Brighton Enhances Self-Insured Health Plan Administration Platform

Brighton Health Plan Solutions has announced new capabilities and updates to its technology solution, which combines a mobile app, enrollment portal, member portal and administrator portal into one platform.

With the latest enhancements, self-insured employers and health systems can harness Brighton’s Create Technology to administer direct contracts, reference-based pricing models, tiered benefits and trust and welfare benefits.

Brighton notes that “intimidating administration requirements and in-house expertise they believe they need to administer the plan” may be a barrier to small and mid-sized employers sponsoring self-insured health benefits for employees. Large employers have been able to provide flexible benefits and realize cost savings through self-insured benefit offerings for years. Use of self-insured benefits increased among smaller employers in recent years before leveling off.

The Create Technology platform can support any provider network, insurance carrier, third party health care vendor or payroll platform. Brighton designed the SOC 2-certified secure platform with modular and scalable architecture that allows clients to select the services they want to use, as well as integration capabilities for connecting to external partner solutions.

The newest enhancements to the Create Technology platform simplify administration of:

• Direct Contracting: Health systems and provider groups can effortlessly administer direct network contracts with self-insured employers, allowing these employers to bypass traditional insurance carriers and save on their medical expenses.
• Reference-Based Pricing: Pay claims according to any carrier’s reference-based pricing model, whether the model is based on Medicare rates or custom fee schedules.
• Tiered Benefits: Reimburse according to tier level, with different copays or coinsurance applied to each tier.
• Trust and Welfare Fund Administration: Manage contribution accounting, delinquency and collection management, online payment collection, hours administration, eligibility determination and enrollment, and COBRA administration.

Brighton says these new capabilities are in addition to the platform’s existing health plan administration functionality: benefits enrollment, member communications, employer communications, collaboration tools, provider search, claims and coverage summaries, spending accounts, appointment scheduling, data reporting, claims adjudication, claims repricing, pre-payment review, and integration with payroll, dental and disability benefits, pensions, 401(k) and other voluntary benefits.