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Healthcare

What is Stop Loss Coverage?

The Ins and Outs of Stop Loss and Reinsurance

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 […]

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No More Mistakes

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

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Reasonable Healthcare Cost

How Can I Offer Care Management and Patient Advocacy to my Employees at a Reasonable Cost?

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

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Bundled Pricing for Employers

How to Make Bundled Pricing Work for You and Your Employees

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

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Lower Your Health Cost

Lower Your Health Care Costs by Offering High Quality Service

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

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The Real Price of Your Prescriptions

For most employers, prescription spend.. drug costs… are steadily increasing. In fact, pharmacy costs account for almost 25% of most employers’ health care budget every year. The Pharmacy Benefit Manager (PBM), is a company that manages your prescriptions, including allowable medications on your formulary, what you pay for them, what the manufacturer paid for them, and

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