Medical Benefits Administrators

Your Health Plan. Your Advantage.
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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.

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Flexibility.

You choose the health care plan options that work best for your employees.
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Regulatory.

Self-funding offers a greater degree of freedom from state and federal regulations.

 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.

MedBen Claims Management… Talent + Technology

MedBen claims management 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 a sophisticated surveillance system. 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 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 secure online 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.

Coverage 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 coverage strategies in place for years and already benefit from healthier employee populations and reduced coverage costs.

Reference-Based Pricing

Reference-based pricing (RBP) strategies establish fair provider reimbursements based on Medicare pricing. Employers benefit from greater cost consistency and predictability, and employees get greater provider choice.
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Direct Contracting

MedBen facilitates direct-to-employer contracting, which brings together self-funded employers and health systems in plans that promote effective use of regional care. You can offer your employees a plan that meets their specific medical needs while controlling costs.
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Bundled Payment Services

MedBen brings together self-funded employers with health care facilities to provide services under bundled care agreements. Employers know procedural costs up front and providers benefit from increased steerage.

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.

Karen Naccarato

Benefits Supervisor, Bartlett (TN) City Schools

Fast Facts

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MedBen claims financial accuracy

Average monthly savings per employee from MedBen claim surveillance

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Average savings on MedBen clinically reviewed claims (after discounts and coinsurance)

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.

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