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How Benefits Advisors Can Give Better Health Plans to Self-Insured Employers

How Benefits Advisors Can Give Better Health Plans to Self-Insured Employers 1004 591 Apostrophe Health

Legacy insurance plans are working against American workers, and it’s costing them trillions.

As a health benefits advisor, we don’t have to tell you how broken the U.S. healthcare system is. You’re deep in this world just like us. You can see the costly pain points affecting your clients and their employees every single day. You have to know they’re sick of it all. 

Aren’t you?

Premiums and deductibles keep increasing (more than 250% since 2006) and yet, wages are stagnant. Employers rightfully anticipate double-digit increases to their benefit plans every single year; benefits for their employees that just keep getting worse. And overall, the U.S. healthcare industry wastes a trillion dollars every year. That’s $1,000,000,000,000 on unnecessary treatment, low-value care, pricing failures, fraud and abuse. 

It all stems from the legacy insurance plans that brokers keep selling and employers keep buying because they don’t know how much control they actually have in this situation. You can give them back that control.

Take 2 minutes to watch Sick of it All to understand:

  • How it all got to be so one sided
  • Where we see the opportunity to fix healthcare in America

Why we should work together to provide better benefits for less money to your clients

As you see, the legacy insurance industry isn’t designed to benefit consumers. It’s setup to make sure the carriers get paid and brokers get a healthy commission for selling through the same broken plans time and again. At Apostrophe, we believe in humanizing healthcare, putting people back at the center of cost, quality and experience where they belong.

That’s why we designed our health plans after the direct-purchase model that works for power players like Boeing, Lowe’s and Walmart. We made it accessible to mid-sized self-insured employers, which allows them to offer their staff benefits that actually feel like benefits. Working together with your clients, Apostrophe Intelligent Health Benefits can save them 20% in year one. Doesn’t that sound a lot better than the rate increase for worse benefits you were going to share at renewals?

If so, let’s talk now and prepare you to take an entirely different health plan to your renewal meetings. 



This is How Americans Waste $1 Trillion a Year on Healthcare

This is How Americans Waste $1 Trillion a Year on Healthcare 1004 591 Apostrophe Health

Learn how the U.S. healthcare system got this bad, and how we’re fixing it for self-insured employers.

The American healthcare system wastes $1 trillion dollars every year. One Trillion. That means $1 of every $4 spent on healthcare in the U.S. could have stayed in someone’s wallet.  That someone includes your employees.

Between 2006-15, employee deductibles increased 255%. Their wages did not.

And each year, health plans increase an average of 12% for coverage that only gets worse. 

We are sick of it all. Aren’t you? 

In this 2-minute video, we explain how the system became so broken that this has become acceptable reality. In Sick of it All, you’ll learn:

  • 4 glaring problems with the current healthcare system
  • Why that puts an unfair burden on American consumers
  • How YOU can save 20% or more on your health plan in year one

There’s this sort of cycle that self-insured employers and benefits advisors find themselves stuck in, and it only perpetuates the problem:

  • Employers need great benefits for their employees that won’t tank the bottom line.

  • Advisors keep showing up with the same broken legacy carrier model designed to put the insurance company first (and employees bearing the financial burden).

  • Employers don’t feel that they have any other options, so they sign the dotted line on the renewal form.

  • Advisors have an opportunity to do the right thing: take the commission for closing the sale, or give your employees benefits that actually feel like a benefit.

  • If you return to renewals next year facing the same increases, you’ll know which your advisor chose.

Self-insured employers have more control over price, quality and experience than they think they do. That’s where Apostrophe’s Intelligent Health Benefits come in and stop this tired system in its tracks. Working together with advisors and employers, Apostrophe provides Better Benefits for Less Money. We’ve made that possible by making accessible the self-insured model used by big players like Boeing, Lowe’s and Walmart. 

This legacy carrier system that is bankrupting Americans may have become the status quo, but it doesn’t have to stay that way. If you’re sick of it all and ready for a change, let’s get to work

Humanizing Healthcare: Health Benefits That Actually Feel Like a Benefit

Humanizing Healthcare: Health Benefits That Actually Feel Like a Benefit 6286 4480 Apostrophe Health

For self-insured employers, it is possible to provide your staff with better benefits for less money. Just treat people…like humans

America’s healthcare system is broken. And the hard-working people you employ are the ones paying for it. From where we sit, people were removed from the healthcare equation and replaced by third-party payers and misaligned incentives. What we got in return were ill-informed consumers going broke to pay for healthcare that keeps getting worse. It all contributes to nearly 20% of the United State’s GDP, and racked up a $556 million healthcare lobbying bill in 2018. 

