Coalition America, Inc.

Beacon Risk Strategies, a leading Managing General Underwriter (MGU) focusing on the Blue Cross/Blue Shield (BCBS) plan market and large self-insured employers, is teaming up with Coalition America, Inc. for more aggressive stop loss coverage in BCBS plans offering ASO services.

"Beacon will reduce its rates for inclusion in Coalition America’s national ‘wrap’ for non-network claims," said Carson Spencer, Principal, Beacon Risk Strategies. "CAI’s combination of supplemental PPO networks and its ability to negotiate on all size claims gives our managers confidence, when assessing risk, that non-network claims are receiving the deepest possible discounts. Depending upon geo-access, we will reflect CAI’s discounts in our specific pricing. However, most client savings will be captured on discounts for claims that never reach the specific."

Coalition America, Inc (CAI) is a leader in healthcare cost-containment and preferred provider organization (PPO) network management services emphasizing transactional excellence. The Atlanta-based healthcare technology company offers one source for PPO network access and administration, while assisting companies in controlling their medical healthcare expenses.

"CAI is excited about working work with an aggressive, proactive company like Beacon Risk Strategies," said Scott Smith, President, Coalition America, Inc. "We work with many reinsurance companies and MGUs, but Beacon is the first to take the aggressive step to provide ‘upfront’ savings for any clients willing to use CAI as their first tier strategy in gaining discounts for their out-of-network claims."

According to Smith, his firm is also talking with several BCBS plans that see this approach as a powerful incentive for them to gain discounts through CAI on claims that otherwise would be paid at retail. "Since many insurers competing with BCBS use CAI or similar providers, this step provides both a much needed competitive balance and further savings for its clients," Smith said.

Beacon Risk Strategies provides medical reinsurance protection for self-funded employers. Its combination of up to 200 regional and national networks gives its risk managers confidence when assessing risk that non-network claims are receiving the deepest possible discounts.

CAI services include cost containment, primary PPO network integration and management, electronic data interchange (EDI), Internet repricing and data-entry options, and out-of-network bill negotiations through supplemental network relationships and negotiations on all claims. For more information on Coalition America, Inc. (CAI), please visit www.coalitionamerica.com.

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