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Novo Connection Fiduciary Responsibility


Understanding the Importance of Compliance in Employee Benefit Programs


Considering recent industry lawsuits, the onus of fiduciary responsibility is now placed on employer groups, putting compliance and transparency at the forefront of concerns for employee benefit sponsors. Plan sponsors are grappling to hold prescription and medical administrators (Pharmacy Benefit Managers, Third Party Administrators, and Network Carriers) accountable for outrageous drug and medical costs while also ensuring the well-being of their employees. Novo Connection’s technology represents a ​paradigm shift in the employee benefit space, ​prioritizing member needs, program cost ​containment, and providing insights into fair ​costs for prescription and medical costs-going ​above and beyond industry standards ​for compliance and transparency.​


Accountability Matters

Holding Prescription Benefit Managers and Networks to Standards with Advanced Market Checks 

At the center of our approach is our ability to hold Prescription Benefit Managers and Network Carriers accountable to contracts and ethical pricing. Novo Connection’s proprietary platform allows real-time analysis and monitoring to find discrepancies and inefficiencies within the group’s current Rx and Medical plans.​


Our Rx Market Checks can:

  • Identify high-cost drugs compared to fair market value and provide solutions to keep costs in check.  

  • Find safe, low-cost alternatives to high-cost medicines. ​

  • Pinpoint key pricing discrepancies and implement solutions that affect plan spend the most. ​

  • Monitor plan performance and contractual guarantees. ​

  • Identify opportunities for contract negotiations. ​


Our Medical Market Checks can:

  • Provide transparency into plan spend at the physician, participant, and individual claim level ​

  • Make shifts in real-time to make sure spending is on track ​

  • Offer insights into plan utilization by plan members and provides recommendations for cost-saving mechanisms  ​

  • Forecast solutions to add-on to improve performance ​

  • Give insights and recommendations into J-Codes, payment integrity, and Medicare pricing ​

  • Identify opportunities for contract negotiations ​

Using our Medical and Rx Market Checks can expose unethical practices and ensure plan sponsors are fulfilling their fiduciary duties to act in the best interest of their members.

Finding Alternatives

Proactive Measures to Avoid Legal Pitfalls

Novo Connection has always offered compliant and transparent program options – from off the shelf programs, to fully customizable self-funded solutions.​

Paired with the capabilities of the Novo Connection platform, our sister company Apta Health offers turnkey, self-funded solutions that have proven to have an increase in member engagement and drive down both medical and Rx costs. Apta Health offers a Cash-Centric program that pre-negotiates procedure prices before they happen - eliminating balanced billing and unethical pricing before the member walks through the door for their appointment and ensuring plan sponsors comply with fiduciary responsibilities.​

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Additionally, our in-house Service Team actively engages members through personalized proactive outreach, using our proprietary data, when it finds potential solutions. These efforts result in a remarkable 400-500% increase in engagement with point solutions.​


Switching to Novo Connection

Navigating Fiduciary Compliance with Confidence 

The era of static benefit planning is over. With our innovative technology, plan sponsors can navigate the task of picking a benefit program with confidence, ensuring fiduciary compliance while prioritizing the health and well-being of their members. ​

By using advanced Medical and Rx Market Checks you can feel safe knowing your plan is offering the best benefits at fair market prices. Novo Connection is the tool you need to alleviate risk and simplify benefit decision-making.​

Novo Connection has saved groups millions of dollars using our analytics platform. Contact us today to schedule a demo.
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