Unique Approach

Expert and Caring Analytical, Consultative

and Administrative Support

Since inception, CEBG has partnered with a company called Virgin Pulse to deliver analytics insight as well as expert, proactive consultative and program administrative support for our members.

• Virgin Pulse provides CEBG with advanced and proven longitudinal and predictive analytics coupled with deep consultative and tactical support to help drive down health risks and costs while keeping quality high.

 

• Their more than 20 years of experience in health insurance, health benefits, healthcare provider management and operations, nurse navigation programs, change management and wellness, gives them a comprehensive perspective into the complex landscape.

 

• Their VP Claims Insights analytics provides visibility to macro and micro level details they can use to support decision-making and action across the CEBG population.

 

• VP Claims Insights allows quick and comprehensive review of medical and pharmaceutical claims combined with additional datasets to understand present and future plan performance as well as population risk, health and wellness.

CEBG’s Plan members are engaged in Analytically-Informed, Evidence-Based medicine

Our unique approach provides proven consultative expertise and advanced and predictive analytics from our partner - Virgin Pulse - drive more informed targeting, decisions and actions to better support member health and wellness needs.

• Current state and predictive analytics visibility

 

• Identifies the people who need support, influence and education

 

• Supports recommendation of the right outreach program for each identified cohort group and individual

 

• Measures program-specific results through Initiative Tracking

  

More Detail on the Support Virgin Pulse provides to CEBG Members:

• Deep support of reporting and dashboard needs as well as findings and actionable recommendations – including quarterly strategic business reviews with the CEBG Board.

 

• Consultative support and executional guidance for building programs that improve member health, positively impact utilization and reduce costs.

 

• Consultative support in developing impactful employee outreach and communication strategies to increase program adoption and participation.

 

• Measurement of clinical and wellness program financial and utilization results.

 

• Oversight of Utilization Review / Case Management with referrals to benefit provider eQHealth.

 

• Guidance in engaging Providers to reduce Gaps in Care and medication risk.

 

• Guidance in network and Rx management to address areas of concern.

 

• Guidance in engaging providers to gain access to clinical resources as needed.

 

• Consultative support with Stop Loss (backed by analytical findings).

 

• Day-to-day administration of the plan and billing of individual diocesan locations.

 

• Claims review prior to payment.

 

• HIPAA Administration.

 

• Member services coordination.

CEBG currently services approximately 300 Subscribing Employer subgroups. These include: churches/parishes, schools, pastoral centers, retreat centers and chancery offices. CEBG’s collection track record is at 100%.

CEBG also provides assistance to Subscribing Employers in their IRS reporting requirements (1094-C, 1095-C, and W-2 reporting).