• First and only plan to advocate for working uninsured/underinsured by negotiating and contracting reduced fees with fully transparent pricing, on members’ behalf
• Innovative, value-driven model posts fee schedules online for providers and patients
• Providers in rapidly growing network eager to have first structured, cost-effective option for uninsured patients not eligible for government assistance programs

NEW YORK, NY- November 2, 2009 – The uninsured and underinsured have a new low-cost option for obtaining health care services and prescriptions at significantly reduced prices, thanks to Transparent Health Network, a unique non-insurance health care access plan introduced today in the New York metropolitan area.

For a low monthly fee -- $39 for an individual; $54 for a family -- Transparent Health Network members gain access to a rapidly growing provider roster that includes primary care, specialist and ancillary health care providers who have contracted to care for them at dramatically reduced fees.  They also gain access to extensive discounted pharmacy benefits, available exclusively at 400 Rite Aid stores across the New York area. Transparent Health Network is not insurance, so in return for the reduced fees, members pay the providers directly, at the time they receive care.

“Transparent Health Network is, quite simply, a health care access model that makes sense. More and more people have been losing their insurance coverage or finding themselves unable to afford the premiums. Now, for the first time, there’s a way for providers to help them,” said Leon Smith, MD, past chairman of Medicine, St. Michael’s Medical Center, Newark, NJ. “Unlike any plan I know of, Transparent Health Network levels the playing field for these patients by providing both fair prices and true transparency, so they can make educated decisions about their care.”

Health care services are one of the most important purchases an individual can make, yet most people seek care blindly, without any idea how much it will cost, how much their insurance companies will pay their providers, or how much they will be reimbursed.  Medical fees are rarely posted, and vary greatly from one provider to the next for the same services. Further, one insurer might negotiate many different fees for the same service with different providers. Typically, uninsured patients are charged “usual and customary fees,” which can be as much as 42% to over 300% more than providers accept from Medicare.  By serving as an advocate for its members, Transparent Health Network uses the power of its network to negotiate fees with participating providers and provides transparency to members so they can make informed, value-driven choices about their health care. 

“Transparent Health Network was created on the premise that health care can and should be affordable, even if health insurance is not,” said Betty Heiman, CEO and founder of Transparent Health Network. “It has always been appalling to me that the most vulnerable patients, the uninsured—who lack the purchasing power of a network— usually pay the most.  Transparent Health Network is a cost-effective solution for these people.”

Transparent Health Network negotiates fees with providers in much the same way as insurers do, but with two significant differences: With Transparent Health Network, contracted rates are the same from one provider to the next within a specified geographic area; and, for complete transparency, the contracted fee schedules are posted online, at www.transparenthealthnetwork.com where members and providers can access them easily.  Members can look up the price of common procedures before seeking care, so they can make educated decisions about when and where to seek care, and maximize the value of their health care dollars.  With Transparent Health Network there are no exclusions based on medical history or age, and memberships can be purchased or cancelled in one-month increments. In addition, Transparent Health Network is a viable companion to high deductible, or catastrophic, insurance plans.

Because Transparent Health Network is not insurance and members pay for care at the time of service, Transparent Health Network also is expected to save money for providers, by eliminating the cumbersome paperwork required by most insurance plans.  There are no claim forms, no referral or pre-authorization requirements, no long waits for payment or denials, and therefore, no need for lengthy appeals processes. 

Transparent Health Network was designed to be an affordable option for individuals who are working and either uninsured or underinsured and cannot comfortably afford health insurance, but whose incomes exceed the maximum limit for government assistance programs. According an analysis of the 2009 US Current Population Study, there are more than 500,000 households in the New York metropolitan area that have annual incomes of $60,000 or more, but are not insured. Although not part of the analysis, it’s likely that many of these households are uninsured by choice.

In such cases, they are gambling that they will not experience a catastrophic event and can afford to self-pay for whatever care they need.  Transparent Health Network refers to these people as the “S-suite,” for “Self-sufficient, Uninsured, Independent Thinkers and Employed.”

“Transparent Health Network has found a novel approach to addressing the health care needs of the population most often caught in the middle of the debate:  those who have a middle class income, too high to qualify for government assistance but not quite high enough for them to comfortably pay for insurance.” said Wendell Potter , a consultant to Transparent Health Network and a former insurance industry executive. “By creating an organization that empowers the uninsured to receive care at fair prices they could never obtain on their own, Transparent Health Network offers a sound, logical solution for its members. While those who can afford the premiums should have insurance, Transparent Health Network is an excellent, value-driven alternative for those who cannot.”

About Transparent Health Network

Transparent Health Network is a product of Transparent Health Group, LLC, a privately owned company committed to providing the uninsured access to affordable health care at fair prices.  Transparent Health Network is currently available in the New York metropolitan region, including the five boroughs of New York City, Westchester and Long Island.  Its provider network currently comprises more than 1,200 provider locations, including primary care, ancillary care and a broad spectrum of specialties, and is growing daily.

In addition, Transparent Health Network membership includes access to pharmacy benefits at 400 Rite Aid pharmacies throughout the New York metropolitan region, including more than 500 prescriptions starting at $6.99/month.  Beyond the formulary, the plan includes discounts on additional prescriptions and a variety of Rite Aid-brand front-of-store products.

Membership in Transparent Health Network is available through employers or online registration through our website at www.transparenthealthnetwork.com. While those who can afford the premiums should have insurance, and Transparent Health Network can be combined with a high deductible health plan, membership can also stand alone.

Because Transparent Health Network is not insurance, in exchange for reduced fees members are responsible for paying providers directly when they receive service.

For more information about Transparent Health Network, visit our website at www.transparenthealthnetwork.com.

The “fine print”
Transparent Health Network is not insurance. For a low monthly fee, the Company provides members with access to a network of health care providers who’ve agreed to accept pre-negotiated, contracted rates for products and services.  Members are obligated to pay providers directly, at the time of service.  Transparent Health Network does not make any direct payments to providers for services to our members, nor do we reimburse members for fees paid to providers.

For more information:

Wendy Mensch
Transparent Health Network
646-367-1750 ext. 109
wmensch@transparenthealthgroup.com

Paul McDade
Corinth Marketing & Public Relations
212-255-5340
paul@corinthgroup.com