To Network, or Not To Network? That is The Question. Q: What do you get when you strip away the network from a health insurance carrier? A: An expensive claims administrator While certainly there are additional roles that insurance carriers fill, ultimately their...
Given enough information, most individuals tend to make the “right” decision. In the case of health insurance, all things being equal, the “right” decision is to go to the highest quality and lowest cost providers. The problem with health insurance is that rarely do...
Within the last two years I was working with a client with approximately 400 employees on their medical plan who was contemplating transitioning from a fully-insured plan to a self-funded plan. Approximately 6 months prior to their potential go live date of the...
Generally speaking, the “fixed costs” (administration, stop-loss/pooling, network access) represent 20% of health plan costs with claims representing the other 80%. As a result, it would be logical for those concerned about cost reduction to focus on the 80%,...