Designed specifically to address rising healthcare costs for employers with 5 to 99 employees, Healthy Choices plan designs generally calculate reimbursement amounts for healthcare services using reference-based pricing. This approach results in a reasonable fee, which is a multiple of Medicare’s reimbursement rate…………….
May 01, 2017
Starmark Pairs Provider Choice with Reference-Based Pricing for New Healthy Choices Plan Designs
LAKE FOREST, Ill. — Starmark®, the leader in self-funding for small groups, is pleased to announce Healthy ChoicesSMplan designs are available, beginning May 1, 2017, for small to mid-size employers. The new plan designs seek to control health plan costs while providing members with freedom of provider choice.
Designed specifically to address rising healthcare costs for employers with 5 to 99 employees, Healthy Choices plan designs generally calculate reimbursement amounts for healthcare services using reference-based pricing. This approach results in a reasonable fee, which is a multiple of Medicare’s reimbursement rate.
Large employers have leveraged the reference-based pricing strategy to control costs, and now Starmark has extended the cost-saving advantages of reference-based pricing for small to mid-size employers through Healthy Choices plan designs.
With Healthy Choices, there are no provider networks except in the instance of organ transplants, where benefits are available when performed at a designated transplant facility, and specialty drugs, where benefits are available when provided by the designated specialty pharmacy as outlined in the plan document.
“After deductibles, coinsurance, and copays, covered charges are paid up to the reasonable fee,” said Angela Paret, Director, Product Development, Starmark.
Starmark developed Healthy Choices in response to brokers’ feedback in a survey on reference-based pricing plan designs. “Brokers liked that the plan designs are fairly unique in the small group market and the opportunity to control costs, which is always a concern for employers,” Paret said. “Brokers are also happy to be able to offer a cost-saving solution with provider choice for doctor and hospital care.”
Healthy Choices helps control healthcare costs by providing Healthcare Bluebook™, an online quality and price transparency tool for consumers, and encourages members to get and stay healthy with telemedicine services via Teladoc®, second opinions via Grand Rounds®, the CareChampion 24/7 health advocacy service and Healthy Foundations® health and wellness management suite.
“Not only do these innovative plan designs offer a lower-cost alternative to traditional PPOs and freedom of provider choice, but they also offer cost-control services for consumers and help support employees’ health and wellness,” said Jim Howe, Executive director, MGA Sales. “The plan designs offered through Healthy Choices are comprehensive and resonate with the small to mid-size employer marketplace that Starmark serves.”
For more information about Healthy Choices, including state availability, visit www.starmarkinc.com/product-availability.
Starmark administers self-funded health benefit plans, offering extensive plan design choices, exceptional personal service and nationwide provider access for small to mid-size businesses. Plans are administered by Starmark, and stop-loss insurance and ancillary coverages are provided by Trustmark Life Insurance Company. Additional information is available at www.starmarkinc.com.
About The Trustmark Companies
Well-being means more than good health. The Trustmark Companies provide a full spectrum of employee benefits to improve well-being through better health and greater financial security. These include payroll-deducted voluntary products, expert benefit plan design and administration, and population wellness programs and fitness center management. Trustmark’s success is based on building and maintaining trust through personal, responsive service and flexible, innovative benefit solutions. Visit us at www.trustmarkcompanies.com.