Tips on Getting Your Health Benefit Plans off to a Great Start!

With the new year comes new benefit plans. The Alliance wanted to provide some helpful tips on what can help employers, and employees, get off to a great start.

For employers that are new to working with The Alliance or those that would like a refresher on what we do, we would recommend contacting your Account Executive to cover the following topics.

What does it mean to be a cooperative?

Learn about your ownership in the company, as well as benefits like stocks and patronage checks.

What is the advantage to working with The Alliance?

We like to discuss our vision for health care and how our reference-based contracting can help you offer your employees and their families quality care at the right price. We also like to connect you with other like-minded employers in your area.

What kind of data intelligence can The Alliance provide?

At The Alliance, we provide employers with detailed reports on utilization, ROI, steerage to high-value health care, a breakdown of spend, and a review of appropriate ER usage to help control costs to name just a few.

If members are new to working with The Alliance, we may not have sufficient data to analyze. We can provide sample reports to give you a sense of what you can anticipate receiving in the future.

How does The Alliance help employers contain costs?

In addition to our network, we can also discuss advanced primary care and how we help employers offer these services to employees. One of the ways we accomplish advanced primary care is through onsite or shared-site primary care clinics. Employers can pay a monthly fee per employee instead of fees for each service that can help save costs for the employee and employer. And by offering longer appointment times, these clinics allow employees to get all their needs taken care of in one appointment. The Alliance can even work to connect employers in an area who may be interested in a shared-site clinic.

We can also can help steer employees to high quality, lower-cost providers and bundled services that offer more transparency in pricing and include the total cost for an episode of care.

What kind of services can The Alliance provide beyond a network and the cost containment strategies above?

We have your data, once you work with us, so we’re happy to customize our services to fit your needs. And we regularly take feedback from our members to develop new analytic capabilities and enhance our offerings.

Does The Alliance have any tips for employees?

• Encourage them to navigate the provider directory to get familiar with how to use it before they need services. If they have questions, they can visit our Frequently Asked Questions page call us at 1-800-223-4139.
• Introduce employees to our concierge service for pricing services. This can help them anticipate and budget for health care costs.
• Remind your employees to show their new id card to providers to ensure proper billing.
• And make sure they understand their benefit plan design and any incentive programs you have in place.

What if I’m new to self-funding?

There’s a lot to learn, and we’re happy to provide education around what that shift means and who does what. Here are some suggestions on who to call for what:

• TPA: Billing Questions, like stop-loss, and helping employees with questions about how their claim is adjudicated and tracking deductible spend.
• The Alliance: How to get a doctor in-network. If you find a doctor that isn’t in our network, we’re happy to negotiate on your behalf to get them in-network.

And don’t forget our events which offer great educational and networking opportunities! If you have any questions, please reach out to your Member Services team!