Services Overview
Our Self-funding expertise has been tested by some of the country’s largest and most notable companies and municipalities. Our Self-funded and compliance expert has reviewed plan documents for employers such as Amazon.com, U-Haul, the City of Las Vegas, Tidewater Barge, and many others. But, what sets us apart from your typical insurance agency is our attention to the details, often overlooked in self-funded arrangements.
Self-funding isn’t for everyone. RTC can meet with you to evaluate if self-funding is the best approach for your company. Whether you’ve been doing it for years or are new to the concept altogether, RTC will help provide the understanding and clarity you need to make an informed decision.
Our Thorough Services Include:
Stop Loss Insurance
When we say we’re “over the top” when it comes to digging into the details of our client’s stop loss contracts, we mean it. Beyond just the quoting process, RTC assesses the finer details like: understanding policy provisions and their impact on their ability to mitigate large claim expenses, examining whether or not a reinsurance arrangement exists and understanding the reinsurers contractual obligations and coverage gaps, evaluating all underwriting contingencies, claims payment history, and renewal rating underwriting philosophies.
We know you have more important things to do than spend hours reading stop loss quotes and contract details. Once each stop loss quote is received, RTC develops a thorough proposal which employers can easily review and comprehend, without leaving out the key details you need to make an informed decision. As an independent agent, we represent all insurers so we can provide you an unbiased look at all your options in the stop loss marketplace.
TPA Selection and Evaluation
Our findings are provided in a comprehensive, customized report for employers to gain a better understanding of the positives and negatives to each TPA evaluated. Due to our agency’s background and expertise, we are well suited to help guide an employer through this important decision and vital business relationship.
Compliance
- Development of Summary Plan Description (SPD) and Plan Document (PD) (if requested)
- Summary Plan Description (SPD) and Plan Document (PD) written reviews
- Review of all plan forms and required notices
- Assistance with IRS and DOL filings, such as:
- Form 5500 Filings
- Reinsurance Fees
- Patient Centered Outcome (PCORI) fees
- Shared Responsibility filings as mandated by ACA
- Affordable Care Act (ACA) compliance review
- ERISA, COBRA, and HIPAA Internal Reviews
- Assistance with any Department or Labor audits or investigations
- Employer Compliance Seminars
The field of benefit compliance is becoming more important each year, due to the increased number of laws and regulations which directly affect employers. RTC is dedicated to helping our clients stay in compliance with these multitude of benefit laws and codes, which appear to be ever-changing and expanding into the operations of businesses each day. .
Our agency has experience assisting employers through audits by the Department of Labor with regard to their health plan. Recently a large employer client of ours who self-funds their employee benefit plans was undergoing a DOL audit and investigation. RTC took a lead role in arranging and presenting all of the information pertinent to the investigation and audit. The outcome of the investigation was that “no further action” was required once the investigation was concluded. If you’ve ever been investigated by the DOL, then you know this is the best outcome a company can hope to achieve!
Custom Reporting
Customized reporting is a key focus of RTC’s overall Self-funded services. This is evidenced by the customized report package we provide to each of our clients on a quarterly basis. The report package includes quality, useful, and easy to understand data, laid out in a professional manner to give employers a better understanding of their plan’s costs and utilization. With this knowledge, employers can evaluate where the plan’s costs exist and how to improve the plans efforts towards cost containment and efficiency.
Here are a few key sections included in our report package:
- Medical Claims
- Prescription Claims
- Dental Claims
- Vision Claims
- Stop Loss Claims
- PPO/Network Discount savings
- COBRA Utilization
- Net Cost to Employer (after Employee Contributions)
- Historical Cost Comparisons
- Large Claim Management Data
Without quality reporting, it is very difficult for a business to assess where it has been cost-wise, and where it is going. Decisions related to benefit design, PPO Networks, employee contributions and the like are all made much easier as a result of the Custom Reports Package provided by RTC.
Large Claims Assistance

RTC is comfortable intervening at all levels of a large claim, including working with the providers, the TPA, Large Claims Management Vendors, and the stop loss insurance company to make sure everything is in line and the claim is properly assessed and covered per the guidelines of the plan.
When it comes to large claims, we see our role as the “quarterback”, helping direct all those involved with the large claim management process. The frequency and average dollar amounts of large claims continue to increase, so RTC plays a vital role to helping employers understand, manage, and control the costs of these claims as much as possible.