1. Plan design and administration – Plan design and administration – North Star Health works with each employer group to customize a health benefit plan that maximizes member participation, wellness and cost effectiveness. We can accommodate a variety of plan designs including consumer-directed products such as Health Savings Accounts. All plan designs include the RoadMap to Better Health compliance features. Learn more>>
   
2. Health risk assessments – Members can voluntarily answer a short list of questions that allow us to assess a member’s overall level of health. In doing so we recommend ways in which to improve one’s risk for developing chronic disease such as diabetes and heart disease.
   
3. Network contracting – North Star Health has access to local, regional, and national networks throughout the United States. In addition, North Star Health contracts directly with physicians and hospitals around the country. In an effort to maximize savings opportunities for its clients, North Star Health provides a layered network environment ensuring that the vast majority of claims incurred fall under available discount arrangements. Learn more>>
   
• Primary Network – through benefit incentives (deductibles, coinsurance & co-pays) plan members are encouraged to utilize a local or national PPO that best suits their needs based on discount and access. This network typically provides members with the higher network benefit level. The employer pays a monthly capitation access fee to the network for their services.


• Secondary Network – should a local PPO be chosen as the primary network, a national PPO would be used to provide network benefit access across the country. The employer’s cost for access to this network is a percentage of the savings.


• Tertiary Network – North Star Health has access to several high quality national networks and other organizations that can generate discounts on claims that would fall outside the primary or secondary networks. While plan members receive out-of-network benefit levels, providers are reimbursed at a discounted amount. The employer’s cost for access to this network is a percentage of the savings. The result of this approach gives North Star Health client’s access to more than 4,500 hospitals and over 500,000 participating physicians nationwide.
4. Case management – Members who develop serious illness or have a significant accident benefit from North Star Health’s case management services. This service helps guide members and their family through such difficult situations utilizing trained nurse practitioners. Learn more>>
   
5. Disease management - Chronic disease accounts for a majority of healthcare related expenses. North Star Health’s proactive monitoring process helps identify members at risk or those with actual disease. Once identified, treatment is monitored to assure compliance with nationally recognized standards of care.
6. Medical utilization data analytics – North Star Health’s HIT (Health Information Technology) platform provides a robust reporting capability for all parties involved in the care management process. Data analytics using health risk assessments, medical claims data, pharmacy data and lab data monitor compliance to national guidelines for prevention and care. As a result, our healthcare inflation trending is 50% below national average or better.
   
7. Online initial and ongoing enrollment - Members enjoy the convenience of a user friendly online enrollment process.
   
8. Eligibility – North Star Health constantly updates eligibility records for its members and their providers.
   
9. Claim payment (electronic and manual) – Our claims processing capability maximizes the latest in automation to insure rapid and accurate payment of claims to member providers. The system includes medical, dental, vision, prescription, flexible benefit and disability benefit adjudication and analytical capabilities. Learn more>>
   
10. Reinsurance negotiation – North Star Health works with best of breed reinsurance vendors to provide maximum protection and cost savings to employers seeking stop loss insurance for their health benefit plan. Learn more>>
    
11. Premium/consolidated billing – North Star Health offers billing for other contracted ancillary insurance products including: employee assistance programs, dental, vision, life insurance, etc. This allows for one monthly payment and a single source for reconciliation.
    
12. COBRA administration – North Star Health makes COBRA administration easy. Employers simply notify us of the qualifying event. Then, remove the insured from the plan. We take it from there by sending out all notices, tracking all election periods and collecting premiums.
13. HSA/HRA administration – Learn more>>
14. FSA administration – Learn more>>
15. New! Risk Mitigation Services – Lumina^TM is a proprietary technology solution for population health risk management designed for health plans (Private and Public), third party administrators (TPAs), insurance companies and brokers.  It was developed in conjunction with a leading U.S. healthcare economist and policy expert, Dr. Kenneth E. Thorpe. 

Predictive, Personalized and Preemptive

According to Dr. Thorpe, chronic diseases are responsible for 7 out of 10 deaths and 75% of every healthcare dollar spent in the U.S..  A majority of these are preventable. Obesity rates have doubled over the last 20 years and account for nearly 30% of the rise in healthcare spending.  Early intervention, diet and exercise can play a major role in reducing the prevalence of these diseases and the costs associated with them.  See: www.fightchronicdisease.org.