Level Premium Self Funded options

TAC Benefits Group builds unique level premium self funded programs for the small group market. These programs work like fully insured plans in that employers are responsible for paying a set premium. However, these programs carry all of the transparency of a self funded plan.

 Using referenced based pricing or a healthcare network of the employers choosing,  TAC can keep the premiums down and the providers pricing reasonable.


Referenced based pricing

Reference based pricing is a cost containment strategy. This method differs from more traditional pricing options by allowing the employer to cap the amount they agree to cover for certain non-emergent medical procedures that vary significantly in price from one provider to another, yet not in the outcome.

The amount providers' bill is typically much higher than the actual cost of the service, its also not t's not an true reflection of the market value for such services. Traditionally, each insurance provider would have a pre-negotiated price they’re willing to pay for services. The only universally accepted payment across most providers is the Medicare-negotiated price.

Reference based pricing agrees to pay a percentage above the Medicare-negotiated price to account for the lack of margin and better satisfy the providers. This approach is largely seen as “reasonable and customary.” With the assistance of TAC Benefits Group, fixed payments are negotiated with providers through our preferred Reference Based Pricing Vendors.