Reference-based pricing (RBP) is touted as the economical alternative to Preferred Provider Organization (PPO) pricing and statistics bolster that claim.
RBP is a reimbursement methodology primarily used by self-funded employers. Instead of carriers negotiating a fee directly with a provider (usually through a PPO network), employers reimburse providers and facilities according to a reference point – such as a percentage above of Medicare rates. For instance, Allied National’s self-insured Funding Advantage Freedom Plans reimburse physicians at 125% of Medicare and facilities at 150%.
The question many people have is whether RBP really can save employers and employees a significant amount of money on group health plan premiums and member out-of-pocket costs.
Article reposted with permission from BenefitsPro. Written by Kelly Smith, Senior Vice President at MVP Health Care.
Brokers are experiencing an increase in demand for level-funded plans, which are an exciting offering providing predictability, funding diversity and innovation to their portfolio.
“Open Enrollment is coming!” – A phrase you’ve most likely heard at least a few times recently.
The federal Open Enrollment Period (OEP) happens once a year for individual health plans in the ACA marketplace. For most states, you have from Nov. 1, 2021, to Jan. 15, 2022, to choose a health plan for 2022 and get signed up. In order to get coverage starting Jan. 1, 2022, you would need to be enrolled by Dec. 15, 2021.
Although Preferred Provider Organizations (PPOs) have been a popular group health benefit plan feature since their introduction in the 1980s, their shine is starting to fade.
PPOs are supposed to be a great way to lower health care costs. Providers agree to a discounted rate in exchange for insurers steering members to their services. The problem is that retail prices charged by hospitals and physicians continue to rise steeply.
Ned Schaut, President at Agency Leverage, and host of Benefits Influencer - a podcast highlighting thought leaders in the Employee Benefits industry – recently interviewed Allied National Executive Vice President Gary Ashley.
The pandemic has had an enormous impact on every aspect of our lives, including the way employees view employee benefits. Employers are having to rethink what kind of perks, benefits and incentives will keep workers engaged and offer a competitive advantage in a post-pandemic world.
Despite the numerous changes to the Affordable Care Act (ACA), applicable large employers (ALE) must still provide group health benefits to their employees. These benefits must meet at least the minimum standard as set by the federal government or the employer will be required to pay a penalty.
Mental health is an incredibly broad subject. When you hear someone talking about mental health, what do you think? It is not just about people who have multiple personalities or severe alcohol or drug additions.
Has this happened to you? Your insurance company sends you a statement in the mail about a medical claim and you’re left wondering if that’s what you owe or if you’re supposed to ignore it.
Don’t ignore it!
Heavy metal is good for your health!
No, not literal heavy metals, which can be toxic and problematic, but heavy metal music. Heavy metal music is a great way to lower blood pressure and believe it or not, reduce anxiety. Experts say that some of the topics sung or screamed about in heavy metal music help fans of the music genre release aggression and deal with some of the existential challenges we all face in our lives.
Welcome to the Allied Blog
Allied National is a 90 Degree Benefits Company, a subsidiary of Blue Cross Blue Shield of Alabama. Founded in 1970, Allied National is one of the nation's oldest and most experienced third-party administrators. We're the small group benefit experts working to provide unique and affordable group health benefits to small business employers.