Business Details
45 Years
experience
Trusted Health Plan Consulting Services in Hanover, MA
Since 1981, our firm has specialized in health plan consulting and administrative services for Massachusetts employer groups. Our expertise in state-specific regulations and federal laws enables clients to navigate complex benefit landscapes with confidence. As a Hilb Group member since 2022, we combine national resources with localized, hands-on service. Our team delivers customized solutions for self-insured and fully-insured clients while maintaining enduring relationships built on trust and regulatory expertise. We focus on minimizing risk exposure through comprehensive stop-loss insurance management and claims administration tailored to municipal and private-sector needs. 
Services
Health Plan Consulting
Medical Stop-Loss Management
Claims Administration
Regulatory Compliance
Insurance Advisory Services
Details
- Year established: 1981
Highlights and features
- 40+ years of Massachusetts-specific health plan expertise
- Direct access to Hilb Group's national insurance resources
- End-to-end stop-loss insurance policy management services
- Proven track record with municipal and private-sector clients
- Personalized consulting focused on regulatory compliance
Services
Health Plan Consulting
Our health plan consulting services help Massachusetts employers evaluate insurance options while complying with state-specific regulations. We analyze benefit structures, negotiate with carriers, and implement cost-effective solutions tailored to municipal and private-sector needs. Our expertise in M.G.L. Chapter 32B and Affordable Care Act requirements ensures clients maintain compliance while optimizing coverage.
Medical Stop-Loss Management
We specialize in managing stop-loss insurance policies for self-insured municipalities. Our services include deductible evaluation, policy feature analysis, and carrier negotiations to ensure financial predictability. By tracking claims history and securing competitive quotes, we help clients mitigate large claim risks while maintaining regulatory compliance with Massachusetts-specific requirements.
Claims Administration
Our comprehensive claims administration handles all aspects of stop-loss insurance claims processing. We verify eligibility, track claims history, and ensure timely reimbursements from top-rated carriers. This end-to-end management reduces administrative burdens for clients while maintaining accurate documentation for regulatory audits and future policy negotiations.
Regulatory Compliance
We provide expert guidance on Massachusetts employee benefit statutes and federal regulations including ACA requirements. Our team helps clients navigate complex legal frameworks through policy reviews, committee consultations, and documentation preparation. This ensures compliance with both state-specific mandates and national healthcare standards while minimizing legal exposure.
Insurance Advisory Services
Our advisory services focus on helping clients understand insurance market dynamics and risk management strategies. We analyze coverage options, recommend policy modifications, and provide market trend insights. This enables employers to make informed decisions about self-insured and fully-insured plans while maintaining financial stability and regulatory compliance.
People
Susan Shillue
Managing Director
With decades of experience in Massachusetts health insurance markets, Susan leads strategic consulting services for municipal clients. Her expertise in state regulations and stop-loss insurance helps clients optimize coverage while maintaining compliance with evolving healthcare laws.
Danielle Chaplick
Practice Leader, Public Sector (New England)
Danielle specializes in public sector health plan solutions, focusing on municipal risk management strategies. She helps cities and towns navigate complex insurance markets while maintaining cost-effective, compliant benefit programs tailored to local government needs.
Merrilyn Rydstrom
Computer Services Manager
Merrilyn oversees technical systems supporting insurance administration and claims processing. Her IT expertise ensures efficient data management for stop-loss policies while maintaining security standards required for sensitive health insurance information.
Questions
What services do you offer for Massachusetts municipalities?
We provide health plan consulting, stop-loss insurance management, and claims administration services specifically tailored to Massachusetts municipal regulations and employer needs.
How do you help employers reduce insurance costs?
Through customized plan designs, competitive carrier negotiations, and risk management strategies that leverage our local market expertise and Hilb Group resources.
What makes your firm different from other insurance agencies?
Our 40+ years of Massachusetts-specific experience combined with national resources from Hilb Group provides unique expertise in municipal health insurance solutions.
How does your stop-loss insurance management work?
We handle policy evaluation, deductible analysis, carrier selection, and claims processing to protect self-insured clients from catastrophic losses while ensuring regulatory compliance.
Do you work with both public and private sector employers?
Yes, we serve Massachusetts municipalities and private-sector businesses with customized health plan solutions that address their specific regulatory and financial needs.
