Priority Health works to lower costs

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Priority Health announced plans to provide financial support to members and employers facing challenges amid the ongoing COVID-19 pandemic.

Due to lowered utilization of health services, as well as efforts to keep administrative costs low, the company plans to offer premium credits and waive cost-sharing for its most heavily impacted populations. Priority Health plans to return any revenue above the company’s 10% administrative rate back to employers and members.

“Our team is focused on people, not profits and the welfare of our members is always our top priority,” said Joan Budden, president and CEO of Priority Health. “Priority Health is constantly looking for ways to make health care more affordable, and thanks to our dedication to running an efficient operation, we are pleased to be able to make this commitment today to offer financial relief to our members.”

Priority Health set premium rates for 2020 based on expected health care costs. With many health procedures either being delayed or canceled, and consumers overall accessing less health care services, the company’s expected costs have been reduced.

Based on these new projections, Priority Health decided to return these excess funds to members and employers by:

  • Waiving cost-sharing for all Medicare Advantage members for in-person and telehealth primary care services from May 1 to Dec. 31
  • A 15% premium credit for June and July for MyPriority Individual plan members
  • A 15% premium credit issued in June and July for small group employers (2-50 employees)
  • Large, fully funded employers will also have an opportunity for premium credits in the fourth quarter when the total amount of excess revenue available can be determined

“Small businesses and individual consumers have been particularly hard hit during this outbreak, we hope this relief will make it easier for them to stay covered,” Budden said. “We also recognize that the lives and health care routine of our senior members have been significantly impacted.”

Along with reduced utilization, Priority Health’s nonprofit status also helped make it possible for the company to provide this financial relief. Priority Health doesn’t pay dividends to shareholders, which allows the company to spend more on member care.

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