Delivery is an exciting first step in long-term, strategic partnership focused on transforming employer healthcare through more efficient, technology-driven products
WELLESLEY, Mass., and SAN FRANCISCO (June 20, 2018)—Sun Life and Collective Health today announced an integrated stop-loss offering that gives self-funded employers financial protection from high-dollar claims, while helping identify better treatment scenarios to get their people the right care at the right time. With their health plan and stop-loss coverage together on the Collective Health Workforce Health Management System, companies’ HR and finance executives now have more ability to predict, manage, and control costs around one of their largest, most important enterprise investments: healthcare.
In a survey published last year by Sun Life, nearly half of employers maintained that while cost savings is their biggest motivation to self-fund, overall financial risk is the biggest challenge they face. This combined stop-loss product helps control that risk—the reimbursement process begins as soon as the claim hits the system, expediting reimbursement, and offering greater opportunity to proactively identify options for cost savings.
In addition to seamless claims reimbursement, the new offering gives mutual customers convenient reporting, improved clinical and risk management, and the opportunity to benefit from pooled experience.
“For financial executives overseeing their companies’ self-funded health plans, high-cost claims can have a huge impact on their resources and bottom line. Now, companies can have better visibility into these claims, better controls to manage them, and can potentially be reimbursed before the claims hit their balance sheet, giving them more control of their healthcare expenses,” said Collective Health’s chief health officer and co-founder Dr. Rajaie Batniji. “We’re excited to deliver this fundamental solution early in our strategic partnership with Sun Life, and look forward to a long line of offerings that will allow companies to harness the power of the Employer-Driven Healthcare Economy.”
The combination of Sun Life’s extensive high-cost claims management expertise—it’s the largest independent stop-loss provider in the country, and has saved employers millions of dollars through cost containment strategies—and Collective Health’s flexible Workforce Health Management System will also help employers identify potential claims issues earlier in the process. Clinical claim reviewers can proactively take steps to address unnecessarily high costs, such as those stemming from duplicate billing, and may be able to identify more effective treatment alternatives, offering the patient added comfort and convenience in addition to savings for the employer.
“We are very excited to be able to offer stop-loss to self-funded employers on Collective Health’s Platform,” said Brad Nieland, vice president of Stop-Loss & Health at Sun Life. “The improved reporting, in conjunction with data and clinical expert-driven claims analysis, will offer employers the tools and knowledge they need to monitor and manage their self-funded plan while addressing healthcare costs and providing a great customer experience for plan members.”
About Sun Life and Collective Health’s Integrated Stop-Loss Offering
Sun Life’s stop-loss coverage on Collective Health’s flexible Workforce Health Management System gives employers the combined benefits of Sun Life’s extensive expertise in managing high-cost claims and Collective Health’s open infrastructure, real-time access to data in WHMS, and trusted member engagement platform.
Benefits of the product include:
- Analytics that enable smarter plan design: Easy-to-understand reports within the Collective Health Platform’s Employer Suite provide a holistic view of claims data, enabling employers to make smart changes to health benefit plan designs when it matters—not six months later.
- The ability to better control high-cost claims earlier in their life cycle: Mutual customers will have access to the Sun Life Clinical 360 program, in which nurse consultants analyze clinical and claim data, and work closely with Collective Health’s team to communicate with brokers and administrators on opportunities for savings, such as correcting billing errors or proposing treatment alternatives that reduce costs and provide patients with better care.
- Work with like-minded employers: Eligible mutual clients can share favorable results via a pooled experience.
- Improved cash flow through automated reimbursement of high-cost claims: Eligible claims will be automatically reimbursed by Sun Life weekly. Because Collective Health adjudicates and administers claims for self-funded companies, the Sun Life integration provides joint customers with a more seamless reimbursement process.
The offering is available for quoting immediately, going live for mutual customers January 1, 2019. More information can be found here.
About Sun Life
Sun Life Financial is a leading international financial services organization providing insurance, wealth and asset management solutions to individual and corporate clients. Sun Life Financial has operations in a number of markets worldwide, including Canada, the United States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan, Indonesia, India, China, Australia, Singapore, Vietnam, Malaysia and Bermuda. As of March 31, 2018, Sun Life Financial had total assets under management of C$979 billion. For more information please visit www.sunlife.com.
Sun Life Financial Inc. trades on the Toronto (TSX), New York (NYSE) and Philippine (PSE) stock exchanges under the ticker symbol SLF.
In the United States, Sun Life Financial is one of the largest group benefits providers, serving more than 60,000 employers in small, medium and large workplaces across the country. Sun Life’s broad portfolio of products and services in the U.S. includes disability, absence management, life, dental, vision, voluntary and stop-loss insurance. For more information, please visit www.sunlife.com/us.
About Collective Health
Collective Health is powering the Employer-Driven Healthcare Economy with the first Workforce Health Management System, giving employers a platform to simultaneously manage their healthcare investment and take better care of their people. With more than 120,000 members and 30 enterprise clients, Collective Health is reinventing the healthcare experience for self-funded employers and their employees across the U.S. Founded in October 2013 and headquartered in San Francisco, Collective Health is backed by NEA, Founders Fund, GV, Sun Life and other leading investors. For more information, visit https://www.collectivehealth.com.