Health Plan Broker
basketball jones
3 Posts
I attended a seminar sponsored by the Liberty Benefits Group. They were talking about saving money by re-writing our contracts with our TPA and perscription benefit manager as well as other cost saving ideas.
What they said sounded good, but almost sounded too good to be true.
Has anyone heard of Liberty Benefits Group ( or Liberty Health Group)? Are they for real, can they do what the claim to be able to do?
What they said sounded good, but almost sounded too good to be true.
Has anyone heard of Liberty Benefits Group ( or Liberty Health Group)? Are they for real, can they do what the claim to be able to do?
Comments
Not to be too cynical, but if you stay with your current TPA, they probably won't lower their fees because of a new broker, same with your PBM. If they offer "off the shelf" fully insured products, then no broker can get a "deal" unless they are rebating, which is illegal in some states. If your plan is self-funded, then be careful of new numbers; these are based on experience and trend and shouldn't be "trifled" with, without good reason. Tell us some more about this company and its propositions.
They were pitching an HRA with high deductible product (nothing new). However they said they would work with our group to be able to negotiate with doctors and pharmacies to be able to get discounted rates on services and perscriptions by paying cash at the time of service rather than waiting for the bill to be processed by the TPA. Similar to an FSA reimbursement arrangement I think?
They said that TPA fees should be between $15-$21 per month per employee. But that some are charging over $100 per month per employee. They said that medical cost inflation is raising at about 6% per year, yet premiums are raising at double digit rates per year.
They told me that they were able to negotiate with one doctors group to charge $27 for an office visit if cash was paid at the time of the visit, instead of their usual fee of $86 if billed through the insurance company.
They said that there are often rebates given to the PBMs that reduce the cost of perscription drugs. And that these rebates are often pocketed by the PBM instead of being passed on to the group (depending on how the contracts are structured).
I wanted to get a brokers perspective without alerting my own broker that we were looking at another option. I really appreciate any thoughts you would have.
I am wary of "discount" plans. There have been several plans like this nailed by states' AGs in the last few years. They don't call themselves insurance (only discounts) to escape the jurisdiction of insurance commissioners.
I don't know how large your community is, but one doctor group for discounts isn't sufficient, in my opinion. Examine what you are trading off.
It's unconceivable to me that a PBM would pocket any savings on prescription drugs; that's the point of PBMs, besides the drug management aspect.
Can your employee population handle a transition to up-front out-of-pocket expenses? They would save on the premiums with a high deductible, but the HRA contribution is their money, even though it's not taxable. I don't know what your current plan design is, PPO?
What kind of compensation is this group going to make on a deal with you? They need to disclose it to you based on your census and choices.
Bottom line, lots of questions. Even with the new allowable OTC items in your FSA if you have one, I don't think the vaseline qualifies.