Erik Davis exemplifies health plan excellence and stewardship.
Rosie Award winners are chosen from plans recommended by benefits advisors, solution providers, or clinical leaders who meet two important criteria: a high Plan GraderTM score and excellent use of their Health Rosetta Dividend.
The Plan Grader™ is the first comprehensive independent plan assessment to measure and improve your health plan strategy. Plan Grader is an independent 360° health plan risk assessment that provides actionable insights to create an effective 2-3 year strategy to lower costs and improve benefits. Plan Grader is built on the Health Rosetta’s eight components that have been modeled on the successes of hundreds of high-performance plans. Employers and unions can evaluate how their health plan benchmarks to other employers or union plans adopting a Health Rosetta-style health plan. Reach out to Erik Davis to get your Plan Grade today.
Health Rosetta Dividend refers to the well-documented over $1 trillion of industry waste that can be reinvested back into an organization or community to improve wellbeing and build the foundation to restore the American Dream. Examples of Health Rosetta Dividend reinvestment include free college education, advanced primary care services, free or subsidize healthy food, pay increases, Dream Manager, $0 medications, or other tangible improvements that have a direct impact on the health and wellbeing of their workforce, dependents, and communities.
Erik has more than 30 years of experience in the insurance and risk management industry. He works to create an environment that supports organizations’ strategic managed care risk goals, while maintaining focus on compliance and financial accountability. Erik is instrumental in vendor negotiations, data benchmarking, population health strategies, claims analysis, recommendations in plan design and communication strategies. In this capacity, Erik has been involved with rate development, payment structures and process-change recommendations, and policies and procedures.
- Industry: Forklift manufacturing
- # of Employees: 3,200
- Location: Ohio
Hyster-Yale benefits include providing benefits that are richer than comparable employers in the industry, while maintaining lower employee contribution requirements. The company also operates near-site clinics available to their workforce and employees’ spouses.
- TPA: Regence BCBS
- PBM: Prime Therapeutics
- Stoploss: Commencement Bay
- PrimaryCare: Premise Health
- Individual Stewardship: Premise Health
- Other Solutions: Mines and Associates, Asserta, soon to add Healthcare Bluebook
- Industry: K-12 Education
- # of Employees: 700
- Location: Montana
Kalispell Public Schools has created a Tier 1 benefit structure that either waives or steps down member out-of-pocket costs if members utilize designated Tier 1 providers. KPS has also embarked on a primary care strategy that includes a district-sponsored near-site clinic, virtual primary care and virtual behavioral health for which there is $0 out-of-pocket for members. KPS has created a direct contract with a specialty hospital that provides pre-determined case rates in which all services and costs are known in advance of service delivery. Out-of-pocket costs are waived for services at this facility and travel expenses are reimbursed up to an annual limit.
- TPA: Allegiance
- PBM: ProvidenceRx
- Stoploss: HCC
- PrimaryCare: Premise
- Individual Stewardship: Allegiance
- Other Solutions: Integrated specialty drug management between near site clinic, PBM and medical management. Reviewing Medication Therapy Management opportunity and using Federally Qualified Health Center access to 340(b) distribution and pricing