Q: Will my employees still have access to their hospitals, doctors and pharmacists?
A: By choosing from multiple national and regionally based PPO networks, we try to match up the providers as well as possible. As with any change in carriers, some providers aren’t in every network. We thoroughly examine the networks that are available during the decisionmaking process.
Q: What about the benefits? Will they be ‘apples to apples’ to our current plan?
A: The Lifestyle Health Program offers 16 different plan designs that your group may select from. Depending on the group size, up to 4 plans can be offered to the employees to choose from. While there will be some differences between the LHP plans and your current plan, we should be able to improve the benefits to the employees by offering a deductible credit through the Wellness Program as well as some other value-added benefits (Care Coordination, Lab Benefit, Diabetic Supplies, Telemedicine, Rx Benefits, etc.).
Q: What are some of the cost-containment features with our Lifestyle Health Plan?
A: A key focus for Lifestyle Health Plans is finding creative ways to manage healthcare costs. Traditional benefit designs and cost management techniques have been relatively unsuccessful in assisting employers and their members with cost containment. Lifestyle Health has integrated a number of cost management programs and benefit coverage solutions into our plan designs. Some of these address ER utilization, implant cost containment, specialty medications and self-injectables and alternative generic drug utilization.
Q: What options are available to ensure that my group is ACA-compliant?
A: For groups of over 50 eligible lives, Lifestyle Health Plans offers a turnkey solution for group medical benefits, including five Minimum Essential Coverage (MEC) Plans and a variety of plans that meet Minimum Value. In addition, from the standard 16 plan designs, there are also a host of ‘buy up’ options for richer benefits. The whole program offers turnkey administration and billing through Medova Healthcare.
Q: I have never heard of Lifestyle Health Plans. Will my doctor recognize it? Is this a new program? How do we know that it won’t fail? I know my current carrier and they are huge.
A: Lifestyle Health Plans is an innovative, boutique health benefits program and has been offered throughout the country since 2006 in partnership with a host of A-rated reinsurance carrier partners. Since Lifestyle relies on PPO networks for discounts and repricing, it is important to use a doctor in the network selected (just like your current plan). On your Member ID Card, you will find a logo for your plan’s PPO Network. Your provider will recognize the PPO Network even if they have not yet had extensive experience with Lifestyle.
Q: What are the benefits of having a Third-Party Administrator (TPA) handle our claims versus having a carrier do it?
A: Many would say that traditional carriers are first concerned with their bottom line, not yours. A ThirdParty Administrator (TPA) works solely on your behalf and has your group’s interests in mind. As the program administrator, Medova Healthcare strategically partners with each client company to proactively address factors that contribute to the rising cost of healthcare. Plus, wouldn’t it be nice to speak directly to the person who pays your claims versus a different customer service person every time you call? At Lifestyle Health Plans, our committed member and client service teams are here to support our agents, clients, and employee members. A friendly voice and great customer service… all standards of care for you, our client.
