PBMs and claims payors negotiate discounts with manufacturers and providers and pay claims. This process is naturally skewed toward their business needs. We identify about 5% of those claims which we negotiate and pay at a substantial discount. Our transparent approach allows employers to see these specific claims including the savings. Now the process is skewed toward employer's and employee's needs which results in lower claims costs for the employer and cash in the employee’s pocket!
Once an employer sees the savings, they are in the enviable position to determine how much of the savings will be shared with the employee. It could be anywhere from hundreds to thousands of dollars. Increased employee engagement means more savings for the employer and more money in an employee’s pocket.
Employers are frustrated by the status quo which includes undisclosed costs, contractual mumbo jumbo, and fuzzy “ROI” calculations. We keep it simple; employers and employees see exactly how we achieve the savings, what is required to access those savings, and fees are disclosed and paid only when the savings far exceed the expenses.
A Great Voluntary Benefit
As health insurance costs continue to rise, many employers shifted some of that cost to employees, through increased out of pocket expenses and higher contributions to the health plan. Our Cost Containment programs take the opposite position. We find ways to reduce the claims costs and provide employees with the opportunity to share in the savings, creating the perfect win/win scenario! In all cases it is the employee's decision to engage in our process or access the system as they normally would.