gauge how well a health plan is performing. Do our employees understand and get the most out of their benefits? How effective is our wellness program? Are we paying too much for services? These are typical questions. An Open-Platform Health Plan is a self-funded health plan with unique features that allow an employer to establish, track and review performance benchmarks and reduce their exposure to risk. HLU Consultants, Inc. is a privately held, independent consulting firm based out of Cincinnati, OH since 1961. The consultants at HLU successfully bring together a tremendous amount of industry expertise, valued partners and innovative technologies to design a better, cost-efficient health plan around a customer’s workforce. They help employers establish meaningful benchmarks so they can gauge the success of their plan with a focus on reducing costs, improving outcomes and helping employees successfully navigate the complex healthcare system.

1. It’s here. It’s time.
Re-Thinking the Traditional Health Plan
with YOUR BUSINESS in Mind

2. Imagine a health plan that offers. . .
Introducing: HLU Consultants
SCALABLE
SOLUTIONS
DESIGNED BY YOU
NO MORE generic,
cookie cutter plans that
consist of identical benefits
and a limited network
of partners
ALL OF THESE
THINGS AND MORE
add up to
significant annual SAVINGS
year after year!
FLEXIBLE,
MODERN-DAY
BENEFITS
NO MORE same-old
thinking based on the
idea of “this is how
we’ve always done it”
STRATEGIES FOR
MANAGING
OUT-OF-CONTROL
COSTS
NO MORE questionable,
error-filled claims
slipping through

3. HLU CONSULTANTS | Reclaim Control of Your Health Plan
For far too long, choosing
a health plan has gone
something like this:
Renewal time is coming so your broker schedules a visit
The same basic year-end spreadsheets are presented and the
dreaded news is relayed: rates are going up AGAIN
Your broker assures you this plan is still the most cost-effective
option (besides, switching now would be a huge headache,
wouldn’t it?)
You renew, shake hands and hope for the best
1.
2.
3.
4.

4. HLU CONSULTANTS | Reclaim Control of Your Health Plan
It’s here. It’s time.
But what if there was an
ENTIRELY DIFFERENT SOLUTION
out there for your business that
would mean a change for the better?
The WAY better?
A plan that would help contain costs
from day one and especially focus on
the key item that is so consistently
overlooked: out-of-control claim
costs? And what if that plan included
predictive modeling once it was in
place so you could actually see the
future impact of your out-of-pocket
cost savings?

5. HLU CONSULTANTS | Reclaim Control of Your Health Plan
HLU Puts Plan Control and
Cost Savings Back in your Hands
Control of Health Plan Employer Insurance company Insurance company
Provider Network Access
Data Analysis & Forecasting
Large Claim Case Management Analysis
Utilize Independent, Best-In-Class
Vendors to Reduce Claim Costs
Pricing Transparency for
Employee Medical Services
Customizable Summary
Plan Description (SPD)
Claim Review Procedure
Compliance & Employee Onboarding
HLU Open-Platform Health Plan
with Healthcare Intelligence
Hybrid Plan Platform
ASO, Insurance Company, Self-Funded,
Level-Funded, Balance Funded Plans
Closed Platform
Humana, Anthem, UHC, MMOH,
Aetna, etc.
Traditional PPO Networks, National Access
and Customizable Networks
Typically 1 or 2 PPO options
(One size fits all)
Typically 1 or 2 PPO options
(One size fits all)
YES - actionable data Basic claims and expense overview only
Data is not actionable
No data provided
YES - actionable data No No
YES No No
YES No or limited No or limited
No or limited
YES Yes - with limitations No
Claims are itemized and reviewed for
overcharges and billing errors
Full Service, Hands-Free Suite: FMLA, COBRA,
5500, ERISA, ACA, FTE Record-Keeper and filings
Claims are passed through and paid
by a summarized invoice
Limited
Usually reference materials only
Claims are passed through and paid
by a summarized invoice

6. HLU CONSULTANTS | Reclaim Control of Your Health Plan
We offer a smarter approach.
It’s an open-platform health plan that provides
the highest quality benefits at the lowest costs
with better employee health outcomes.
An exciting change for the better, this efficient and
cost-effective self-funded plan allows employees
and employers to reclaim ownership of their
healthcare benefits and costs.
It provides data you can act on and use to tailor
your plan for the greatest value . . . it’s structured
around a long-term strategy to continually control
plan design effectiveness and costs . . . and, it
simplifies administration and compliance
along the way.
For the employee, it’s empowering. HLU’s
Open-Platform Health Plan provides employees
with educational resources to help them make
informed decisions to select the best available
healthcare plans and options for their needs. The
result . . . better employee health and lower
plan costs.

7. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Consultant vs. The Broker
HLU serves as an independent consultant, not a broker. What does this mean?
Operating on our own, we take a totally objective approach to match your
plan with the best benefits and partners.
We’re not limited to working with a small ecosystem of defined partners or
big-name vendors, but rather, we’re connected to a wide-ranging network
of systems, resources and solutions to match accordingly with clients.
We don’t tack on costly brand-name fees and our business
isn’t driven by extra incentives or sales commissions.
Your account is handled by the same consultant,
not handed off from rep to rep.

8. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Understanding Health Care Hikes
& Hidden Costs
Health care costs are rising faster than inflation and wages. Another problem on top of that?
The traditional health plan is bloated with waste and inefficiency and offers very minimal control.
20-40%+
Rate Increases
9.3%
Employee Health
Plan Costs Increase
10x
Amount Overcharged
by Some Hospitals
80%
Family Premiums
Increase
There was a 9.3% increase
in employee health plan
costs from 2011-2012 (Kaiser)
Over the last 10 years,
family premiums have
gone up an average of
80% (Kaiser)
In 2012, the 50 hospitals
with the highest prices were
found to be charging 10 times
more than what’s allowed by
Medicare (The New York Times)
Health insurance companies
around the country are
seeking rate increases of 20
percent to 40 percent or
more for 2016
(2015, The New York Times)

9. HLU CONSULTANTS | Reclaim Control of Your Health Plan
How can your
business possibly
keep up with such
unpredictable hikes?

10. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Here’s the thing –
But things
can change . . .
Most companies have no idea how much their
health claims are costing them or that the issue
of excess, unnecessary charges has become so
incredibly routine.
All too often, claims get processed and paid
without a thorough review to catch errors and
inconsistencies.
Common issues like overcharging, miscoding and
duplicate charges are slipping through the cracks
resulting in ridiculously high payments that are eating
away at your bottom line.

11. HLU CONSULTANTS | Reclaim Control of Your Health Plan
HLU’s Winning Formula
LOWER
CLAIM COSTS
EMPOWERED
EMPLOYEES
IMPROVED
QUALITY OF CARE &
BETTER OUTCOMES
AN AVERAGE
OF
27%
TO REDUCE OVER-UTILIZATION
AND IMPROVE CARE

12. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Consider
Fixed Costs vs. Flexible
In a traditional plan, you pay a set
amount no matter what your
employees’ collective claims add
up to at year’s end. But what if you
pay more than the care your group
actually receives? That money is lost.
In the open-platform, self-funded
plan, you pay only for the care
that’s administered. Your dollars go
directly toward the cost of claims,
and stop-loss insurance kicks in
to cover the very large claims, as
needed. This approach eliminates a
substantial portion of the overhead
and profits paid to a traditional plan.

13. HLU CONSULTANTS | Reclaim Control of Your Health Plan
On top of sky-high claim
costs, the old, outdated
plan model means:
• A major lack of flexibility
• Less engagement and education among employees, often
resulting in unnecessary and costly care
• Limited or no claim data to use in being proactive and making
informed decisions
• Limited selection among benefit solutions and vendors
• Renewals driven by extra perks like incentives and commissions
• High turnover rates among staff and a lack of experience in
who is managing your account
• More manual compliance management and HR
administration needs

14. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why HLU Open-Platform Health Plan?
The reasons are plenty. Simplified compliance is a big one.
HLU Open-Platform Health Plan puts YOU back in control through:
Employee onboarding with 360-degree reporting and billing that’s seamless and integrated
FMLA and COBRA compliance that’s hands-free and full-service
ACA compliance and employee notifications for your added convenience
1095-C or 1094-C tracking and reporting

