Health care costs have been trending upward for a number of years. Employers in the U.S. expect the cost for medical plans per employee to raise 5.6% on average in 2023, according to Mercer, a human resources consulting firm. This has led many employers to search for affordable insurance options to lower expenses without sacrificing quality for their employees.
With traditional group health insurance plans, employers use their bargaining power to purchase coverage from insurance companies at a lower rate than individuals usually pay, and they cover a majority of employees’ premiums. The insurance companies pay employees’ claims using the premiums paid by the employer and keeping all unused premiums for themselves.
Level-funded group health plans allow employers to pay for claims themselves, saving money on profits that typically go to insurance companies and are protected by stop-loss insurance that caps their total claims exposure. These plans have become increasingly popular among small employers because they set level monthly payments, the same as a tradition insurance plan. These payments go towards covering the estimated costs of expected claims, administrative costs and stop-loss insurance. But with a level-funded plan, employers can actually see money returned when their group has a healthy, low-cost year.
Telehealth, also called telemedicine, allows you to receive health care without an in-person visit to a provider by using computer, tablet or smartphone.
Telehealth technically started in the 1940s in Pennsylvania when providers realized they could send radiology images over the phone lines between two townships. In the 1950s, a Canadian doctor expanded on the concept and constructed a teleradiology system that was used in and around Montreal. And in 1967, the University of Miami School of Medicine partnered with a local fire department to transmit electrocardiographic rhythms over radio to Jackson Memorial Hospital in rescue situations.
With the school year beginning, that means kids across the country are back to playing sports in middle school, high school and college. In addition to playing for their schools, some student athletes participate in club athletics over the course of the year.
As the parent of a student-athlete, you obviously know what’s best for them when it comes to their athletic careers and that includes being prepared for things like injuries in case the schools and athletic organizations don’t have medical coverage.
It’s no wonder small businesses are confused when they are told they need to file Form 5500 with the Internal Revenue Service (IRS) and pay PCORI fees. For instance, if you look up 5500 filing requirements on the Internet, most sites say something like, “Form 5500 is required on behalf of any welfare benefit plan that has 100 or more participants as of the beginning of the plan year or is funded through a trust, regardless of participant count.”
Clear as mud to the average employer, right? WRONG! Let’s break it down.
Since 1949, May has been observed as Mental Health Awareness Month. It was established to increase awareness of the importance of mental health and wellness and to celebrate recovery from mental illness.
Telehealth is now playing a huge role in treating mental health and substance abuse. Telehealth is a covered benefit by many employer-based health plans as well as Medicare and Medicaid plans.
For many, the end of the year is a time to slow down, relax and reflect on the year behind us while setting resolutions for the year ahead. At Allied National, our employees are busy paying claims, providing agent support, closing new business and booking renewals. But we still have time to look back at what we accomplished in 2021 and share with our readers what’s ahead for Allied National in 2022. And be sure to take our quick survey at the end for a chance to win an Amazon gift card!
Direct Primary Care (DPC) is capturing the attention of employers who want to offer better health care coverage to their employees. With DPC, a patient can form a one-on-one relationship with their doctor and have 24/7 access to medical care. DPC has been shown to help provide superior healthcare for individuals, lowering their overall healthcare costs and improving outcomes.
The challenge for employers who want to offer DPC – how to ensure employees are covered for both primary care health services and care the DPC doctor can’t provide.
The Affordable Care Act (ACA), also known as Obamacare, is a health care reform law that was enacted in March 2010. Some of the key goals of the ACA were to:
However, even though there are some “pros” to the Affordable Care Act, there are just as many “cons” for an ACA plan, many of which led to significantly higher health insurance premiums for individual and small employer health insurance.
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.
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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.