Health Insurance PoolsLinks:Contacts:Suzanne Riley, Executive Director, 507-281-6673, firstname.lastname@example.orgBill Colopoulos, Health Benefits Consultant, 507-281-6690, email@example.comDale Walston, Director of Operations, 507-281-6675, firstname.lastname@example.org
Health Benefits Pooling with the Southeast Service Cooperative
The Southeast Service Cooperative pool is a non-profit, member-owned pool that is locally managed by its members. SSC employs Blue Cross Blue Shield of Minnesota to administer its program. SSC is one of seven Minnesota-based cooperatives that have been providing pooled insurance programs since 1983. The Service Cooperatives together insure 100,000 public school and government employees and family members across the state of Minnesota.
The Advantages of the SSC Health Insurance Pool
The SSC pool provides the advantages of both self-insurance and being fully insured. The pool provides you with the low administrative cost savings of a self-insured plan while providing you with the protection of a fully insured program.
Wellness programs! The SSC pool continues to provide funding and coordination of wellness programs, including participatory and outcomes-based wellness incentive plans. In the past four years, the health pools have contributed hundreds of thousands of dollars to group level wellness initiatives.
ACA compliance services. SSC provides all participating pool groups with full ACA compliance services; including service cost and utilization reporting information that all groups need.
Economies of Scale
As one of the seven regional Service Cooperatives, we leverage our collective purchasing power statewide to form a single competitive purchasing pool for health benefits administration, high claim protection, and a lower maximum overall risk exposure than other pools. Our administrative and stop loss fees are low; bringing the buying power of Fortune 100 companies to all of our groups; regardless of their size. This means that our more of our groups’ premium dollars goes towards paying actual health care costs; payments to the insurance company are minimal.
Regional Claim Pooling. At the regional level, each Service Cooperative reduces the volatility of claim cost fluctuations by managing pools of similar risk groups (schools in one pool, political subdivisions and other governmental entities in another pool). Our groups experience far less volatility in their annual renewals than they would if insured on an individual basis.
Min-Max Renewal Formula. Our pools use a proven “minimum-maximum” renewal formula to reduce renewal increase volatility. The members’ Renewal Formula Committee establishes a minimum rate floor and a maximum rate increase cap. Each participating group is then assigned their own rate renewal limited by either the minimum floor or the maximum cap.
Pooling shares common risks over time. Pool groups find there are years where they give help to other pool members and years when they receive help from other pool members. Over time, long-time pool participants find that these periods even out and result in less volatility in their renewal experience than the groups would otherwise experience if they were insured on their own.
The Value of Blue Cross
Our members have consistently enjoyed the advantages of the widely recognized Blue Cross brand here in Minnesota and nationwide. When you need healthcare services most, providers everywhere recognize the quality of your insurance coverage with Blue Cross and Blue Shield. The Blue Cross benefits ID card and its guarantee provides your members’ access to the healthcare they need where and when they need it – and by the provider of their choice with no hassles.
Lower fees for Healthcare Services. Blue Cross also has the largest provider network in Minnesota and across the country – and with services that are priced 8-10% less than with any other insurance company in our region.
Open Access Networks. Our open access Minnesota Provider Network and Aware network include 100% of all hospitals and 98% of all primary care providers throughout Minnesota and bordering communities. Quite simply, we have more contracted providers than any competitor, which translates into the most claims paid in-network and dramatic cost savings for your employees.
Mayo Clinic and Hospitals. In addition to our broad network coverage, we include Mayo Clinics and Hospitals in our network; payable at the highest benefit levels. U.S. News and World Report recognized the Mayo Clinic as the best hospital in the nation, and it is a valued participating Blue Cross provider. Currently, the Mayo Clinic represents about 20% of our annual claims spend. This is greater than any other regional carrier and provides us with the ability to negotiate the best discounts for all of our members.
Gundersen Clinic and Olmsted Medical Center are also included in our network.
BlueCard. With BlueCard, there are no additional claim forms for your employees to file and no billing hassles when they need health care outside of Minnesota.