This serves no one. The lobbyists are winning. Legacy health insurance companies are winning. Where are you and your employees supposed to come out ahead in all of this? If you maintain the way things have been…you don’t.

THE COST OF INACTION
We know that changing health plans is scary. The cost of doing nothing is far scarier than upgrading to benefits that actually feel like benefits. Under Apostrophe’s Intelligent Health Benefits, employers save 20% in year one and see an average annual increase of about three percent. That’s a substantial savings your company will see in its bottom line, and your employees will notice in their bank accounts. Those numbers are hard to ignore when you consider most health plans increase by an average of 10-12% each year.

BETTER BENEFITS FOR LESS MONEY

We’ve seen this come to light for so many of our members. One, in particular, stands out. 

Last year, a Wisconsin member was earning $7.50 per hour, and had been paying full out-of-pocket expenses for her family’s healthcare needs for years. Then the company switched its health plan to Apostrophe, giving her access to our Member Care team. By working together to make smart choices, we helped her reduce out-of-pocket expenses to $0 for the year! She walked into the CEO’s office…and hugged him! Because of the thousands of dollars she saved, her family was able to take their first vacation. 

HUMANIZING HEALTHCARE

Apostrophe Health took on this mismanaged healthcare system by putting simplicity, transparency and love at the center of everything we do. It’s a hard departure from the established rules legacy health insurance providers use to take advantage of their own customers. 

Our members access quality care, market-leading support from the Member Care team and realize tremendous savings through smart shopper options, all at a price that is often less than they paid under the legacy model.

Apostrophe Intelligent Health Benefits were informed by the best practices of the direct-purchase model refined by big players like Boeing, Walmart and Lowe’s. We’ve made this model accessible to self-insured employers who are ready to take back control of cost, experience and quality.

Watch our short Humanizing Healthcare video and then ask your broker about Apostrophe. You’ll learn a little more about how we simplified billing, why it’s important to treat humans like humans and hear a few more Member Care success stories. 

The Benefits Advisor Survival Guide for Renewal Season

The Benefits Advisor Survival Guide for Renewal Season 1004 591 Apostrophe Health

How to avoid burnout in the insurance advisor industry when your work never stops.

When 72% of sales directors work evenings and weekends, and 72% of salespeople want more time off, it’s clear we’re working against our own best interests. Insurance advisors used to have two big renewal cycles each year, and could really coast the rest of the time. Now it feels like we’re running an endless sprint that, frankly, can’t be sustained. We’re burning out, and we need to make it stop by making ourselves a higher priority. 

In this webinar, hosted by Apostrophe’s Director of Sales Ethan Merk, we talk about tactics for working smarter, not harder as we prepare for another round of back-to-back renewal cycles. 

In less than 10 minutes, we’ll cover:

  • Self-care tips like actually sleeping, which affects every aspect of our lives
  • Work-life balance that allows us to be present when it matters most
  • Using technology to work smarter, and put all of this tech to work for us
  • Apostrophe’s PowerPlan, which delivers big for clients with less hands-on time from you

Commit to even some of these tips and you’ll be more apt to bring your A-game to every situation you’re in, and maintain the stamina to show-up for your self-insured employer clients no matter what time of year it is. 

For more information about how Apostrophe’s PowerPlan can better serve you and your clients, contact Ethan Merk. 

Price Transparency to Become the Standard in American Healthcare

Price Transparency to Become the Standard in American Healthcare 1004 591 Apostrophe Health

With Apostrophe’s smart shopper, our members already enjoy the cost-saving benefits of price transparency without waiting on a new federal law.

Everything we do at Apostrophe is guided by simplicity, transparency, and love. We place the highest value on transparency, believing that every patient should know what they’re spending and what they’re saving.

That’s why we’re encouraged to see price transparency requirements issued by the Trump administration. Healthcare in America needs to be fixed, and this is a place to start that benefits every single patient. This historic effort aims to increase competition and lower costs for all Americans. 

The Health and Human Services Secretary Alex Azar says our current system deserves an F, but that after this takes effect, the president has promised an A+. This will be “a more significant change to American healthcare markets than any other single thing we’ve done, by shining light on the costs of our shadowy system and finally putting the American patient in control,” he said.

According to CMS, the executive order for Improving Price and Quality Transparency in American Healthcare outlines two rules designed to empower patients, and will take effect January 1, 2021. 

