Mutual Medical Plans

Self-funded healthcare plans, or self-insured employer-sponsored health plans, offer greater control and flexibility in managing employees' medical benefits. However, these plans mandate more administrative resources and expertise to manage effectively. Employers often work with third-party administrators (TPAs) for help with plan administration, claims processing, and regulations compliance.

Mutual Medical Plans (MMP) is an Illinois-based TPA that offers self-funded healthcare plans that control costs and provide the highest quality customer service.

Unlike major medical insurances, MMP’s alternative healthcare plans provide employees with full coverage for their claims, eliminating any out-of-pocket expenses and resulting in substantial cost savings for the plan sponsor.

“Our plans ensure that affected employees enjoy full coverage without the burden of deductibles, coinsurance, or co-payments, which are usually not reimbursed. This strategic approach significantly lightens the financial burden on the plan sponsor, allowing them to allocate resources more efficiently and sparing them from the substantial costs associated with traditional medical insurance,” says Ron Jones, president, MMP.

In essence, this is a win-win, benefiting both employees impacted by cost controls and the employer, who ends up spending only a fraction of the funds they would have spent on other major medical coverage.

MMP’S healthcare plans are meticulously crafted, incorporating myriad cost control strategies to keep costs down without reducing employee benefits, as demonstrated by their impressive statistics.

According to Kaiser’s data, when employer health plans saw a 47 percent cost increase from 2012 to 2021, MMP client’s healthcare plans decreased by over one percent in the same decade.

Similarly, in 2021, Express Scripts reported that MMP's clients had a lower combined drug expenditure per employee, of only 41 percent, compared to its peers. In the same year, while specialty drugs made up 53.4 percent of drug expenses in Express Scripts' peer groups, MMP's combined groups spent only 1.6 percent on them.

These exceptional numbers are a testament to MMP's commitment to client-centricity.

In one of the instances, MMP managed the self-funded medical plan of Federal Companies, with its creative solutions to out-of-control costs. The client’s health care plan had faced a $750,000 laser deductible on stop loss mainly due to a costly dialysis claim. Their former TPA, one of the largest in the country, was paying around $58,000 per month after negotiation fees were added.

Mutual Medical came to the rescue and amended their healthcare plan to install one of its optional plans, resulting in them spending less than $15,000 the first year, including the kidney transplant.

An employee beneficiary association, Plumbers and Pipefitter Local 551, has also been partnering with MMP for the past four years. Their funds were in the red, facing a deficit of $600,000 before partnering with MMP. Today, they stand at a substantially positive figure of $1,500,000, with continuous growth.

The City of Clinton has hired MMP to administer their employee healthcare plan as well. In the past 19 years, the company has effectively controlled the alternate plan costs, which have only undergone an average annual increase of one percent. Thirty-seven percent of plan participants also enjoyed full reimbursement, even with deductibles, co-pays, and coinsurance.

MMP has penned many similar success stories under Ron and Carol Jones’ leadership with its cost control strategies. Partners in real life, they have cultivated a winning combination of employee retention, operational efficiency, and strategic marketing that has nurtured the company's success. Carol is skilled in healthcare plan development and HR affairs, and Ron excels in marketing, crafting effective cost-saving claim control strategies, and collaborating with agents, brokers, and employers.

The company offers online portals for its members, providers, and employers to maintain a streamlined exchange of information in real-time and ensure ease and convenience. Via the member portal, MMP cardholders have online access to their personal benefit, eligibility, plan information, out-of-pocket totals, and processed claim details. Providers can use the portal to confirm patient eligibility and determine out-of-pocket responsibility and claim processing status, while employers can assist their staff with questions and monitor the claim status.

Cost reduction and operational efficiency are necessary to overcome skyrocketing medical expenses in the modern healthcare industry. Self-funded plans have gained prominence by easing financial burdens and fostering seamless medical experiences. MMP, through cost-effective and flexible self-funded insurance plans, aims to guide employers to navigate risks while tailoring coverage to their workforce's needs.