Cost-Effective Healthcare Solutions Needed Now More Than Ever
Ready for Post-COVID Premium Price Hike?
When the curve flattens, the trendline slopes downward, and we’re no longer sheltering in place, COVID-19 economic fallout is likely to leave the executives of your groups searching for low-cost healthcare solutions.
Best estimates now stand at 2021 premiums increasing between 4 and 40%.[i] Cost escalation is compounded by the revenue cessation the virus caused American business.
Writing in Benefits Pro April 2[ii], Larry Thompson of Advanced Medical Pricing Solutions, cited an estimate from Covered California, the state’s Affordable Care Act marketplace:
“The cost of COVID-19 testing and treatment is expected to soar for employers and commercial insurers, likely to top $100 billion.”
No matter how easily our politicians toss around billion- and even trillion-dollar financial figures, the recapturing of coronavirus costs -- coupled with a likely decline in company profits – creates the perfect storm of benefits downsizing through whatever means possible.
Mr. Thompson advised Benefits Pro readers that “layoffs, cost-shifting and dropped coverage should be the employer’s last option to combat rising health costs.” He offered three strategic suggestions:
- Self-funded plans with medical bill review
- Reference-based pricing
- Care navigation
We couldn’t agree more and have a couple more solutions to add to the list.
As a TPA, we process thousands of claims for our OptiMed Health branded products, putting each medical charge under the microscope to assure its accuracy. We sift out upcoding, duplications, and erroneous charges.
Self-funding and reference-based pricing blend together like peanut butter and jelly. Maybe that’s because when you’re paying the claims directly – meaning the employer – cost concerns soar. Our reference-based products set reimbursement at a percentage of the Medicare rate.
Finding providers and filing claims are accommodated through our website, OptiMedHealth.com.
Cost-Effective Coverage: Limited Medical Indemnity Plans
Many essential industries, such as healthcare and transportation, are working around the clock to keep us safe and keep our shelves stocked with essential goods and are adding many new part-time. Limited Medical Plans are a cost-effective healthcare plan to provide immediate benefits to these workers. Highlights of Limited Medical Plans include:
- Customizable solution.
- Coverage effective on the date of hire.
- 100% employee-paid, 100% employer-paid or combination thereof.
- Low participation requirement.
- Guaranteed Issue, no pre-existing conditions.
- Unlimited telephonic doctor office visits with NO copay for the member.
Savings Through GAP Secondary Insurance
While the current estimates fluctuate between 4 percent and 40 percent, the only real certainty is that sticker shock is likely to prevail at renewal time.
One of the most cost-effective solutions to lower costs on a major medical healthcare plan is to increase the deductible. The downside is the exposure of employees to out-of-pocket expenses.
GAP Secondary Insurance is a solution to out-of-pocket expenses. If you have never sold a GAP policy, now is the time to do so. Our online rating tool makes it easier than ever to select a GAP plan that will work for your group.
Don’t Forget About the Non-insurance Extras
Limited Medical and Gap plans come with non-insurance extras that are providing tremendous value, such as:
- Telemedicine for a phone or video doctor’s appointment within about 15 minutes any hour of the day, any day of the year.
- Employee Assistance Program for counseling on financial, personal, and work-related matters.
- WorkPlace Wellness for expert advice on eating healthfully and exercising effectively, with options for weight-loss programs and disease-management.
For more information on any of our products or services, please contact your OptiMed Health sales consultant.