Frequently Asked Questions

General
What are your hours?

We are open Monday through Friday from 8 am to 5pm, closed during the lunch hour.

How can GM&A negotiate better rates than the large carriers?

GM&A has industry insiders. Michael Jenike (former Hospital Administrator) and Dr. Herbert (former hospital Chief of Medical Staff) negotiating on your behalf. They know, from being on the other side of the desk, that providers are willing to give their BEST rates to employers who are willing to have a direct, multi-year contract.

What TPAs do you work with?

We will work with the TPA of your choice as long as they are willing to cooperate with us in your best interest. GM&A can evaluate and/or recommend a TPA for you on request.

Can we keep our current network?

Not as you know it. We will be creating a custom network for you. Your current provider utilization will be a factor in the creation of the new network.

What is the disruption?

As little as possible. We will start the process by looking at the providers your employees are currently utilizing. Generally, when the negotiations begin, the providers who are currently receiving the highest utilization will be the most competitive. We will contact and try to negotiate with individual physician providers at the request of any member. New physician providers can be added at any time to your custom network.

What other negotiations can GM&A provide?

Pharmacy benefits, stop-loss coverage, utilization review and other vendors as requested.

How does GM&A get paid?

At the beginning of the process, GM&A and the client agree on an historical per-member-per-month cost (benchmark). GM&A then receives a percentage of the reduction from the benchmark.

Who manages the contracts?

GM&A, unless the client decides otherwise.

Are the agreements between GM&A and the provider?

No, they are between the client and the provider.

Does GM&A do credentialing?

Yes.

Can GM&A provide fully insured?

As an independent insurance agency GM&A can provide a fully insured product.

I still have questions...

Please visit the Contact Us page and send us an e-mail or give us a call -- we'll be happy to answer all of your questions.

For a Consultation and detailed Health Plan Analysis
Call Hurb VandenHoogen at (858) 775-9170
or email hvandenhoogen@gma-usa.com