AdminaHealth Liquidity

All the advantages of being fully self-funded, with fixed monthly payments similar to being fully-insured.

The AdminaHealth Healthcare Expense Management (HEM) Solution is structured around a liquidity facility and inexpensive, high deductible stop-loss protection. This mechanism allows for level (within a program year) monthly payments like fully-insured plans, irrespective of actual healthcare claims. It also spreads claims experience over the three-year program term. If claims are higher than expected, AdminaHealth effectively loans your organization the spread between the stop-loss attachment point and your expected monthly payments. The repayment of the liquidity facility can be spread over the three-year program term.

  • More efficient & financially responsible approach to self-funding employer-sponsored benefit plans
  • Methodology for actuarial soundness used in the financial budgetary and forecasting process follows generally accepted actuarial principles.
  • Mitigate monthly cash flow volatility and smooth claims experience over multiple years
  • Traditional self-funding benefits of greater flexibility and choice of plan design, networks, carriers and claim administrators
  • Provide economic savings over fully insured alternatives
  • Ability to fully customize plans to meet your specific population's needs

HEM: How it Works

Combines any self-funded benefit program with stop loss protection and a cash smoothing mechanism.

In the event of higher claims than expected, cash smoothing mechanism covers them.

Level monthly payments during each year of the 3-year contract program.

Client’s monthly payment is adjusted after each year.

Client’s cash smoothing balance is factored into annual payment adjustment, as are actual claims paid.

Client’s monthly payment may increase to pay off its cash smoothing balance, or often decreases due to lower-than-expected claims.

Cash Flow Smoothing

Fixed Payments

  • PEPM payments funded by the client are fixed over the course of the year (similar to a fully insured premium equivalent rate).

Mitigated Risk

  • Risk of disruptive monthly cash flow volatility is mitigated.

Smoothed Claims

  • Claims experience is smoothed over the 3 year or 5 year program.

Cost Effective Stop-Loss

Utilize a higher-deductible policy

  • Our HEM Liquidity Facility spreads claims experience over a longer time frame (up to 3-5 years). This allows clients to utilize a more cost effective higher deductible Stop Loss Policy to cover catastrophic events rather than as a form of liquidity enhancement.

No lasering

  • We have worked with a network of stop-loss providers to be able to offer laserless stop-loss options to ensure risk-mitigation.

Agnostic to Network, Stop-Loss, or Carrier

Highly Flexible

  • HEM has been designed for flexibility and to be able to work with most major Networks, Stop Loss Providers, Carriers and TPAs.

Use Any Network

  • You can use any network that offers an ASO or other fully self-funded arrangement.

Transparent to Employees

  • If you use the same network, this change should be transparent for your employees.

Administrative Ease for Clients

Automatic Processing

  • Monthly scheduled administrative payments and all claims payments are processed automatically upon online authorization by the client.

Help with Payments

  • The HEM solution assists the company in the payment of its claims, TPA payments, stop loss and actuarial fees, and other program related charges.

Real-Time Data

  • Clients can view their current reserves, balances, claims, and all analytical data and reports online 24/7.

Reporting Done-for-You

  • All self-bill reporting for stop loss and other vendors is completed automatically on the company's behalf.

Contact us to learn more about the AdminaHealth®  Liquidity product today!

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