GRAND RAPIDS—Officials at Priority Health will provide financial support to all large, fully funded active employer groups amid the ongoing COVID-19 pandemic.
The company plans to offer premium credits to employer groups in their February 2021 invoices. Priority Health previously announced in May its plans to return any revenue above the company’s 10 percent administrative rate back to employers and members.
The credit, available to groups with 51 or more eligible employees, will be based on the analysis of claims experience, generally ranging from 5 percent to 35 percent of one month’s premium. Priority Health will be analyzing 12 months of claims data through September 2020 and will have specific group amounts available prior to February 2021 invoices so groups can plan accordingly.
In addition to premium credits, Priority Health has also worked to provide relief for fully funded employer groups and members to help offset the effects of the pandemic in the following ways:
- Allowed employers to continue to offer health benefits to employee who are temporarily laid off or reduced hours below full-time status
- Waived member cost share for the testing and treatment of COVID-19
- Waived member cost share for virtual visits as well as expanding the zero-dollar cost share to all telehealth delivered by primary care physicians and specialists including behavioral health through Dec. 31, 2021
- Offered no cost added benefits to members like Prescription Drug home delivery and the myStrength behavioral health online tool
COVID-19 caused widespread disruption to the way consumers accessed health care. Priority Health set premium rates for 2020 based on expected health care costs. With many health procedures scheduled for earlier this year either being delayed or canceled, and consumers overall accessing less health care services, the company’s expected costs were reduced. In addition to the upcoming premium credits for large, fully funded employer groups, Priority Health returned excess funds to members and employers through:
- A 15 percent premium credit for June and July 2020 for MyPriority Individual plan members
- A 15 percent premium credit issued in June and July 2020 for small group employers (2-50 employees)
- Waive cost sharing for all Medicare Advantage members for in-person and telehealth primary care services May 1, 2020 through Dec. 31, 2020
Along with reduced utilization, Priority Health’s nonprofit status and focus on efficiency also helped make it possible for the company to provide this financial relief. Priority Health doesn’t pay dividends to shareholders, which allows the company to spend more on member care. Priority Health operates with some of the lowest administrative rates in the country, spending 90 cents1 of every dollar on member care.
Priority Health is Michigan’s second largest health plan, serving more than a million members and offering a network that includes 97 percent of primary care physicians in Michigan.
More at www.priorityhealth.com.