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Garner explains provider-rating app and reimbursements for top providers under Alpine health plans
Summary
Garner representatives described an app-based benefit that reimburses members who see Garner-designated 'top providers; Alpine employees on eligible plans can be reimbursed for qualifying costs (up to plan limits) after meeting HSA deductibles where applicable.
Representatives from Garner described a new employer-sponsored benefit available to Alpine School District employees enrolled in EMI Health plans: a provider-rating app and reimbursement program that pays members who receive care from Garner-designated 'top providers.
Britton of Garner said the program identifies top providers based on claims data and outcome measures, then reimburses plan participants for qualifying out-of-pocket costs when they see those top providers. "Garner wants to make sure that you're actually receiving care from high quality providers," Britton said, noting the company's algorithm uses claims history and outcomes to rank clinicians. Garner reimburses up to $2,000 per individual (or $4,000 per family) for plans A—C; the Plan D amounts shown were lower (the presenter cited a different limit for Plan D).
The workflow Garner described: (1) create a Garner account (the presenter said about 70% of Alpine employees had created accounts), (2) search the app or website to find and add a top provider to the user's approved-provider list before the visit, (3) see the approved provider and have Garner reimburse qualifying expenses (office visits, imaging, lab work, etc.). Garner staff said they receive claims details from EMI and process reimbursements, typically taking six to eight weeks from date of service to reimbursement; direct deposit was presented as the faster option.
Garner staff explained a special accommodation Alpine agreed to: if members have an established primary care provider, pediatrician, OB/GYN or mental-health provider who is not identified as a Garner top provider, the member can request that provider be added to the member's approved-provider list before visits so care remains eligible for reimbursement. Concierge support is available for adding providers, helping locate top providers, and checking claim status; Garner's chat-based concierge operates weekdays and supports English and Spanish.
Garner and Alpine staff pointed out a key IRS/HSA constraint for members on high-deductible plans (Plan C or D): Garner reimbursements for members with health savings accounts (HSAs) will not begin until the member meets the IRS minimum deductible for the plan year ($1,600 individual / $3,200 family for 2024 plan year). Garner recommended members track their out-of-pocket accumulators and avoid using HSA funds for expenses they will seek to be reimbursed for, to prevent prohibited double-dipping.
Ending: Garner staff encouraged employees to use the web or mobile app to find top providers, to request assistance from concierge if needed, and to watch for reimbursements via direct deposit after EMI completes claim processing.
