This supplemental benefit is a value-add and cost-saving measure

Register now

At a time when employers are increasingly concerned with lowering their health care costs, it can be difficult for advisers to sell supplemental benefits perceived by clients as merely value-adds with little to no return on investment. EmployerDirect is out to change that with a new supplemental benefit they claim not only increases the quality of an employer’s plan, but also saves them money.

SurgeryPlus is an add-on benefit for self-funded plans that offers employers and its employees discounted bundled rates for planned surgeries from vetted health care providers. In other words, it can do for medium-sized employers what the likes of giants Walmart and Lowe’s have done on their own.

SurgeryPlus offers the same benefits of international medical tourism, only within 30-60 miles from the patient’s home, thereby saving the patient a trip out of the country, according to Thomas Johnston, CEO of EmployerDirect. And, there’s a clear place for the broker to sell the product.

See related: A place for brokers in medical tourism

EmployerDirect, an Austin, Texas-based health care solutions company — together with a medical advisory board — only choose providers for employer clients that meet a list of strict criteria, including board certification, high patient satisfaction rates and low complication and infection rates and mortality/morbidity rates. Because EmployerDirect is bringing the provider patients who would normally go elsewhere, as well as handling the bulk of costly administrative tasks, the providers are willing to perform the surgeries at a discounted price.

Where brokers fit in

At a time when brokers are looking for something new to offer employers, SurgeryPlus “sells itself,” says Amanda Bary, vice president of sales and implementation for EmployerDirect.

Brokers can introduce the benefit, which can be added on to an existing medical plan at any time of the year, as a product that “quantifiably reduces medical spend and offers a better benefit,” Bary adds.

Working with employers for the past two years in preparation for the launch of the product last September, she says, SurgeryPlus has been able to negotiate bundled fees that are 30-50% lower than traditional insurance would pay for the same service.

And, because all of the costs are pre-negotiated by EmployerDirect and bundled together beforehand, employers and employees know exactly what the cost of the surgery will be, rather than receiving a trail of hospital, doctor and anesthesiologist bills in the mail for months following the surgery, according to Bary. She adds: “We’re giving large, self-funded employers access to the cash price.”

Put to the test

Brian Cramer, CEO of the Orthopedic Hospital of Wisconsin in Glendale, Wis. has worked with EmployerDirect as one of their centers of excellence providers for three years and tells EBA the SurgeryPlus product offers employers and their employees several benefits, including high-quality medical care at a reduced cost.

“[SurgeryPlus] doesn’t just select any provider. They only choose those that provide the highest quality of care,” he says.

Also of great benefit to the employer, employee and the provider, he says, EmployerDirect takes care of almost all of the administrative details, including the transfer of medical records, scheduling of all pre- and post-operative appointments and surgeries and travel arrangements for employees needing to travel for care.

For reprint and licensing requests for this article, click here.
Sales and marketing Benefit plan design Voluntary benefits