Notice of Benefit and Payment Parameters Finalized for 2022
On May 5, 2021, HHS finalized its second Notice for Benefit and Payment parameters under the ACA that apply for 2022.
Your Third-Party Administrator’s Hidden Revenue
Your TPA makes more money from processing out-of-network claims than from doing its job—administering your health plan! Employers pay a fee to a third-party administrator (TPA) to administer, adjudicate, and pay claims on behalf of their company’s health plan. However, this investigation details how, in some cases, TPAs make MORE money on “negotiating” your out-of-network …
Does Size Really Matter
Large brokerage firms couldn’t save you money if they wanted to. When partnering with another company, executives tend to worry about whether this new partner is big enough. “Will they be able to handle our growing company?” they think. “And do they have the resources to support our expanding objectives?” This Industry Insight argues against …
Overcoming the Know-Do Gap in Fixing Healthcare
Healthcare is already fixed. It’s time to implement. There is often a gap between what decision-makers know, and what they choose to do with such information. We call this the “Know-Do Gap.” Relying on more than 50 authoritative sources and 7 other internal education content pieces, this Industry Insight explains the strategies the employee benefits …
Fully Insured vS. Self Funded Health Plans
It’s the difference between paying rent and investing in a mortgage. Many employers are understandably confused about the difference between having a fully insured health plan and a self-funded one. This Industry Insight compares the two models of financing one’s health plan, explaining how self-funding is superior to being fully insured in all cases with the …
Your Plan to Reduce Healthcare Spending by 20-50%
Controlling healthcare costs means understanding the core parts of your health insurance plan. Wincline’s plan for employers to reduce their healthcare spend by 20-50% has been a while in the making. It is the product of 15 years of employee benefits experience, 4 of which were spent intensely studying what causes healthcare plans to fail and succeed. It also took our …
Your Plan to Reduce Healthcare Spending by 20-50% Read More »
Does Your Broker Outsource Your Stop-loss Insurance?
Your benefits broker is likely using a third-party to shop for stop-loss insurance quotes and policies, which introduces hidden overrides and commissions.
Employer Checklist: What to Ask of a Benefits Broker or Advisor
If you don’t know what to ask of the person who manages your benefits, you are likely being taken advantage of. When employers get bad news at their benefits renewal, they often wonder if there are better options available. How can they make an intelligent decision about which benefits company to choose? This checklist of …
Employer Checklist: What to Ask of a Benefits Broker or Advisor Read More »
Why Medicare is a Good Benchmark for Reference Based Pricing
Medicare is an excellent benchmark for pricing medical services, acting as a concrete reference point for negotiations between employers and providers.
Are You Paying to Get Ripped Off?
Health insurance is designed to cover large costs. So why are employers regularly paying more for procedures through network discounts?