Published by John Castelli III on January 20th, 2026

Stand Out with a Healthcare Option That Delivers What Clients Really Want

You are under pressure as a broker to bring clients a healthcare option that addresses very real needs. Rising PPO rates, increasing deductibles, and clients demanding both affordability and quality care have created a tough environment. But these trends also create an opportunity for you to stand out from other brokers—to win new business, and to create a stable book of business that is 15% likelier to renew, year after year. You just need to bring the right solution.

And what is that solution? Reference-Based Pricing, or RBP, is an idea that is gaining traction and changing the healthcare benefits conversation. RBP is a way for you to stand out and deliver value to clients with transparent and sustainable pricing that is up to 35% less than PPOs without cutting benefits. 

RBP Is the Next Evolution in Cost Management

The story of RBP is really the story of healthcare innovation. Every major shift in health plan design—from HMOs in the 1970s to PPOs in the 1980s—has tried to solve two challenges: Access to care and cost containment. HMOs limited access. PPOs expanded it, but cost containment weakened over time.

That’s where RBP comes in. First introduced by the State of California in 2011, RBP was designed to reset the pricing conversation by using a transparent reference point—Medicare reimbursement rates—to determine what’s fair and reasonable. Unlike other types of plans, the pricing is clear. RBP plans reimburse providers based on a multiple of Medicare, typically around 120–150%.

Here’s what this healthcare option looks like in real life, based on estimated averages of Trustmark data:

A hospital may bill $69,000 for a knee replacement. Medicare pays about $15,000 for the same procedure. A PPO network might pay around $32,000. With RBP, the payment averages around $24,000—a significant savings for the employer while still compensating the provider more than Medicare.

And because RBP plans are non-network, members have freedom of choice—they can see any provider without worrying about “in” or “out” of network. That’s innovation that truly expands access and reduces costs.

Breaking RBP Myths—Why This Healthcare Option Works

If RBP is so effective, why isn’t everyone using it? For years, brokers and employers hesitated, citing four main objections:

  • “Doctors won’t accept it”
  • “Balance billing is a nightmare”
  • “Employees won’t understand it"
  • “It just doesn’t work"

Those concerns about the RBP healthcare option were valid—in the early years. But RBP has evolved dramatically, and Trustmark has refined the solution through nearly a decade of experience.

Trustmark’s Reference-Based Pricing plans are built on fair and reasonable reimbursements and a robust Trusted Member Care Team that directly supports members and providers. When a provider questions a claim, our team steps in—resolving 90% of balance bills in two business days.

In the rare occasion that additional payment is needed, it is sent directly to the provider, so members don’t have to handle it. (Reminder: members are still responsible for their copays, deductibles, coinsurance and non-covered charges.)



The Broker Advantage

The benefits to your business you can enjoy by bringing the RBP healthcare option to clients are tangible and lasting:

  • Retention: RBP delivers stronger loyalty—RBP plans are on average 15% more likely to renew their plans with Trustmark
  • Growth: Plans typically cost up to 35% less than traditional PPOs, giving you a compelling advantage in competitive RFPs
  • Opportunity: RBP makes coverage accessible for employers who might otherwise be priced out of the market—opening doors for new business
Take Dallas, Texas, for example. Trustmark’s data shows that our RBP plans there average 18.1% lower premiums than comparable PPOs—and with a claim appeal rate of just 1.1%. Let’s take the hypothetical example of a 25-person group there, worth $250,000 in annual premium.  For a 25-person group, that’s a potential savings of $45,250 per year without cutting benefits.

Even in markets with more complexity, Trustmark provides transparency. Each region is scored for RBP performance based on real claim data, helping brokers set the right expectations and choose the right strategy. And in markets where one hospital dominates, brokers can offer dual-option plans that combine RBP with PPO access—maintaining flexibility and cost control.

Real Results, Real Savings: Why Trustmark Stands Out

Will RBP work for your clients? The results speak for themselves:
  • Members have freedom of provider choice without network restrictions
  • According to Trustmark data, employers are 20% more likely to receive a refund or administration fee credit with RBP plans vs others
  • Brokers maintain stickier business and stronger client loyalty
And because RBP helps curb medical inflation, Trustmark’s RBP plans show a 5% lower paid-claims trend than PPO plans—delivering sustainable savings year after year.

RBP is now more than 30% of Trustmark’s business—and for good reason. Over nearly a decade, the company has built a fully integrated solution: stop-loss, TPA, and carrier all under one roof. That integration means fewer handoffs, faster resolutions, and a smoother member experience.

Lead with the Healthcare Option That Wins You More Business

Healthcare cost increases aren’t slowing down—but innovation from Trustmark is how you—and your clients—can catch up and even get ahead. With RBP, brokers can finally offer employers a better path forward: Transparent pricing, lower premiums, and a better member experience.

Brokers who lead with RBP aren’t just selling a product—they’re delivering a smarter healthcare option that is backed by nearly a decade of proven results.

Ready to Set a New Standard for Lower Healthcare Costs?

Explore how Trustmark’s RBP solution can help you win more business and strengthen client relationships.

Want to see the latest RBP webinar? Access it here.

Got questions about RBP?  We have answers. Reference-Based Pricing Toolkit

Trustmark®, Trustmark Healthy ChoicesSM and Trustmark Small Business Benefits® are trademarks of Trustmark Insurance Company. Plans are administered by Star Marketing and Administration, Inc., and stop-loss insurance and ancillary coverage are provided by Trustmark Life Insurance Company.