Since the ACA introduced a medical loss ratio rule, capping insurer's profits at 20%, all the major carriers have managed to post record breaking profits! How? They own their own pharmacy benefit management companies which don't have capped profits! Pharmacy spend is outpacing medical year over year. We have partnered with major international pharmacy firms (all sourcing from tier 1 countries with as tight or tighter federal regulation on their medicines as the U.S.) as well as nation-wide 340b pharmacies to drastically reduce the amount your plan spends on medicine!
We have major hospital systems that have agreed to pricing of 145%-165% of Medicare - far less than the major carrier networks that are built in as a tier 1 network in the plan. Employees who stay within this tier spend far less on copays and deductibles...not their network preference? That's fine, we wrap a nation-wide PPO around it to give them a robust offering of their choice.
Built into out plans, we screen for 501R eligible claims drastically reducing hospital spend at all non-profit hospitals!
Have issues getting IVF treatment or genetic therapy? We have a network of JCI accredited hospitals worldwide that guarantee a savings over 150% of Medicare reimbursement - complete with travel expenses that can all apply to stop loss!
No Problem! All of this comes with white glove concierge service! One phone number for medical advocacy and steerage to the most pertinent cost saving measures - making win/win scenarios for employers and employees! Employees don't even need to use a network lookup tool, simply call and talk to the team about the condition you are experiencing and they will find provider options for you, help you steer to the best fit, and they will even help you schedule.
We got you covered here too! We provide all of our clients with a 24/7 online benefits administration platform that, in most cases, integrates with your payroll provider. We integrate COBRA services, all ancillary lines, load customizable enrollment videos as well as support numerous HR functionalities like collecting signatures on employee handbooks. We also give all of our clients access to the Mineral HR platform at no cost! This gives you salary comparison calculators, a living handbook that HR professionals automatically draft new language to make your handbook compliant when your state or federal government passes a law that impacts your current handbook, and daily access to HR professionals to answer any questions or concerns you might have with your business operations!
Negotiating with our stop loss carriers, we've leveraged our programs and vendor partners to get decrement on our underwritten rates! Some of our stop loss carriers give our plan, that includes a network, lower rates than their reference-based pricing plans! No balance bill headaches and full provider acceptance with the same if not lower rates!