June 2023
Guiding Members to Cost-Effective, Quality Care Options
Applies to large groups, fully insured and ASO
Health care costs can vary widely based simply on where a medical service or procedure is performed. A knee MRI might cost more than $2,500 in one location, for example. Another equally qualified provider, however, might charge only $500 for the very same knee scan.
For employers, members’ health care choices can have big financial impacts. It can pay to reward members to shop for the best value. Doing so can earn the member cash, while employers gain the benefit of paying less by encouraging cost-effective, quality services and procedures.
Realizing big savings
Member Rewards is a comprehensive engagement and rewards program available to large fully insured and ASO groups as a buy-up. Administered by Zelis (previously Sapphire Digital), the program guides members to cost-effective options that can drive measurable savings.
Here’s how it works. The member:
- Searches online via Provider Finder® (or contacts a Benefits Value Advisor or Health Advocate, if applicable) to find a reward-eligible location for a procedure or service.
- Gets the procedure or service at their chosen reward-eligible location.
- Receives a cash reward by check – mailed to their home – after the claim is paid and the location is verified as reward-eligible.
Savings per claim
Easy-to-use Provider Finder guides members to cost-effective options. Member Rewards gives members a cash reward (up to $500) for making cost conscious choices. The program has 200+ reward-eligible options for procedures and services, such as scans, colonoscopies, surgeries and more.
In 2021, the average savings per claim was $527* for members who used Member Rewards, based on Zelis SmartShopper data on activated members in our book of business. The average reward paid to members was $107*.
Member engagement is critical to the success of the program. The Member Rewards product features an integrated marketing strategy designed to engage members and includes email, SMS text and quarterly employer toolkits with fliers, posters and more.
All tax documents are taken care of by our partner, Zelis. No additional administration is required from the employer.
Ask your account executive how Member Rewards could help trim costs.
*The average savings figure is based on Zelis data from January through December 2021 for medical services only. Estimates found on Provider Finder are estimates for various providers, facilities and procedures. Savings and reward amounts depend on the options members choose.
MDX Medical, LLC dba Sapphire Digital, a Zelis company, is an independent company that has contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) to administer the Member Rewards program for members with coverage through BCBSIL. Reward-eligible options and reward amounts are subject to change. Eligibility for rewards is subject to terms and conditions of the Member Rewards program. Amounts received through Member Rewards may be taxable. BCBSIL does not provide tax advice. Members that have primary coverage with Medicaid or Medicare are not eligible to receive incentive rewards under the Member Rewards program.
BCBSIL makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.
