Even before the Transparency in Coverage Rule (TiC) was finalized in October 2020, requiring health insurance plans and issuers to disclose healthcare pricing information to plan participants, we were asking ourselves how to build a platform that would usher in this new era in healthcare. Compliance is an essential and foundational element, but at our core, we aim for something beyond that – a transformative shift in healthcare dynamics. This means a comprehensive suite of solutions, each one building upon the last, that embody the true potential of TiC.
The starting point is empowerment. Our current landscape of high-deductible health plans has left many “functionally uninsured” and hesitant to seek medical care. What good is insurance if consumers avoid care for fear of landing a medical bill that barely begins to touch their steadily increasing deductibles and out-of-pocket costs? Nearly 50% of U.S. adults say they have difficulty affording health care costs, with 4 in 10 stating that they have delayed or gone without medical care in the last year due to cost.1 This is not surprising when you consider that the average deductible for single coverage individuals has increased a staggering 61% over the past ten years.2 MyMedicalShopper™ puts cost control into the hands of the consumer with immediate access to price and quality comparisons. Armed with this information, they can make informed decisions while mitigating any financial apprehensions.
The next step is to drive utilization of the pricing tool through rewards-based incentives. And what better way to incentivize members than by investing back in their healthcare? It’s the best of both worlds since higher utilization leads to a decrease in plan spending for the employer, while lowering costs and adding a health benefit for the members. MyMedicalRewards™ ensures member engagement and drives them toward low-cost, high-quality care. But there’s still one final element that brings everything together and further increases savings.
When considering the most effective way to deliver earned rewards, we recommend leveraging tax-advantaged accounts such as Health Savings Accounts (HSAs) and/or Health Reimbursement Arrangements (HRAs). These types of accounts allow pre-tax funds to be set aside for qualified medical expenses, providing additional healthcare savings. Here’s a quick overview of these accounts.
Health Savings Accounts (HSAs) – Triple-tax-advantage accounts for people with HSA-qualified high-deductible health insurance plans. Both the person who owns the account and their employer can contribute to the account up to a certain amount each year. These accounts combine the best attributes of IRA and FSA accounts without the fear of the use-it-or-lose-it feature that comes with other tax-advantage account types.
These funds can be used to pay for qualified medical expenses for things like:
- Most medical care
- Most dental care
- Most vision care
- Over-the-counter drugs3
Health Reimbursement Arrangements (HRAs) – HRAs are employer-funded plans that pay back, or reimburse, employees for qualified medical expenses and sometimes health insurance premiums. Unlike an HSA, HRAs are not accounts; they are an agreement between the employee and employer.
Employers are allowed to claim a tax deduction for these reimbursements. Plus, the money that employees get from their employers is typically tax-free as well.3
TALONPay™ integrates member rewards with these tax-advantage accounts to complete the cost savings ecosystem with a simple way to pay. Once members earn rewards, they are available for immediate use on their TALONPay™ app. Not only does this increase savings by eliminating tax (which can quickly add up), but it also reduces or eliminates member out-of-pocket expenses.
TALON has created a unique, beyond-compliance platform with savings embedded into every aspect of our complete circle of solutions. We have held ourselves to a higher standard since before the inception of TiC, and this is the standard that will light our way into the future of healthcare.
TiC legislation was not intended to be another bothersome government regulation that must be implemented to stay away from fines. It was conceptualized as the foundation for building a healthcare consumerism ecosystem with aligned incentives.