Tools to Maximize Accuracy and Efficiency

Our clients trust us to help them make informed decisions. Having the right tools and knowing how to use them makes all the difference. At Pentra, we build and purchase tools that help us identify, evaluate and solve for a wide variety of employee benefit challenges.

Accurate financial forecasting, plan design pricing and funding analysis are essential to risk management and reliable budget development - you have to get the numbers right. Your advisor must excel at this. Pentra uses Actuarial Advisor Solution tool, a comprehensive healthcare cost modeling tool developed by actuaries at Windsor Strategy Partners, LLC (“WSP”), a healthcare actuarial consulting firm specializing in product pricing, model building and data analysis, underwriting, strategic planning and business strategy. Insurers and reinsurers, brokers and consultants, third party administrators and managing general underwriters use Actuarial Advisor as a first dollar, stop loss and excess loss rating manual. The Advisor can help to evaluate the impact of plan design and provider network changes, and can be used as a basis for new product development and simulation studies.

The Affordable Care Act (ACA), also known as the Patient Protection and Affordable Care Act (PPACA), is a federal law designed to ensure that most U.S. citizens have health care coverage. It is an extremely complex law that has already been subject to significant regulatory interpretation. The potential consequences for non-compliance can be substantial, and the law should prompt employers to rethink how they approach benefits. Pentra has developed a comprehensive Employer’s Guide to help prepare for and comply with the ACA. The ACA Employer’s Guide is a concise, easily understood piece ideal for busy executives who need to understand the essence of the law and how it will impact their organization. It summarizes all key provisions and includes a question and answer format as well as examples of how various provisions of the law work. Click here to read the guide.

Employers must understand the benefit practices and offerings provided by their peer groups and competitors to make informed decisions about their own plans. Industry knowledge provides essential context for decision making. At Pentra, we have access to virtually every survey and benchmarking instrument in the marketplace. We maintain a large proprietary database with over 4,000 employers to empower us to benchmark a client’s benefit plan against those offered by other similar employers, defined by size range, industry, geographic location and plan types. Just as importantly, we understand how to interpret surveys and benchmarks. It is unfortunate, but common, for surveyors to inconsistently combine response data. As a result, it is particularly important to properly interpret survey and benchmark results. Informed interpretation and use of these data is critical to sound decision making.

Regulatory compliance burdens associated with the sponsorship of employee benefit plans have grown increasingly complex and require focused attention. Our Compliance Checklist provides employers with an outline of key questions to help determine what areas may be in need of focused attention. It is designed to assist employers with compliance regulation as it relates to company Health and Welfare benefit plans. The checklist is used in conjunction with our more comprehensive Health and Welfare Compliance Guide. While not intended to be all inclusive, it provides guidance sufficient to understand the key issues and identify gaps. If gaps are identified, we can help determine the best course of action. This can range from a simple resolution at the employer level to getting counsel involved in more complex issues. The Compliance Guide generally describes the legal requirements that apply to health and welfare employee benefit plans and is designed to help evaluate plans’ compliance with these requirements. The guide should not be solely relied upon; however, it serves as an excellent foundation. Our account teams can help you determine if there are areas in need of attention. If a situation becomes too complex, we access a member of our legal team to assist.

Organizations will need to continuously revisit their strategy of providing compensation and benefits to employees. Part of that process will be to evaluate the costs and benefits of providing health care to employees or “opting out” and directing employees to the exchange. Our “Play or Pay Analyzer” software has been created by experts and is copyrighted for our exclusive use. Currently in its third version, this tool enables us to quickly and accurately provide financial estimates of the non tax-deductible penalties associated with a decision not to comply with the Employer shared Responsibility provision of the Pay or Play mandate.

The ACA’s required 1095 reporting and the myriad of associated codes brings an additional burden of administrative complexity to an already complicated law.  Pentra has prepared an additional reporting guide with definitions and examples to help employers validate the construct and accuracy of the information being supplied to employees and the IRS. Click here to read the guide.