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Effective in 2021, MBA VEBA will attempt to break this old short-term paradigm. Based on the concept that health plan premiums will not go down unless we actually pay less for good health care, the VEBA Trust will offer member banks the option of moving to an alternative set of plans that determines the fair level of allowable facility charges based on reference- based pricing.


Member banks will have the opportunity to receive a 0% increase in rates for 2021 under this new program. MBA VEBA will offer the same set of benefit plans with a new claim pricing and network model beginning Jan. 1, 2021. MBA VEBA’s Reference-Based Pricing Rate Plan uses a model


that considers both the cost of the service and the Medicare reimbursement rate to determine a facility claim payment that is fair and reasonable. Tis approach is universal for inpatient and outpatient facilities and eliminates the concept of in- network for facilities only. Te program will use the PHCS provider network for physician claims and most labs and imaging providers, providing in-network benefits for these services.


Te new initiative is aimed at the long-term financial well- being of the VEBA Trust. Te goal is to create a new paradigm for future annual renewals that focuses on stable costs and positive benefit improvements.


THE MISSOURI BANKER 13


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