Self-Funding Solutions.
Since 1938, MedBen has helped groups of all sizes manage their benefits plan… and today, self-funding offers employers an unprecedented level of plan control. We work with employers both large and small to maximize the advantages of self-funded plans, including ultimate flexibility and saving opportunities.
Savings.
You keep any money that doesn’t go toward paying claims… and MedBen helps you keep as much of that money as possible.
Flexibility.
Regulatory.
If you’re fully insured, MedBen can assist you in making the switch to self-funding. And if you already have a self-funded plan in place, you’ll find that we offer outstanding service and benefit management tools.
Fast Facts
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Average savings on MedBen clinically reviewed claims (after discounts and coinsurance)
Avgerage client savings per employee per month through claims surveillance
%
Claims payment accuracy
MedBen Forensic Claims Review… Talent + Technology
MedBen forensic claims review blends talent and technology to help employer plans defy national claim cost trends. We start with a skilled examiner team that processes claims based on your specific plan benefits.
MedBen complements internal processing with advanced surveillance software. On claims identified for potential savings, board-certified medical specialists work them to find cost-saving solutions.
Claim Processing: Traditional vs. MedBen
MedBen claims processing starts and ends like traditional claim processing. It’s what we do in between that makes the difference.
Data Analysis to Maximize Your Plan Potential
It’s one thing to promise lower costs, and another to prove it. That’s why MedBen Analytics provides clients with measurable and actionable reports that show not only how we help you reduce your health care spending, but reveal opportunities for future savings.
With our online employer dashboard, you can spot risks, study trends and identify opportunities for improving care and reducing costs. The dashboard gives you ready access to plan data, while benchmarking capabilities allow you to compare your plan performance against regional and national norms.
Alternative Reimbursement Strategies
Benefits managers are extolling “innovative” new ideas to lower their clients’ health care costs. We agree that they are great ideas… so much so, many MedBen clients have had these alternative reimbursement strategies in place for years and already benefit from healthier employee populations and reduced coverage costs.
Reference-Based Pricing
Direct-to-Employer Contracting
Fair Market Reimbursement
Fair Market Reimbursment compares your plan members’ claims against national market data to determine the right reimbursement for billed services. You’ll see the difference in your bottom line.
Stop-Loss: More Choice, Better Protection
Stop-loss provides added financial protections to make self-funding even more appealing. A stop-loss carrier serves as a safety net for catastrophic claims and balances quality coverage with cost considerations.
MedBen offers stop-loss independence. We shop multiple carriers to ensure that clients retain the desired level of specific and aggregate protection, and negotiate the best possible rates.
I just wanted to thank you on behalf of Bartlett City Schools employees for sending EDITH to be at our employee meetings. All the employees I talked with spoke highly of her knowledge and ability to offer solutions.
Building a Better Self-funded Plan for You
The Medical Benefits Administrators model is designed to deliver the tools necessary for your plan to succeed, whether it’s our flexible claims management system, our technology to unveil important decision support data, or our service solutions built around the voice of the customer and continuous improvement. In short, our goal is to link our success to that of our clients.
Self-funding Saves. MedBen Delivers.
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Benchmarking
MedBen Analytics' benchmarking capabilities enable you to compare your data against state and national norms and/or specific industries. You can narrow your benchmarks by plan type, number of lives and other metrics to get a true measure of how your plan stacks up.
Your benchmarking choice is immediately reflected on the dashboard content.
Straight RBP
Providers receive fair reimbursement by using Medicare pricing as the primary source of repricing. And because your plan no longer has a PPO, your plan members can go anywhere they choose for medical care.
Pharmacy Cost Plus Pricing
RBP for your prescription drugs.
Layered RBP
Target high-cost medical treatments, such as kidney dialysis.
An Extensive Reporting Library
Once you've chosen your population, reporting period and benchmark preferences, just sit back and watch MedBen Analytics go to work for you. Dozens of charts, graphs and tables, instantly generated. Our financial, clinical, risk and savings reports show you what is working with your plan while highlighting areas of potential improvement.
FSA Store is the largest online marketplace for guaranteed FSA-eligible products, helping flexible spending account holders manage and use their FSAs and save on more than 4,000 health items using tax-free money. You can pay for purchases using your MedBen FSA debit card so they are automatically noted on your account balance.
Use these convenient links for finding FSA-eligible products and calculating your FSA tax savings. FSA members can check their current account balances by visiting MedBen Access or downloading our mobile app from the Apple App Store or Google Play (search for "MedBen").
Use this secure 24/7 service portal to access claims and benefits information. MedBen Access enables you to:
- Check claims status
- Review benefit coverages
- Download explanations of benefits (EOBs)
- See deductibles, out-of-pocket costs and calendar maximums
- Look up drug information, compare local pharmacy prices and check availability of lower-cost equivalents
- Review FSA and HRA activity and balances
- Check wellness exam and screenings compliance (for WellLiving members)
If you need assistance logging in to MedBen Access or using its features, please contact MedBen Customer Service at 800-686-8425.
MedBen Access is also available as a mobile app with the same great features! Download it from the Apple App Store or Google Play (search for "MedBen").
Download the MedBen Client Report
Please register to download the Client Report. Thanks!
Frequently Asked Questions about using the debit card (PDF).
Download a list of participating pharmacies, discount stores and supermarkets that can identify FSA-eligible items at checkout using an Inventory Information Approval System (IIAS).
Download a list of participating pharmacies, discount stores and supermarkets that do not use IIAS, but 90% of whose sales come from medical care items (thus making them FSA-eligible).
Medical Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Pharmacy Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Medical Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Pharmacy Solutions.
MedBen Rx follows a simple philosophy: The client's money belongs to the client. Our pharmacy solutions are designed to get members the right drug at the lowest cost, with total transparency to the employer. These include:
- Pricing solutions that ensure clients pay just what the pharmacies pay.
- Appropriateness solutions to find the most effective drugs at the best cost.
- Access solutions that give members new ways to lower their drug cost.
Direct-to-Employer Contracting
Many MedBen clients blend their RBP plan with direct-to-employer (DTE) contracts, which promote the use of quality care through local providers. In exchange for encouraging members to visit contracted facilities, providers bill the plan at mutually agreed-upon rates.
MedBen has been facilitating DTE contracting for over a decade with doctors and hospitals across the Midwest, and we continue to gain access to more exclusive DTE contracting. This strategy ensures that when members utilize area providers, they receive the best pricing options available.
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