15. HLU CONSULTANTS | Reclaim Control of Your Health Plan
It’s simple. This is a smarter way to manage health benefits … one that works AND saves you money
now and for the long-term. HLU Open-Platform Health Plan puts YOU back in control through:
Meaningful data with the ability to analyze, model and forecast … this significantly reduces the
costs of administration, insurance and claims, and allows you to adapt your plan whenever and
however needed
Better care and improved outcomes because employees are more engaged in their care … this
leads to more effective disease management and reduces excess office visits, lab tests, hospital
admissions, etc.
Thorough claims review to identify overcharges and billing errors and address them before
claims are processed and paid
Best-in-class partnerships without being limited to a minimal number of vendors
A “pay for what you use” approach to care with a plan built from the most appropriate modules
Pricing transparency for medical services is achieved by giving employees the resources they
need to make the best choices and avoid overpaying for provider services
Why HLU Open-Platform Health Plan?

16. HLU CONSULTANTS | Reclaim Control of Your Health Plan
A Real Example: Diabetes Management
TRADITIONAL PLAN
An employer needs more coverage
focused on diabetes care, but
the current, not-so-flexible
plan only includes basic disease
management services.
HLU OPEN-PLATFORM HEALTH PLAN
We offer award-winning programs that address disease management and make
employees active participants in their own care. This emphasis on disease
management lowers costs to the plan and to the employee . . . and, it also results
in better employee health through well-coordinated outreach programs.

17. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why is HLU for You?
Benefits Done Better: Our Roots
• We are fully independent consultants with each employer’s
best interests in mind
• We have 55 years of experience in the industry, backed by a
team of professionals who truly understand what works in a
plan and what doesn’t
• We are a focused and efficient company with national reach
that takes an objective approach to finding the best vendors

18. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why is HLU for You?
Benefits Done Better: Our Method
• You’ll work in partnership with the same account
representative who is focused on the full relationship,
from sales to implementation and strategy
• You’ll receive one-on-one customer service with a
high-touch, hands-on approach
• You’ll never have to worry about brand-name fees,
incentives or sales driven by commission coming into play

19. HLU CONSULTANTS | Reclaim Control of Your Health Plan
It works for everyone.
While some plans might make sense from the
owner/CFO perspective, they don’t function for
the HR team. And vice versa.
Here’s the good news about the open-platform,
self-funded design: it works for everyone.
The plan saves you for the long-term, not just
the first 365 days.
Plus, the switch is seamless. It doesn’t put a
strain on your HR department or result in any
troublesome compliance gaps.

20. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Right Solution: CFOs/Owners
The Before: CFOs/owners see that plan costs are rising
sharply and quickly, making it hard to achieve a profit. Any
experience shopping other traditional plans has typically
been limited to some first-year savings, but increased rates
(once again) beyond that.
The After . . .

21. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The After with HLU: Our clients have
experienced an average health plan cost
increase of less than 3% since 2007.
They also benefit from better health plan
intelligence through detailed claim reporting
that allows them to:
• Take action on trends and issues that impact the bottom line
• Analyze what-if-contingencies to predict improvement cost
and effect
• Gain visibility into questionable billing trends
• See ROI on cost control features
• Take an effective wellness approach to lower costs and
improve quality of care
The Right Solution: CFOs/Owners
Average
health plan
cost increase of
since 2007

22. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Right Solution: HR Team
The Before: For HR groups that have tried other plans
without seeing results, it’s hard to believe a successful
alternative actually exists. Plus, it often feels like there
are too many moving parts with hiring, open enrollment,
changing insurances, etc., to consider. There’s also the fear
that any change in the process could result in mistakes,
compliance issues and added headaches.
The After . . .

23. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The After with HLU: Things are simpler and more streamlined
than ever with our technology-rich solutions. A few ways your
HR team will benefit:
• Employees keep the same benefits for many years, and
there’s no need to tweak deductibles and copays to manage
plan costs
• Universal ID Cards and Employee ID Numbers remain the
same even if you change insurance providers
• The renewal process is streamlined, with advance notice
of rate changes . . . no need for employees to complete new
applications to shop for new providers
• A dedicated customer service team provides personalized
service and is available to handle billing and answer
employee questions
The Right Solution: HR Team

24. It’s here. It’s time.
Learn more about HLU Consultants:
Are You Ready for a Smarter Health Plan
that has YOUR BUSINESS in Mind?
hluconsultants.com
Browse our site or sign up
for a webinar
info@hluconsultants.com513.559.7503