Business

Are you paying your benefits advisor for activity or for results? Are you paying them to administer your plan or to control your costs? There are eight questions you can ask to find out. 1.  Are you able to provide my medical and claims data and insights from my fully insured health plan? You will find out […]

Many midsize employers believe that self insurance is full of rules and redtape that fully insured plans don’t have. However, that’snot necessarily the case. Compliance is integral to self insurance and there are several items that you are responsible for as a self-funded employer, including:• ERISA fiduciary responsibilities,• Non-discrimination rules,• Reporting and disclosure,• Requirements notices,•

The number one concern I hear from employers when we talk about migrating to a self-insured or partially self-insured environment, is that they don’t want to be responsible for all the claims. What is stop-loss coverage? Stop-loss or reinsurance is how you protect yourself from large claims if you are self-insured. You should always have reinsurance. What

I imagine you’ve heard about several different ways to manage your stop-loss coverage as a mid-sized employer. I’m going to explain on option, stop loss coalitions, and how to make these contracts work for you. With group stop-loss coalitions you would purchase stop loss coverage as a group to help mitigate your risk, like you

UPDATE: We filmed this video a bit ago. At the time we made this, unemployment was quite low. That the unemployment rate is significantly higher and the economy is uncertain is even more reason to contain your costs. Not just because you want to keep those people, but because you want to keep those people

What Is RBP? RBP stands for reference-based pricing, a tool that many employers today are using to cut their health insurance costs.The most common concern I hear from employers about RPB is that providers won’t accept reference based plans, or that the employee will have a large balance bill. Neither of these things are accurate if

If you’rereading this article, you’re likely considering offering care management and patient advocacy to your employees. Congratulations! You want to help your employees, but at the same time, it needs to be budget-friendly. The process to add patient advocacy and care management is relatively simple. However, like most things in the health insurance industry, it’s not

It’s no secret that employers want to control their costs, and at the same time help their employees to have access to the highest quality care at the lowest possible price. Bundled pricing is a one-off arrangement that employers have with a specific facility (i.e. hospital, outpatient facility, imaging center, etc.) where the price is negotiated

The buzz around health insurance right now is all about user experience and access to care. The problem is two-fold: insurance literacy and health literacy. Would it surprise you to learnthat 90% of employees do not know the difference between a copay,coinsurance,and a deductible?While that may seempretty basic to people like me in the insurance industry,this lack

Have you ever wondered if large employers get a better deal on health care costs? The answer is a resounding yes. That doesn’t seem quite fair as an SME employer does it? Well, what if I told you that you could buy health care the same way that they do through a direct contract? A direct