Give your employers access to two provider networks for the price of one
June 2007
As an insurance carrier, TPA or broker, we know you are always looking for ways to combat your employer groups’ rising healthcare costs. That’s why Encore has developed a third network option, the Encircle/Encore Combined network. Encircle/Encore Combined gives employees access to the entire Encore network of hospitals and providers while empowering them to obtain greater savings when they choose Encircle hospitals.
Encircle/Encore Combined Product Overview
The Encircle/Encore Combined Product has a plan design incentive for employees to use Encircle Hospitals which have deeper discounts or lower fixed cost DRG pricing. With Encircle/Encore Combined, members have access to all the providers and hospitals in the Encore and Encircle networks. However, they will pay less out of pocket when they choose a hospital from the Encircle network. And, as with any network, they may also choose hospitals from outside of the Encore and Encircle networks, but they will pay more out of pocket.
Advantages of the Encircle/Encore Combined Product
- Saves both the Employer and Employee money by steering employees into one of the lower cost 43 Encircle Hospitals.
- Full access to all hospitals in Encore, but highest savings are achieved when seeking service at an Encircle hospital.
- Full access to physician panel in Encore and Encircle.
- Easier for Employers to administer. (No need to separate Encircle employees from Encore employees for eligibility).
- Employee determines which network to use at time of service, not at time of enrollment.
- Substantial reinsurance savings.
- Substantial savings over using the Encore Network alone.
- Average overall savings 47%.
Best suited for employers with employees in the following counties: Allen, Bartholomew, Blackford, Delaware, Floyd, Grant, Hamilton, Hendricks, Howard, Huntington, Lawrence, Madison, Marion, Monroe, Noble, Orange, Tippecanoe, Vanderburgh, Vermillion, Vigo, Warrick, Whitley.
The option has been tested and shows to save employers and employees money by steering them to low cost hospitals first. For example, a two thousand life group health plan design achieved a savings of $800,000 per year by choosing both Encore and Encircle together. Encircle/Encore Combined plan design requirements include a 20% differentials or a 30% differential between in and out-of-network. In addition, the plan requires a $600 deductible when an encore hospital is used. Therefore, the Encircle/Encore Combined network offers employees an incentive to use hospitals with a lower fixed DRG pricing.
To learn more about the Encircle/Encore Combined Network, simply contact your Encore sales representative toll free at (888) 574-8180 and press 2 at the prompt, 8:30 a.m. to 5 p.m. EST Monday through Friday.