  • Price Transparency Requirements for Hospitals to Make Standard Charges Public, Final Rule

    All hospitals operating in the U.S. will “establish, update, and make public a list of their standard charges for items and services they provide.”

  • Transparency in Coverage, Proposed Rule

    Real-time access to cost information, including estimate of patients’ cost-share liability, through an online tool in order to shop and compare costs before care.

    It also requires that providers disclose, on a public website, the negotiated rates for 300 common, shoppable services (like x-rays, outpatient services, lab work, or bundled services like knee replacement or a c-section). This would include:
  • Full price before any discounts
  • Cash discounted price
  • Price negotiated with payers
  • The minimum/maximum with all payers

These disclosures are required under the ACA to some extent, but the data is hardly accessible, often too detailed and complicated. This new price transparency ruling aims to fix that by requiring accessibility and clarity by way of prominent publication and use of plain language.

This is what Apostrophe has offered its members all along through our smart shopper program. By selecting smart shopper options, which include high quality, low-cost providers, our members save enough money to result in $0 cost to them. We help them find the best possible rate from quality providers; it’s the difference between paying $2900 for a head CT, or $480 for the same service with the same (or better) results. We’re rewarding our members for making smart healthcare decisions.

That’s exactly what this price transparency ruling aims to do universally. This is a net-positive for employers who want to take control of healthcare costs (which, we imagine, is all of them!). For self-insured employers, this gives you power to help employees put published pricing information to work for both of you.

When price and quality data are available side by side, patients are more likely to opt for lower-cost care from highly-rated providers. In fact, they’re 94 percent more likely to choose the lower-priced option, according to SHRM. This can dramatically reduce healthcare costs for both employers and employees. Communicating the value of this information, and educating on how to use it, falls to the employers. 

Self-insured employers don’t have to wait for a transparency ruling to start saving their company and employees money, though. Contact us to learn more about Apostrophe.

4 Questions Self-Insured Employers Should Ask Their Insurance Advisors

4 Questions Self-Insured Employers Should Ask Their Insurance Advisors 1819 1021 Apostrophe Health

As you prepare for renewal season, learn how to take control of the cost and experience of your health plan to gain better benefits for less money.

Before you dive head-long into renewal season, stop and assess the current relationship between your company, your insurance advisor, and your legacy insurance carrier. How’s that working out for you? 

Watch this 1-minute video if you are a self-insured employer who is:

  • bracing for another rate increase
  • confident you won’t see any savings
  • certain your benefits will be worse than where you started.

Take these four simple questions to your next advisor meeting to show that you hold the power over your health plan’s cost and experience:

1: Do you run a transparent business model? 

2: Do you work exclusively with any carriers? 

3: Is your commission tied directly to my insurance rates? Or do you earn a flat rate?

4: Will you sign a document disclosing your sources of revenue on my account?

For most of the self-insured employers we speak with, the number one goal for their health plans is: “I just don’t want my rate to go up anymore.” 

That’s a sad reality.

The expectation isn’t to save money, or to get better health benefits at the same bloated rate

The goal is simply to avoid yet another rate increase. 

This is the broken thinking Apostrophe Health if fixing. Better health plan options exist for you right now, and you don’t have to lose healthcare coverage to get them. 

Learn more by downloading our eBook Sick Of It All: How American Healthcare Got This Bad and Why You Don’t Have to Accept It, or read how our Intelligent Health Benefits are Good for Your Business.

How confident are you in your rented health insurance network?

How confident are you in your rented health insurance network? 1280 854 Apostrophe Health

Legacy health carriers don’t operate with the best interest of self-insured employers. Apostrophe Health is fixing that.

United Healthcare delivered a hard blow to Houston residents who rely on Methodist Hospital: It is planning to remove the hospital system’s in-network provider designation at the start of 2020. Benefits advisor Michael Andrade called out United Healthcare for the move, highlighting how these changes create uncertainty and fear in the members who rely on their existing healthcare providers and services.

Watch as he takes two minutes to compassionately guide members on proactive steps they should take to protect themselves before January 1, 2020.  


The type of disruption United Healthcare HAS CREATED can happen anywhere; and it does all too often. Self-insured employers who rent provider networks from traditional insurance carriers take a hard hit in these scenarios. And health plan members—your employees—carry the biggest burden in cost of out-of-network expenses, time spent to find new providers or arrange new appointments and stress of upending their comfort zone.  

