Self-funded Solutions

Minimum Essential Coverage Plans

We offer minimum single and family coverage to ensure that you do not get penalized for having health insurance by the IRS.

 

Small-group, Self-funded Bundled Services

Clara Care features pre-packaged plans that look and feel like fully funded plans but deliver additional savings.

 

Large-group, Self-funded Bundled Services

If you are currently self-insured and would like to know if you can save even more, request a quote. Send us six months of loss-run and we will tell you what you would have paid if you were on a Clara Care plan. Typically, we can save you an additional 10% on your overall healthcare spending.

 

Clara Care Rx

Clara Care Rx is not a discount card. It is included in our Silver and Gold MEC plus our MVP plans.

  • Pay a maximum of $30 for Select Generic Prescription Drugs!
  • No health restrictions.
  • No limitation of use.
  • No reimbursement procedures.
  • No paperwork: Pay $30 or less at the time of visit.
  • Covers over 700 Generic Drugs for most conditions.
  • No prescription coupons.
  • Use immediately upon receipt of card.
  • Network of over 60,000 pharmacies (all national chains and most locals).
  • Savings of 10% to 85% on all other medications.

 

Complete TPA Services

TRISTAR Insurance Group Background:
  • Established 1987
  • Largest privately held TPA
  • Full Service—P&C, Benefits, and Managed Care
  • $100+ million revenues
  • 1,000+ professionals
  • Risk Management, Program, Carrier, and Public Agency segments
Breadth of TPA Service:
  • Group health claims administration and services for self-funded plans
  • Self-funded and partially self-funded plans
  • Partial self-funded (spend-down) plans
  • Dental plans
  • Vision plans
  • Flexible-spending account plans
  • Transit/parking account plans
  • Healthcare reimbursement arrangement plans
  • Short-term disability ASO (administrative services only)
  • COBRA/HIPAA administration

 

Population Health Management

Utilization Management

We promote quality of care and eliminate unnecessary services while maximizing your healthcare dollars. Our team of highly skilled nurses focuses on helping you understand your plan and the options you have for receiving high-quality, affordable care.

Case Management

Our program is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services. We work proactively with physicians and family members to help achieve our members’ goals to bring about better outcomes.

Specialty Programs

Specific trends in data may indicate the need for specialized programs. Depending on the need, these programs can include oncology management, transplant management, end-stage renal disease, care transitions, and an emergency department program.

Disease Management

We have advanced predictive modeling tools to help identify individuals who would benefit from our programs.

Maternity Management

We focus on the care needs of maternity members through ongoing assessment, collaboration, support, and care planning. Our goals include promoting the length of the gestational period and improving outcomes for newborns.

 

Wellness

Our comprehensive wellness solutions engage members to help the healthy stay healthy and, at the same time, we deliver programs and interventions to help others improve their health. We provide member engagement strategies, an online wellness portal, and, most importantly, results.

 

Consulting

Looking for additional cost savings? Not getting the savings you expected? You think your plan is working OK but you would still like a fresh look to see if there is something on the market that would complement your efforts. Every situation is unique. If you are a client of Clara Care, oftentimes you will receive a free consult to ensure you are getting the maximum savings in plan design. If you would like a critical look at your self-funded plan design, simply reach out to us to have an introductory discussion.

 

Clara Care HR: HR, Training, Compliance

Clara Care HR is an online human resource, regulatory compliance, training, testing, performance tracking, and reporting system. Clara Care HR is vastly more than an online learning system. While the system contains well over 300 training modules that cover regulatory compliance, mandated employee training, and much more, “self-customization” puts Clara Care HR in a league of its own. While our HR system contains over 8,000 pages of content, it is easily learned and navigated. Content is delivered to employees based upon individual need. Forms, documents, manuals, self-created training, and anything else you wish to maintain on the system is accomplished in minutes, if not seconds—and at no cost! In short order, Clara Care HR becomes your indispensable human resources tool.

 

Clara Clinic

The union of self-funded leadership with healthcare administrators, using state-of-the-art population health management tools that target specific patient needs, will define our model. Clara Care Clinics will provide a physician and/or nurse practitioner on-site with the use of technology applications in partnership with Telligen. We design incentives that empower the physician and/or nurse practitioner to increase patient engagement at a Clara Care on-site clinic through the introduction of technology and motivational opportunities that expand patient participation, which is the key element in reducing healthcare costs.