Sierra-Berkshire Associates, Inc., is a Reno based actuarial consulting firm for insurance carriers, Physician Hospital Organizations, Independent Practice Associations, Plan Sponsors, TPA’s and marketing organizations. One aspect of their work is designing group health insurance plans for insurance carriers.
In 2005, well before the market began to move away from managed care contracts, Sierra-Berkshire designed a program to approximate Medicare coverage features, employing an approach to medical expense treatment that already had wide acceptance by consumers and by the medical community. After all, most hospitals and doctors accept Medicare patients and almost never balance bill. So if a provider is happy to accept Medicare and the fees paid to them, they should be quite satisfied with the plan Sierra-Berkshire designed.
Attached is the Business Plan for the product developed by Sierra-Berkshire in 2005. Apparently the concept did not fly with the carrier/s and the product was never marketed.
One of the principals of Sierra-Bershire writes: “We were too visionary in 2005 . . . no carriers were interested in our concept. Funny how stupid ideas become smart as wisdom is gained from the suffering of pain.”
Editor’s Note: The ComparaMed Care Plan would sell today, fully insured or self-funded. If almost all hospitals and doctors accept Medicare and don’t balance bill patients, why should they object to a Medicare Look-Alike Plan that provides the same exact benefits with the same exact reimbursement rates? “Hey doc, since you take Medicare patients, accept assignment of benefits, and dont balance bill, you should have no problem with my insurance either.”