Can you and your employees afford to be blindsided this way? You’d need a substantial continuity plan to ensure your employees’ treatment and care could carry on seamlessly, with little-to-no interruption. Andrade describes the painstaking effort needed to feel somewhat protected in such a transition:

  • research high-quality surgeons
  • learn if existing physicians have privileges at other hospitals
  • develop treatment plans
  • hunt down lower-cost imaging services

…and do it all in the next 30 days. 

This is exactly the broken healthcare system Apostrophe is working to fix. Situations like the one United and Methodist have created in Houston aren’t serving anyone’s best interests. The alternative is what we call Intelligent Health Benefits, wherein Apostrophe treats all providers as in-network to minimize disruption in care. 

By putting our members’ needs (without limiting network rules) they’re happier, healthier and saving a lot of money. Providers love that we eliminate their AR needs. And employers love that they can take control of quality, experience and cost of their health plan. 

Ask your advisor if renting provider networks is still your best bet. If they agree it’s time for a change that protects the company’s and your employees’ interests, let’s talk.


A Broken Leg, A Broken Healthcare System And A New Approach

A Broken Leg, A Broken Healthcare System And A New Approach 2500 1478 Apostrophe Health
Healthcare benefits advisor Matt Cole knows the industry inside and out, but he hadn’t personally experienced the system beyond a few minor treatments, the birth of his child and the standard wellness visit. That all changed when an unexpected and unsatisfying 4-day stay at the hospital made him wonder: How could this have gone differently?

From Soccer Game to Emergency Room

The day started as most do. I was up at 5 a.m. for a quick workout and then off to the races with meetings, emails and other appointments. It was a Thursday, which meant I would be meeting friends in the Detroit area for a game of soccer — and hopefully a delicious beer afterward.

On the field, everyone was enjoying themselves until a single play changed everything. Trying to telegraph a pass from the other team, I ended up tangled with another player who lost his footing. My leg was extended in an awkward position as I helped break his fall and everyone heard the snap. I thought maybe I just sprained an ankle, but it seemed everyone around me knew the injury was much more severe.

Fortunately, a friend was able to drive me to an emergency room near home. When we arrived, the staff placed me in a wheelchair. I spoke to a woman at the front desk and another took my insurance information. Then I sat for about 45 minutes before receiving medical attention.

As you can imagine, I was in some severe pain by this time, with what I would later find out was a broken tibia and fibula.

Treatment and Care Are Two Different Things

Finally, after a long wait, I was seen by the ER physician to determine if any time-sensitive issues needed to be treated right away. He gave the all-clear and I was sent to x-ray and admitted to the ER.

Let’s consider how long that process took: The injury had occurred around 5 p.m. on Thursday. Friday morning was fast approaching as I sat in a bed in the ER. Why the delay? The medical staff was waiting for the orthopedic specialists to review my records and determine the treatment course.

Late in the evening, I was told I was being discharged. I was relieved until the medical staff came in again to let me know that the orthopedic specialist finally had a chance to review my x-rays and determined that I would spend the night after all: My leg needed to be reset, and I had to be prepped for surgery the next day.

I was thrown off by the 180-degree change as much as the opioids and other pain meds I was given. On that note, much of my time spent in the hospital is a bit blurry. From what I can recall, here are some frustrating events that came up during my stay and treatment:

      • I had little say in my treatment plan. I recall several times asking to speak to medical staff on options, outcomes and best practices. I essentially was left with minimal explanation.
      • I wasn’t given multiple treatment options. Surgery was presented as the only course of treatment, and I wasn’t given any alternative options.
      • I didn’t know the recovery rate of my injury. Likewise, I wasn’t informed of any of the long-term side effects of such a traumatic injury.
    • Ididn’t have any information about my surgeon. Despite my med-induced fog, I was able to do some quick research about him and was relieved that he had extensive experience with the procedure.

I was getting the correct treatment (I could only assume) from a qualified expert (from what I could tell based on hasty research). Going in for surgery is scary enough. Getting emergency surgery without enough information, patient advocacy or presence of mind? That’s terrifying.

Based on that experience, I’d say I received treatment — but I can’t say I received quality care.

The Damage: Someone Could Have Bought a Mercedes Benz S-Class

I remember trying to go home Saturday evening because I was tired of being in the hospital. I felt okay enough to leave, but soon realized my pain levels were so low because of the nerve block the doctors gave me. Once that wore off, I was uncomfortable again. After a quick phone call with my wife, I decided to stay until Sunday.

In total, I entered the ER on Thursday, May 31 and was discharged Sunday, June 3. I was confident that my $7,000 out-of-pocket maximum was going to be met. The grand total for my 2018 medical expenses was $91,000!

