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In our recent Self-Insurance 101 blog, we reviewed the basic concepts of self-insurance and its underlying features and benefits. In this blog, we’ll dive a little deeper on how employers can efficiently and effectively transition from fully insured to self-insured and the key questions employers should address before setting out on the self-insured journey. Read more>>>

Over the past several years, there has been a steady increase in interest from brokers and employer groups in self-insured health benefits models. As more clients are evaluating their plan design, make sure they understand the fundamentals of self-insurance. Read more>>>

A new level-funded health plan is now available to North Texas and Houston employers thanks to HealthSmart, one of the nation’s largest third party administrators. DFW SmartCare and Houston SmartCare are comprehensive level-funded health plans that offer market-leading discounts to DFW-area and Houston-area small to mid-sized employers. Read More>>>

Even with the recent momentum toward price and cost transparency, as a self-funded health plan sponsor, do you know the true value of what you’re paying for? HealthSmart offers transparency resources like no other TPA. Do you know what’s changed and how those changes affect you and your members? HealthSmart keeps up on the latest revisions to federal regulations so when you partner with us, you don’t have to worry about being in the know and being compliant. Read More>>>

Plan sponsors are always looking for new ways to manage the cost of providing benefit plans while maintaining high member satisfaction. Reference Based Pricing (RBP), which reimburses hospitals and facilities based on a percentage of Medicare, offers an effective way to rein in hospital costs, but leaves the plan responsible for physician and ancillary charges. Members also often find the healthcare system complex to navigate, creating further dissatisfaction. SmartDecision, HealthSmart’s approach to Reference Based Pricing (RBP), offers a unique alternative. Read More>>>

There are many advantages to self-funding group health plans, but there are some large potential challenges, in the form of high unexpected claims, that can potentially threaten the stability of the plan. That’s where having the right stop loss partner is essential and having a plan administrator that can reduce the cost of caring for high-risk members becomes a critical success factor.  Read more>>>

The rising costs of specialty drugs are no longer just a concern. This has now become an obstacle for many Americans in their ability to receive proper healthcare. Sadly, these enormous price tags are placing many medications out of reach for some people who are forced to choose between their medications and other essentials. According to AARP, the average specialty drug price reached $84,442 in 2020, and the costs are rising more than three times faster than the prices of other goods and services. HealthSmart can help. Read more>>> 

Creating Value Beyond Reference Based Pricing
As the cost of health benefits continues to rise faster than the rate of inflation, many plan sponsors are looking for alternatives to traditional PPO networks. Plan sponsors want benefits administration partners that can deliver creative and comprehensive solutions that control costs while delivering high quality clinical outcomes and member satisfaction. SmartDecision, HealthSmart’s approach to Reference Based Pricing (RBP), offers a unique alternative. Read More>>>

Welcome to the new year! Last week, we posted an article summarizing the successes we saw in 2021.  The future looks bright for HealthSmart, especially the opportunities that await us and our clients. We can't wait to get started! Read more>>>

Most of us won’t soon forget 2021. For many, it was another year of hand washing, social distancing, masking, and staying home. Yet, even in the face of these seemingly unsurmountable challenges, our HealthSmart team pulled together to continue to provide innovative solutions and excellent service to our clients. Perhaps at no other time in our history has it been more important to deliver on our promise of treating our customers and our colleagues with dignity and respect. Read more>>>