those insurance companies, who have enough patients, can go to providers and negotiate a lower price because they can guarantee them business/income, simple principle. do you not think the government does not negotiate, well they do not, they actually tell the providers, you charge X but we are only going to pay you X - 30% or something, same principle though one is negotiated the other is forced. the idea is to cut costs for the govt or ins company thus attempt to hold down the consumer premium and out of pocket cost. of course, the consumer plays no part in either of these entities' bargaining just as we do not when a retailer buys their products to sell to us. feel for you, being self-insured, you have no advocate to attempt to lower your costs other than finding a big enough company, blue cross comes to mind, which can lower your costs, somewhat, by negotiating with docs, hospitals and labs, etc. my son is self-insured, millions are and they are now in the midst of having their coverage dropped or their premium tripling or quadrupling in order to meet this new boondoggle of a law. realize that our insurance system is not perfect, it needed some tweaking but we have is so grossly overbearing and the wrong way for us the consumer and the country cannot afford it, period, my only problem. this is our government, so bloated, inefficient, wasteful, fraud-ridden taking over something they cannot possibly handle. we have just made the wrong turn on this, my only complaint. A, hope you can find something that will be better for you but not sure you will but who knows. we are now stuck with this so can only hope that it does not destroy the country financially and at some point it might work properly but, again, it is the government and if they were a private business would be gone, shut down, out of business because a business cannot be run this inefficiently and recklessly and survive for even a month or two.