The COBRA Tax You're Not Tracking
Most benefits leaders can tell you exactly what they pay their COBRA administrator each month. That PMPM fee is easy to find on an invoice. But I've been in...
Claims & Appeals
520 posts
Most benefits leaders can tell you exactly what they pay their COBRA administrator each month. That PMPM fee is easy to find on an invoice. But I've been in...
You know the drill. Renewal season rolls around, and suddenly you're staring at a spreadsheet filled with claims data, a pricing model you didn't build, and...
You negotiated a 30% discount from a major health system. Your CFO is thrilled. Your broker is patting themselves on the back. Then the claims start rolling...
You've seen the demo. A vendor walks into your office, pulls up a sleek calculator, types in your total medical spend, and-boom-a 25% savings number...
Everyone loves a good cost-saving story. For years, the benefits industry has been telling one about high-deductible health plans: lower premiums, smarter...
You’ve probably seen the pitch: “Give your members a simple way to shop for healthcare, just like they’d compare prices on Amazon.” It sounds great. Every...
You sat down with your finance team, ran the numbers, and set your HRA budget at $1,200 per employee. Clean. Simple. Predictable. That's the illusion,...
You’ve heard the promise of reference-based pricing. Pay a fair multiplier of Medicare rates instead of whatever inflated charge a hospital throws at you....
Every time an employee fills a prescription or visits a doctor, it creates a tiny data point. For companies that self-insure, those points stack up...
For years, the conversation around Accountable Care Organizations (ACOs) has been stuck in a loop: doctors, hospitals, regulators, and insurers. Employers?...
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