Solutions

Designed for Employer Needs, Crafted by
In-House Experts

Point C designs flexible solutions around the demands of self-funded health plans. We make it easy to match the right solution to each employer's priorities and build a strategy that can evolve over time.
Point C team supporting a self-funded plan
Employer reviewing plan options
Health plan member
Access Care

Solutions That Strengthen Self-Funded Plans

Whether you are reviewing your current TPA approach or looking for a more coordinated self-funded strategy, Point C's in-house solutions will enhance your health plan's cost savings, member experience, and more.

Medical Cost Containment

Medical spend can shift plan performance quickly, especially when claim accuracy, reimbursement, and specialty expenses are not being reviewed closely enough.

Our approach focus on the claims that carry the most financial weight, supported by:

  • Clinical claim review before payment.
  • Fraud, waste, abuse, and billing review.
  • Drug optimization for high-cost medications.
  • International sourcing when appropriate.
  • Focused review of specialty and complex claims.
Explore Medical Cost Containment

Care Management

When members are navigating a serious diagnosis, a complex treatment plan, or an ongoing condition, better support can improve both the care experience and the way the plan performs.

We provide clinical guidance across:

  • Large case management
  • Disease management
  • Maternal health
  • Behavioral health
  • Oncology support
  • Transplant support
  • Utilization management
Explore Care Management

Pharmacy Benefit Management

Pharmacy decisions affect overall plan cost, but the drivers behind that spending are not always easy to see in standard reporting.

We conduct an in-depth review of:

  • PBM contract analysis
  • Pharmacy vendor evaluation
  • Drug spend trends
  • Transparency opportunities
  • Overall pharmacy strategy and performance
Explore Pharmacy Solutions

Consumer-Driven Products

Account-based benefits and continuation coverage need to work cleanly for the employer administering them and the member relying on them.

Our support is structured around:

  • COBRA
  • Family Medical Leave
  • HSA
  • HRA
  • FSA
Explore Consumer-Driven Product
Why Point C?

Point C is a national Third-Party Administrator with local market presence, providing customized self-funded benefit programs.

Through thoughtful administration, innovative cost-containment strategies, and high-touch service, Point C empowers clients to go beyond the standard “point A to point B” to Point C.
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Point C team collaborating with an employer

Ready to build the right solution strategy?

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Frequently Asked Questions

What are self-funded health plan solutions?

Self-funded health plan solutions are services and programs that help employers manage the cost, performance, and administration of a self-funded health plan. These solutions may include medical cost containment, care management, pharmacy strategy, consumer-driven products, and TPA administrative support.

What solutions does Point C offer?

Point C offers self-funded health plan solutions through its independent TPA model, including medical cost containment, care management, pharmacy solutions, consumer-driven products, specialty carve-out support, and administrative services. These solutions are designed to help brokers and employers control costs, support members, and strengthen overall plan performance.

How do self-funded health plan solutions work together?

Each solution addresses a different part of plan performance, but the greatest value comes when they work together. Combining cost containment, care management, pharmacy strategy, and administration creates a more coordinated approach to managing a self-funded health plan and helps employers make better-informed decisions over time.