When it comes to health plan management, the stakes are high – and the risks are even higher. Data is a self-funded gold mine. But employers need to act on the data they have. With so much information to analyze, where – and how – do you start? Nova Healthcare Administrators has identified 4 helpful READ MORE>
Pinterest has joined a growing rank of employers who are fed up with the healthcare system and doing away with traditional insurance models as a result. The social media platform switched from their traditional healthcare plan to a self-funded model.... Pinterest isn’t the only employer to seek out alternatives to the traditional healthcare system. Last year, Amazon.... READ READ MORE>
The combination of working with a TPA to better understand the health care usage habits of your employee population (through plan data analysis) and having the flexibility to make plan adjustments when needed is a big benefit of the self-funding structure. A TPA with 25-plus years of experience, Integra Administrative Group was asked to bid READ MORE>
Following a recent hearing that covered the issue of surprise billing in health care, the Society of Professional Benefit Administrators (SPBA) was part of a collaborative effort in which 30-plus organizations urged the United States Congress to pass additional legislation as a protection to patients.... “As an advocate for our third party administrator members and READ MORE>
Self-funding and reference-based pricing are hot topics with small businesses. They are so popular, in fact, that a recent survey shows an overall increase in their 2019 projection of small employer clients having a reference-based pricing health benefit plan design.... Self-funded health benefit plan designs that use reference-based pricing can allow for a great deal READ MORE>
Having access to plan data is a unique advantage in self-funding that gives employers the ability to identify cost-driving trends and make the necessary adjustments to address them. Nova Healthcare Administrators, Inc., shares an example of how this diligent data monitoring led one client to recognize a trigger behind the overutilization of emergency room visits READ MORE>
Marilyn Bartlett took a deep breath, drew herself up to her full 5 feet and a smidge, and told the assembled handful of Montana officials that she had a radical strategy to bail out the state's foundering benefit plan for its 30,000 employees and their families. The officials were listening. Their health plan was going READ MORE>
Drew Calver, a high school history teacher and swim coach in Austin, Texas, had a heart attack at his home on April 2, 2017. A neighbor rushed him to the nearby emergency room … which was out-of-network on his school district health plan. …his health plan paid nearly $56,000 …. but the hospital charged Calver READ MORE>
Society of Professional Benefit Administrators (SPBA) Chair Kevin Schlotman, Benovation, testified on August 4, 2018, before the Health Insurance and Managed Care (B) Committee ERISA (B) Working Group at the National Association of Insurance Commissioners (NAIC) Summer Meeting held in Boston, Mass. One of the main issues discussed by the NAIC at the summer meeting READ MORE>
Rising prices, billing disputes, and a quirk in federal law are creating a new health-care headache -- When three-year-old West Cox’s fever hit 107 degrees, doctors called a helicopter…. Flying would cut a 90-minute drive in half…. Three years later, his parents are still reckoning with the aftermath of his 76-mile flight: a bill for $45,930 READ MORE>