| Participating
Provider (PPO) Network
 Our
Participating Provider Network is a good illustration
of the commitment Island Group has to their clients
and the service we provide. In 1985, we first
pursued the development of our PPO; primarily
to serve the needs and requirements of our public
sector clients who desired an alternative to the
then conventional methods of providing benefits
i.e. (The Empire Plan, a fully insured programs
or restrictive HMO programs). We chose to develop
our own PPO, rather than merely "buying into"
a pre-packaged, "off+ the+shelf" PPO.
The reason is simple. We deal directly with the
practitioners; we credential the practitioners;
and we negotiate the reimbursement schedules that
the practitioners receive.
The
"rent a PPO" method would have excluded
a direct relationship with practitioners and Hospitals,
and we would have eliminated any ability to negotiate
the best rates for our clients. We believed that
the "off the shelf" PPO concept would
have negatively influenced the results of the
self-funded plans we were administering. In 1998,
the utilization of our PPO network by our Long
Island based clients routinely exceeded 90 per
cent and, frequently, reaches 100 per cent utilization
by plan participants in a given month. This translates
to very significant claims savings for our clients
and enhanced benefits for plan participants. What
was once considered an impossibility (savings
+ enhanced benefits), we have been able to make
into a reality. It has taken us nearly 15 years
to create this particular PPO network, which is
growing on a daily basis.
The
Island Group Administration Inc. PPO network coupled
with the IGA hospital discount program, routinely produces
savings of 50% or more in expenditures that would be
typified by a self-funded program without discounts
or PPO. Some of our established clients on Long Island
have seen virtually no increase in their claims expenditures
for more than 24 months.
 We
do not force a provider list on plan participants.
We encourage the plan participants to list their
own doctors/specialists for us to contact and
enroll. Rather than canvassing an area for any
provider who would be on any list, we pursue the
most reputable providers in each specialty, particularly
those located in areas of high utilization that
our clients' employees actually use. The plan
participants enjoy increased benefits, ie. elimination
of deductibles and coinsurance, assignment of
benefits though direct billing, ease of claim
filing, etc. Our client employers save claim dollars
each and every time a plan participant uses a
PPO provider. Unlike an HMO program, the plan
participants have the free choice of any practitioner,
and/or a member of the PPO. This provides the
utmost flexibility within the self funded program.
Island
Group Administration Inc. has one of the largest
preferred provider networks in New York and Long
Island and the largest in Suffolk county to date.
Virtually all Long Island hospitals participate
in the IGA network, including several hospitals
that chose Island Group to administer their own
employee health plans. The IGA practitioner network
is provided at no cost to our clients and is proprietary.
Our clients exercise complete control over every
aspect of plan utilization and management through
IGA by virtue of this fact. Our contracted rates
and fees with providers and doctors are noteworthy
as it is pivotal to the success of any future
program a perspective client may consider, and
one of Island Group Administration Inc. greatest
strengths. As you are aware, 92% of the costs
associated with any program are claims. Historically
the collective impact of Island Group contracts/discounts
have provided for a 50% savings or more to our
clients.
Island
Group Administration Inc. is committed to the continuing
expansion of our PPO network, so that the maximum results
can ultimately be achieved by our clients.
Addendums
are provided monthly so that employees and clients
are aware of new providers. This information is
provided either by hard copy or computer disk.
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