News & Events
A collection of upcoming events and Total Control Health Plans mentioned in the media.
No Results Found
The page you requested could not be found. Try refining your search, or use the navigation above to locate the post.
Start a Conversation
Let’s have a conversation on our dime to see if a Total Control Health Plan will meet your business or organization’s goals.
Contact us to schedule a free consultation today.
What is MLR?
MLR, or Medical Loss Ratio, is a prime example of misaligned incentives in the health care supply chain. The Medical Loss Ratio is a provision in the Affordable Care Act that was intended to keep insurance carriers from over charging their customers. It requires that carriers spend $.80 of each dollar collected in the small group market, and $.85 of each dollar collected in the large group market, to pay its customers’ medical claims and activities that improve the quality of care. The remaining portion can be used for overhead expenses, such as marketing, profits, salaries, administrative costs, and agent commissions. If health care costs go up, however, then the carrier is justified in charging higher premiums increasing the value of their 15% or 20%. With a model like this, carriers benefit when health care costs go up.
What’s the Difference?
Implementation & Negotiation
We work directly with the highest quality healthcare providers, PBMs, TPAs, drugmakers and medical managers to negotiate competitive pricing and clear processes for employees.
Empower Your Employees
In collaboration with your management team, we help engage your employees in the changes and advantages of the new benefits offering. Your employees will be able to make more informed care decisions when equipped with insight into cost and quality of available providers.
Implementation & Negotiation
We work directly with the highest quality healthcare providers, PBMs, TPAs, drugmakers and medical managers to negotiate competitive pricing and clear processes for employees.
Empower Your Employees
In collaboration with your management team, we help engage your employees in the changes and advantages of the new benefits offering. Your employees will be able to make more informed care decisions when equipped with insight into cost and quality of available providers.