We have several clients who have decided to take control of their health care spending by reimbursing hospitals on a cost-plus basis rather than rely on PPO discounts off billed charges.
Here are a few recent examples:
Billed Charges Plan Payment
1. $59,248.72 $11,034.84
2. $ 7,682.20 $ 865.02
3. $25,245.63 $ 6,864.73
4. $443,076.26 $116,086.39
Under ERISA a Plan Fiduciary must pay only what is fair and reasonable. Fiduciary liability is transfered to a third party who handles claim appeals and provides defense in Federal Court. An insurance policy indemifies the employer. 
