Priority Health to offer financial relief to members and employers in response to COVID-19

(Grand Rapids, Mich. – May 12, 2020) 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 low, ten percent 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.”

COVID-19 has caused widespread disruption to the way consumers are accessing health care. 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 made the decision to return these excess funds to members and employers in the following ways:

  • Waive cost sharing for all Medicare Advantage members for in-person and telehealth primary care visits May 1, 2020 through December 31, 2020
  • A 15% premium credit for June and July 2020 for MyPriority Individual plan members
  • A 15% premium credit issued in June and July 2020 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,” said Budden. “We also recognize that the lives and health care routine of our senior members has been significantly impacted. We want to make sure these members are able to reengage with the health care system without having to worry about the cost of a copay to see their doctor.”

Along with reduced utilization, Priority Health’s nonprofit status and focus on efficiency 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. Priority Health operates with some of the lowest administrative rates in the country, spending 90 cents1 of every dollar on member care. 

This action is just the latest in a series of steps that Priority Health has taken to support its employer groups, members and physician and provider partners since the emergence of COVID-19 including:

  • Fully covering the cost of physician-ordered COVID-19 testing for all members
  • Waiving all copays, deductibles and coinsurance for the treatment of COVID-19 through June 30
  • Expanding $0 virtual care to most members for routine care through June 30
  • Expanding free home medication delivery for all members
  • Providing free access for all members to myStrength, an online mental wellness tool
  • Accelerating value-based payments and quality bonuses to offer physician and provider partners financial stability
  • Offering flexibility to employer groups on premium payments and eligibility criteria
  • As part of an integrated health system, Priority Health is also participating in temporary measures announced by Spectrum Health including executive compensation reductions, suspension of retirement matching program for employees and aggressively reducing expenses and prioritizing 2020 spending

Priority Health also continues to follow the CDC’s activities and work with local health departments and the Michigan Department of Health and Human Services to share COVID-19 educational information. Learn more about Priority Health and ongoing efforts surrounding COVID-19.

1 According to Priority Health Medical Cost Ratio for most recent fiscal year ending June 30, 2019.

About Priority Health:

With over 30 years in business, Priority Health is the second largest health plan in Michigan, offering a broad portfolio of health benefits options for employer groups and individuals, including Medicare and Medicaid plans. Serving more than a million members each year, and offering a network that includes 97 percent of primary care physicians in Michigan, Priority Health continues to be recognized as a leader for quality, customer service, transparency and product innovation. Priority Health is the smart choice for people seeking affordable, quality health coverage.