Reference-Based Pricing Explained
Who Offers Reference-Based Pricing?
National General Health Insurance is very similar to a Level-Funded Product. You're still going to fill out the health insurance questionnaire. And you have the Claims Account where the insurance company can reimburse you the 50% of the leftover balance. Nat General deals specifically with the Aetna and Cigna directors.
Consider Nat General like an umbrella where they rent out Aetna and Cigna directors. The one thing that Nat General offers that none of the other carriers offer is Reference-Based Pricing.
What is Reference-Based Pricing?
Reference-Based Pricing means you have no directory, you have no network. You can go to any doctor you want and the doctor or the hospital is paid as a percentage of Medicare. This is something, a little outside of the box that a lot of brokers don't sell. However, for a lot of companies that don't want to deal with the directory and for those who are sick and tired of saying, “I got this great carrier, I have Verizon, I have Oxford, but my doctors don't take it”, they are willing to go with a carrier with no directory.
This is an option to take a look at when Jim goes over your plans and addresses all the companies and options during the conversation.
ABOUT JAMES RESTAINO
James Restaino is part of Relax Benefits. He is a Managing Partner/Broker at Specialized Health Services LLC, an Employee Benefits Company that specializes in group health insurance, life insurance, and dental/vision insurance servicing companies in New Jersey and New York. His ideal clients are companies that have at least 2 enrolled employees on Employee Benefits. With his 25 years of experience, he can help you find the right coverage for you or your employees.
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