Group Health Captives

A Group Health Captive allows members to share a layer of risk with other group members.  If the group runs well, money is returned to the group members that participated in the surplus.  If it runs poorly, (cont)

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Self Funded MEWAs

One variation of self-funding is a Self Funded MEWA.   In this arrangement, many small employers pool their health insurance needs into a single plan, seeking greater economy of scale (common for PEOs).  

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Magellan Risk Management Small Group Models

Small Group Consortiums

Historically self-funded health plans focused on the middle and large group market and are a funding mechanism used to more efficiently finance long term benefits cost. There have been a (cont)

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Association Health Plans

For many years, trade and professional associations were able to offer individual health insurance to their members at special rates based on the association group’s claim experience.  

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Everything we do at Sawgrass Benefits start with our values — a clear, strongly held set of core beliefs that reflect who we are and what you can expect from us.

  • Excellence – we strive to deliver the best innovative, value based programs possible.
  • Integrity – we do the right thing for the right reason.
  • Inspiration – we inspire each other to create ideas that can change our world.

Since the passage of the ACA, Employee Benefit Consultants have been squeezed by a collapsing revenue source and higher administrative cost. Producers still want to offer high value products to their clients but they must be mindful of an eroding client base. They want to know the partners they choose have the experience and stability to deliver high value products for their clients, while offering them the financial security they need.

At Sawgrass Benefits we’ve incorporated the best medical stop loss products and claims cost management processes with a personalized approach to sales support. We can’t make all your ACA challenges disappear, but we can make your job easier and empower you to grow your business.

We promise our clients, which include Producers, TPAs  and Carriers alike, that we offer the highest value self-funded stop loss models on the market. We’ll never argue we’re the cheapest but we will always argue we’re one of best.

Our Reference Based Reimbursement models eliminate “cost shifting”, which in turn dramatically lowers claims cost. Your clients can keep their current plan designs, yet realize claims cost savings of 10-30% or more beyond what a typical PPO offers. This plus our active involvement in Medical and Pharmacy Management is our defining value proposition!.

How Sawgrass Benefits Lowers the Trend

Despite the many advances made in healthcare transparency and improvements in efficiency, cost shifting to Private / Commercial Payers is alive and well.  As the Johns Hopkins research report indicates, the Nationwide Average Charge to Cost ratio is around 3.5, with the top 50 most aggressive hospitals charging over 10 times cost. (more)
 
Specialty drugs are high-cost prescription medications used to treat complex, chronic conditions like cancer, rheumatoid arthritis and multiple sclerosis, in addition to very rare “Orphan” Diseases (i.e. “Bubble Boy” disease).  Specialty drugs often require special handling (like refrigeration during shipping) and administration (such as injection or infusion). (cont)
 
Nearly 20 years ago, one of the founders of the Evidence Based Medicine (EBM) discipline, David Sackett, described EBM this way: “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. (more)
 
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