Tag Archives: stop loss insurance

Does Reference Based Pricing Make Sense for Your Organization?

The lack of transparency around medical pricing puts self-insured employers and their employees at a disadvantage. Without the bargaining power that major insurers have, self-insured employers can’t be certain that they’re getting the best possible prices for the services that their plan members need. Enter reference based pricing. It’s a pricing strategy that more and more self-funded employers are using to control costs. Traditionally, hospitals and health care providers set inflated prices for services and insurers negotiate lower rates for their members. A procedure that a hospital charges $10,000 for may only be billed at $5,000, depending on the patient’s insurance plan. Continue Reading >

Subrogation: What Is It & How Can It Lower Insurance Costs?

The insurance industry is saturated with complicated jargon that can be overwhelming to anyone buying insurance. However some of these complex terms found in your policy can save your city or town money. An increasingly popular term that is listed in nearly all self funded plans and stop loss insurance contracts is subrogation. So what is subrogation and how can it lower the cost of your insurance? Continue Reading >

Backdoor Regulation of Self-Funding | Stop-Loss + the ACA

When the Patient Protection and Affordable Care Act (“PPACA”), (now commonly referred to as the  Affordable Care Act, the ACA, or "Obamacare") was signed into law by President Barack Obama on March 23, 2010, both the health benefits and health care industries were abuzz with rumor, conjecture, and fear.  As the dust has settled, we who service these industries have begun to appreciate the real impact the law has had on both the provision of health care, as well as payment for that care. Continue Reading >