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Highlights • HM Insurance Group

Across the country, HM Insurance Group companies work with first-rate partners to create the best overall experience that ultimately cascades down to employees covered through group plans. Healthgram, a third party administrator (TPA) based in Charlotte, is one of those partners.

For Healthgram: A partner that helps address cost

Across the country, HM Insurance Group companies work with first-rate partners to create the best overall experience that ultimately cascades down to employees covered through group plans. Healthgram, a third party administrator (TPA) based in Charlotte, is one of those partners.

The rising cost of health care is an ongoing concern, and both HM Insurance Group and Healthgram constantly monitor cost trends, partner to create savings opportunities and provide information and tips about how to control costs to both employers and their covered employees.

"We work together with HM Insurance on a daily basis to educate employer groups and their employees about the importance of knowing and understanding their plan language and about strategies to help them contain costs," said Heather Grey, vice president of medical management for Healthgram.

"At Healthgram, we review all high-dollar claims exceeding $10,000. We have several initiatives to help contain costs, including moving members from high-dollar inpatient facilities to outpatient infusion facilities," said Heather. "And we also review all medications that are rejected by the pharmacy benefit manager and exceed $1,000," all in the interest of recommending solutions to these costly incidents.

At HM Insurance Group, medical professionals routinely review potential claimant notices for savings opportunities, pursue potential third-party recovery situations, and add competitive out-of-network discount programs and Centers of Excellence to maximize cost savings for catastrophic claims.

In 2014, HM generated savings of nearly $18 million through its cost-containment efforts, bringing the three-year total savings on claims to more than $46 million.*

It's also the ease of doing business with HM Insurance Group that Heather really appreciates. "We like working with HM Insurance Group because our contacts there are always very easy to work with," said Heather. "We have had a great working relationship between our companies for many years, and we receive feedback on the positive work we do together."

She added, "The case managers are very easy to work with. They are very knowledgeable and provide help to our case managers wherever and whenever needed."

For Healthgram and HM Insurance Group, getting health care right means working together, every day, to help make care more affordable for employers and their covered employees.

*Data gathered from HM Insurance Group internal financial reporting, 2015.


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