Services

The SSMMC team makes extensive efforts to provide our customers with high quality services, personalized for their unique needs. Our expertise in the benefit industry is very broad and includes, but is not limited to the services listed below

Self-Funded Plans (and Fully Insured as applicable)

Association Health Plans

SSMMC is taking an active role to offer clients a full market roadmap to help companies either create Association Health Plans (AHPs) or gain access to them. Our experience cuts across all needed phases of AHP deployment and management, including but not limited to:

Compliance reviews
Plan design options
Access to leading reinsurers, Pharmacy Benefit Managers
Multiple provider costing arrangements, e.g. Reference Based Pricing, Health Systems
Best-in-class cost management services, technology
Leading-edge member toolsets
Strong supporting analytics at AHP and employer levels
Customized underwriting
Full array of ancillary programs to complement core Medical, Pharmacy plans, e.g. Dental,
Life, Vision
Distribution channel assistance

Health System Programs

Full array of services in areas including Medical product design, network configuration, clinical engagement, reinsurance, PBM and ancillary product procurement, pricing, marketing and sales guidance. As an example, our leadership has been involved with one of the largest health systems in the country in a successful EPO/PPO program build-out and launch over the last six years.

Administration

Leadership at SSMMC has worked in a variety of capacities with multiple administrative services firms and insurance carriers, as well as leadership roles in operational and sales/client engagement. We have a strong knowledge base of historical, current and emerging delivery models in the administration space that proves invaluable to our clients.

Benefit Technology

We have worked with some of the largest and most innovative technology vendors in the healthcare vertical and are constantly evaluating new, innovative technologies from a variety of stakeholder sources.

Reinsurance/Stop Loss

Our team has deep knowledge and contacts in the reinsurance space, cutting across a full array of traditional, level-funded and Captive arrangements.

Benefit Program Design

In the past 30 years we have been exposed to almost every form of Health program design in the US and even some internationally. We strive to impart that design knowledge to our clients where needed to help maintain their competitive edge and provide guidance for new program development.

Network Development

Strong experience in narrow networks, wrap network alternatives, commercial networks, specialty networks and a variety of Out of Network negotiation services.

Vendor Selection

Our vendor evaluation metrics are detailed, meant to function at both a tactical execution and strategic guidance level. This is a crucial part of the procurement process for our clients (see RFP Development & Procurement).

Cost Containment

SSMMC can access a wide variety of cost management and outcomes-based tools, then in turn provide strong analytics and technology to support deployment of these tools when elected by our clients.

Reference Based Pricing

Our firm has knowledge and access to the industry leaders in Reference Based Pricing. RBP is an important component in the negotiation-based services category and a growing trend nationally.

RFP Development & Procurement, Vendor Selection

Deep and broad experience in the entire procurement cycle, from requirements development to vendor evaluation, negotiations, selection and contract execution with our clients.

Pricing & Market Checks

In concert with other functional expertise areas noted, we can help our client determine competitive posturing for their Life & Health programs using our extensive contacts and market data sources.

International Programs

Work outside the United States has provided SSMMC with knowledge to help customers make strides in the Healthcare space in a certain international regions like the Caribbean. This expertise includes domestic delivery models as well as US-based expatriate coverage.

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