America's Benefit Specialist December 2023

PRODUCT NEWS

Today more than 70% of people who use Optum Rx already pay less than $35 per month on insulin. Effective January 1, 2024, 98% of all Optum Rx consumers will have access to insulin for $35 or less per month. “I’ve seen firsthand how high prices for insulin and other necessary medications can cause patients to limit or skip doses,” said Dr. Patrick Conway, chief executive officer of Optum Rx. “Medicine that people can’t afford is useless, and by taking this important next step to change our formulary, we will lower costs and improve access for more people who need this life-saving medication. Our goal is to make all es sential medicines affordable.” For more information, visit www.optum.com/optumrx. CENTRO BENEFITS RESEARCH ANNOUNCES LAUNCH OF BROKER-CARRIER RFP AND QUOTING API INTEGRATION WITH METLIFE Centro Benefits Research, an employee-benefits consulting and technology firm, has announced the launch of a bro ker-carrier RFP and Quoting API integration with MetLife for all ancillary employee benefits products. This API connection will enable Centro and MetLife to exchange RFP and quote proposal data directly between the Centro platform and the MetLife Group operating platform and, as a result, signifi cantly improve the speed, accuracy, operational efficiency and cost of this manually intense process. “In an era where digital transformation has become an in dicator of progress, Centro is creating a unique value by deliv ering a powerful technology platform that eliminates most of the manual steps across the value chain for the carriers and brokers we serve,” said Treg Balding, chief revenue officer at Centro Benefits Research. “Working with MetLife to launch the RFP and Quoting API integration is a big step towards modernization of these processes.” Centro’s RFP and Quoting API Integration with MetLife transforms the labor-intensive RFP and Quoting process for employers with fewer than 100 employees and enables seamless, real-time data exchange. This results in faster turnaround times, greater accuracy and downstream error reduction, leading to an enhanced overall user experience for brokers and employers. For information, visit centrobenefitsresearch.com.

“The Leaf Health Captive will allow our clients to greatly reduce their healthcare costs and mitigate their risk. We’ve combined our specialty administration, medical-rebates, clinical-review and alternative-funding programs with Berkley Accident and Health’s risk-management strategies to offer our clients a flexible solution that works for them,” Robert Shelley, founding partner and CEO of Leaf Health, explained. The Leaf Health Captive manages specialty claims costs through an extensive clinical-review process performed by an in-house pharmacy and mitigates volatility by providing no new lasers and rate cap options. It also increases healthcare savings through returned surpluses and lower insurance premiums for members. “We’ve taken a new approach to a typical captive solution with the Leaf Health Captive,” Shawn Lanter, vice presi dent-captive business development of Berkley Accident and Health, said. “With Leaf Health’s industry expertise, we have the opportunity to greatly reduce our client’s prescription drug spending without sacrificing a member’s quality of care through a robust clinical review of high-cost drugs.” For more information, visit www.leafhealth.net. PRODIGY ADOPTS GRADIENT AI’S SAIL FOR ENHANCED MEDICAL STOP-LOSS INSURANCE RISK MANAGEMENT Gradient AI, a software provider of artificial intelligence solutions in the insurance industry, announced that Prodigy Health Insurance Services, a managing general underwriter specializing in medical stop-loss insurance, has chosen Gradient AI’s SAIL solution to optimize its self-funded insurance plans. Prodigy is using Gradient AI’s SAIL group health under writing solution to quote new business and transition clients from fully insured to more cost-effective self-insured plans. The company’s Integrated Health Solutions offers employers fixed monthly costs for administration, claims payments and stop-loss insurance. Prodigy uses SAIL’s analytics to help em ployers be more proactive in improving healthcare outcomes while reducing healthcare costs. Gradient AI’s medical data and advanced analytics enable Prodigy to offer innovative self-funded plans and to partner with employers to offer affordable high-quality healthcare to their employees. SAIL has the ability to leverage prescription, medical and lab data at scale to inform predictions. Using SAIL’s analytics, Prodigy’s solutions focus on deliv ering proactive employee healthcare management and cost reduction. This approach benefits employees and employers, and aligns with Prodigy’s mission of ensuring quality care and outcomes. To learn more, visit www.gradientai.com.

LEAF HEALTH AND BERKLEY ACCIDENT AND HEALTH TO PROVIDE CLIENTS WITH A COMPREHENSIVE GROUP CAPTIVE SOLUTION Leaf Health, a pharmacy benefits consultant, has partnered with Berkley Accident and Health to establish the Leaf Health Captive, a turnkey, group captive solution.

12 ABS | benefitspecialistmagazine.com