New Year, New Health Plan

Now that it’s 2016, we are getting inquires on getting started with direct contracting during the open enrollment period – and that’s a good thing, because the beginning of the year is the best time to inquire. Every healthcare program requires some time to implement, and direct contracting is no exception. The truth is, if a company is serious about getting started with direct contracting for its employer health plan, then everyone should be prepared for the timeline to be up to six months in duration, from start to finish. Keep in mind, the steps include:


The first consult is an important appointment that provides the potential client with all the necessary information on the direct contracting healthcare model. If you are interested in being a client, you want to schedule your consultation as early in the new year as possible.


Once the client is on board, we perform an analysis of the company’s healthcare data – namely, examining the number of employees and dependents requiring coverage and analyzing their past claims data. This is important because it helps us identify the most appropriate providers to approach with contract proposals.


Next, we enter the request for proposal (RFP) stage. This is when the right providers are identified and approached with proposals on contracting with your company; it is the stage where the actual healthcare services are secured.


We then obtain signatures and process the contracts with each provider, ensuring that they are legally binding contracts for the enrollment year.


Finally, we prepare for open enrollment. This is a process that requires us to obtain the most up-to-date data on your employees and their dependents so we can get them enrolled during the eligibility period.

As you can see, it takes months to put a complete employer health plan program together. That’s why it is in every client’s best interests to begin the process at the beginning of the year. It’s not too late to inquire now, so we can begin creating and establishing your new company health plan. Contact GM&A to learn more today!

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For a Consultation and detailed Health Plan Analysis
Call Hurb VandenHoogen at (858) 775-9170
or email