RBP Vendor Offers More For Less

By Bill Rusteberg

As RBP grows so will the number of new entrants into the market with improved benefits and competitive pricing. That’s good for business.

The shelf life of any product is limited to the extent that it wants to be. Old time RBP vendors who fail to follow the market will suffer a short shelf life while those that grow with the market in terms of adaptation and innovation will survive longer.

Years ago we predicted a maturing RBP market. Now we are seeing it happen faster than a melting raspa on a hot August day in deep South Texas – Xerox, Eastman Kodak And Cost Plus Insurance.

From our vantage point we have discovered what we believe could be the best choice in RBP vendors for plan sponsors open to changing RBP vendors and for plan sponsors considering a move to Reference Based Pricing.

Here’s why:

  • Tail coverage can be crafted for run-in and/or runout legal liabilities
  • Credit repair on steroids (no other RBP vendor we know of does this to the extent this vendor does)
  • Ability to bolt on to any claim re-pricer and TPA whether or not anyone approves but the plan sponsor (I’ll explain should you wish to discuss)
  • Competitive PEPM fee, no percentage of billed charges or savings

We are still amazed to find legacy RBP vendors charging a percentage of billed charges. No one in their right mind, never mind fiduciary responsibilities, should be squandering plan assets in such an irresponsible manner. A percentage of billed charges turbocharges fees in some cases to well over $100 pepm. This scheme is simply taking money from medical caregivers to enrich the pockets of third party intermediaries.

Not only are some RBP vendors raping clueless plan sponsors in fees alone, they are crafting contracts cleverly designed to divert much of the potential liability back to the plan and plan members. Plan sponsors should be asked Have You Read Your RBP Contract? And if they affirm they did, one might ask in return “Then why did you sign it?

You may wonder why we are not naming the RBP vendor. We are too.

It’s refreshing to see more choices in the RBP market these days. Brokers, consultants and plan sponsors must exercise caution when considering a RBP partner.