Self Funded Insurance

Using Innovation to Lower the Cost of Self-Funded Health Plans

Our U.S. Healthcare System is Expensive and Wasteful

It is a sick care system that focuses its resources treating people after they have been diagnosed with a medical issue, as opposed to proactively helping people live healthy, full lives. BowTie Medical has created an innovative benefit program that puts members in control of their health and their health care. This approach leads to better health outcomes and lower overall cost.

Cost Containment Tools and Strategies

Each member’s care team includes Health Guardians. BTM Health Guardians help members:

  • Become engaged, educated consumers of health care
  • Find care and services providers that use fair medical pricing
  • Avoid unnecessary care
  • Utilize tools proactively to minimize the cost of procedures and surgeries
  • Coordinate access to Capital Rx, a high quality, low cost pharmacy benefit program
  • Earn valuable rewards available in the Good Karma rewards program

An Innovative Funding Model

BowTie Medical is offering small to medium sized employers access to insurance options that were previously only available to large employers. BTM’s self-insured health plans are designed to provide employers more choices in plan design and greater control of costs throughout the year. Almost more importantly, BowTie is funding the collateral needs and other upfront expenses associated with developing self-insured benefit programs. As your healthcare provider and insurance partner, BowTie Medical is in alignment with your interests in lowering the overall cost of care and maintaining a healthy, productive workforce.

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Employers and employees realize better health outcomes and a lower overall cost of care by utilizing BowTie’s Virtual Comprehensive Care service, Health Guardians and the Good Karma rewards program

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With greater access to providers with fair medical pricing, employees reduce their out-of-pocket costs and the community’s overall cost of care

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Employers will see lower monthly rates than they typically would see with fully-insured health plans

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100% of funding in excess of claims reimbursed is retained by the employer

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Employers have full insight into claims and can actively exercise cost containment tools and strategies throughout the year

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Employers avoid multi-year commitments

Innovative Health Insurance Solutions

Comprehensive Medical Care + Health Guardians = A lower overall cost of care and better health outcomes
Comprehensive Medical Care

Even though our goal is to prevent our members from becoming patients, BowTie is there when our members need us most.  Care teams made of doctors, nurses and health professionals help our members get the care and services they need —everything from routine and preventative care to complex care provided by specialists and surgeons. 

Health Guardians

Health Guardians help members navigate our complex health care system and lower the overall cost of care. Acting as case managers, the guardians guide members to avoid unnecessary care, find fair medical pricing providers and negotiate pricing with hospitals and specialists. Guardians are impactful and deliver a more efficient use of health care dollars.

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The good karma rewards program will drive engagement by providing incentives for members when they seek out and use fair medical pricing providers. Rewards could include reducing or waiving deductibles for big ticket items or gift cards for more routine services such as x-rays or bloodwork. In addition to individual rewards, good karma rewards are available at year-end when the larger community achieves its cost-saving goals.

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