A Smarter Way to Take Control of Your Health Plan Costs

If your health plan costs seem to rise every year with little explanation, you’re not alone. Many employers feel stuck—paying more while having less visibility and control over their healthcare spend.

At Southern Benefit Group, we believe there’s a better way to manage your benefits strategy. One approach gaining traction is Reference-Based Pricing (RBP)—and it’s helping employers take back control.

What Is Reference-Based Pricing?

Reference-Based Pricing is a different way to pay for healthcare.

Instead of relying on carrier networks and negotiated discounts, RBP sets a fair, transparent reimbursement rate—often based on a multiple of Medicare. This means your plan pays a reasonable, data-backed price for services, rather than inflated provider charges.

Why Employers Are Making the Shift

Traditional health plans often leave employers with:

• Rising and unpredictable premiums
• Limited insight into actual costs
• Little flexibility in plan design

RBP offers a more strategic alternative, with benefits like:

• Lower costs on high-ticket claims like surgeries and hospital stays
• Greater transparency into where your dollars are going
• More control over your overall plan design

For many organizations, this can translate into meaningful savings and more predictable budgeting.

How It Works

With an RBP model:

• Your plan sets a reimbursement benchmark (e.g., a percentage of Medicare)
• Employees access care, often with guidance toward RBP-friendly providers
• If a provider bills above the benchmark, expert support steps in to negotiate

The result is a more disciplined, value-driven approach to healthcare spending.

What About Employee Experience?

This is often the first question—and rightly so.

With the right support in place, employees can:

• Access quality care at fair prices
• Receive guidance on where to go for services
• Get help resolving billing issues if they arise

Education and advocacy are key, and when done well, employees become more informed and confident healthcare consumers.

Is RBP Right for You?

Reference-Based Pricing may be worth exploring if:

• You’re self-funded (or considering it)
• You’re frustrated with rising costs and lack of transparency
• You want more control over your benefits strategy

Let’s Rethink Your Health Plan

You don’t have to accept the status quo when it comes to healthcare costs.

At Southern Benefit Group, we help employers build smarter, more transparent benefit strategies that align with their goals—and their budget.

If you’d like to learn more about how Reference-Based Pricing could work for your organization, we’d be happy to talk.