1% of Plan Members Make Up 40% of a Health Plan’s Spending Each Year.*

Prioritize transparency and protection for your clients.

Our Stone Mountain Risk stop-loss solutions provide unique products and creative risk modeling to solve your clients’ problems with the best tools and technology available in the industry.

*https://www.advisory.com/daily-briefing/2022/08/30/healthcare-costs

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Creative Risk Mitigating Stop-Loss Solutions

Group 190

Reference-Based Pricing

Group 194

Group Stop-Loss Captives

Group 196

Community Health Plans

Component 10 – 1

PBM Solutions

Reference-Based Pricing

  • Direct Contracting
  • Redirection of services with no deductibles and co-pays
  • Concierge front end services
  • Fiduciary responsibility
  • Member balance billing protection
  • Baseline PPO protection

Reference-Based Pricing

  • Direct Contracting
  • Redirection of services with no deductibles and co-pays
  • Concierge front end services
  • Fiduciary responsibility
  • Member balance billing protection
  • Baseline PPO protection

Group Stop-Loss Captives

  • Build your own Captive Cell
  • Manage your own risk
  • Participate in an existing Captive

Reference-Based Pricing

  • Direct Contracting
  • Redirection of services with no deductibles and co-pays
  • Concierge front end services
  • Fiduciary responsibility
  • Member balance billing protection
  • Baseline PPO protection

Community Health Plans

  • Custom built plans for Local and National hospitals
  • Direct Primary Care Models
  • High Performance Networks
  • Direct Contracting
  • Chamber Plans
  • Association Health Plans

Reference-Based Pricing

  • Direct Contracting
  • Redirection of services with no deductibles and co-pays
  • Concierge front end services
  • Fiduciary responsibility
  • Member balance billing protection
  • Baseline PPO protection

PBM Solutions

  • Best in class pricing
  • Focused clinical solutions
  • PBM Consultants on request
  • Innovative specialty procurement and alternate sourcing
  • Gene Therapy management
  • Patient Assistance Programs

Reference-Based Pricing

  • Direct Contracting
  • Redirection of services with no deductibles and co-pays
  • Concierge front end services
  • Fiduciary responsibility
  • Member balance billing protection
  • Baseline PPO protection
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