Before this injury, I had seen the doctor for my annual wellness visit. That’s it. In less than 4 days, I accumulated tens of thousands of dollars in medical expenses.

When did treatment for a broken leg get this expensive? How is the average person supposed to recover both physically and financially from an injury that sets them back 6-12 months and over $7,000?

I am fortunate to have an employer who supported me throughout my recovery and someone who offers their employees great healthcare by today’s standards, but when this situation arose, it was a rude awakening to the flaws we have developed in our system.

The Aftermath: Dealing With Billing

The bills started to roll in before I made it home from the hospital. I knew they were going to be big, but I underestimated the number of invoices and their complexity. Surgery bills, anesthesiologist bills, bills from physician practices, bills from doctors that I never met and, if I did, do not remember.

All in all, I had about 10 different bills sent to me in the mail for my three-and-a-half-day treatment.

For the first few weeks, I let the bills stack on the counter. I wasn’t ready to try and make sense of the madness. Plus, I wanted to make sure my insurance carrier, BCBSM, had a chance to review the invoices and guide me, as a member, on what to pay.

Easy enough, right? Not exactly. I had over 20 listed claims in my member portal on my carrier’s website for the time I was in the hospital. The claims had various doctor names, physician practice names and listings, even though my whole stay was at the same place.

As I tried to sort through this confusing mess, I kept coming back to the same questions:

  1. How could this be so difficult?
  2. Why would I be left to sort this mess out?
  3. How hard could it possibly be to get a single bill from the hospital that performed the services with my insurance carrier’s stamp of approval?

What Could Have Gone Better? Lots, Apparently.

Dissatisfied with the care I received and the exorbitant cost of my emergency care, I decided to get in touch with my friends at Apostrophe to play a little game — kind of like those old Choose Your Own Adventure books. How would this have been different if Apostrophe was handling things?

Apostrophe’s Intelligent Health Benefits deliver excellent health plans at a fair price for self-insured employers. They developed their platform and exceptional member care services to eliminate legacy insurance carriers like my own.

Apostrophe prides themselves as the health plan that’s fixing America. We decided to audit my bill and overall experience together, and what they found was eye-opening.

Solving Problems with Simplicity, Transparency and Love.

Nothing’s going to make a broken leg painless, but Apostrophe’s Intelligent Health Benefits could have helped with some of the headaches Matt encountered along the way. Here are a few ways Apostrophe’s Member Care team could have made Matt’s experience go much more smoothly.

1. Guided decision-making for critical care

Problem: Matt had little say in his treatment plan and wasn’t given any multiple solutions.

Solution: Matt could have called Apostrophe’s member care team — yes, from his hospital bed — for a second opinion from a medical expert. He also could have consulted with our member care specialists to learn more about his doctors and surgeons. We have access to industry-leading databases about providers across the country and use these resources to recommend quality care for our members.

2. Negotiated rates for lower total costs

Problem: Matt’s hospital stay and surgery ended up costing $91,000 — the longer he stayed, the longer his bill grew.  

Solution: Apostrophe links provider payments to the Medicare pricing schedule so that costs are transparent to members and tied to a hospital’s actual costs — rather than the billed amount, which is set by the hospital. Medicare pays about $13,000 for an inpatient stay for a fractured tibia, which would have been Apostrophe’s starting point for the cost of the treatment.

3. Eliminated unknowns with transparent pricing

Problem: Matt didn’t know his total medical expenses until he got home from the hospital, and was amazed by how many costs had accumulated in just four days.

Solution: Apostrophe pays hospitals based on a multiple of Medicare, so charges are based on your diagnosis, not a list of itemized charges. This means the hospital gets paid the same amount regardless of how long you stay or what services you receive during your stay.

4. Simplified, easy-to-understand billing and flexible payments

Problem: The hospital bills kept stacking up, and Matt couldn’t get a straight answer from his insurance company about what he owed and what he didn’t.

Solution: Apostrophe provides single, fully-audited bills for members on a monthly basis. No one needs to get piles of bills to sort through and reconcile, especially after a major medical treatment. Members can also take advantage of single payment plans for all medical bills. Pay bills down over a period of time that works for you and your budget.

Another option: Apostrophe’s Member Care team could have directed Matt to a vetted surgery center with a much lower price before he was admitted to the hospital. All it takes is one call to Member Care find high-quality care at a fair price.

If you’re ready for a change,

let’s talk.

You have so much more control over your health plan than you might realize. There are better options out there for you. Let’s find them.

info@apostrophe.health

www.apostrophe.health