We Tailor Health Plans to Fit Your Employees Needs

The most common plan employers offer employees since the plans have low fixed fees, co-pays to see a primary care physicians, specialists, chiropractors, therapists, as well as prescription medications without having to first meet the plan deductible. Deductibles for these plans range from $1,000 to $10,000. Premiums for Participating Provider Organization (PPO) plans are typically higher in cost vs. a High Deductible Health Plan (HDHP) primarily, because of the upfront coverage for doctors visits and prescriptions.  

High Deductible Health Plans (HDHP) are plans that require the enrolled employee to cover 100% of the healthcare expenses, except eligible preventive exams, before the plan pays any share of one's healthcare expenses. These plans are are typically offered in conjunction with a Health Savings Account (HSA) and are designed to where the employee-owns the HSA providing the employee the ability to set aside non-taxable dollars to be used for eligible health care expenses including but not limited to physician visit charges, deductibles, coinsurance for medical, dental, and vision services, as well as prescription medications and Over-the-Counter (OTC) products. HDHP plan deductibles generally range from $1,650 to $10,000.  

As of 2013, the Affordable Care Act (ACA), created Non-underwritten health plans also referred to as "Fully-Insured" and are the most common plans employers’ select for their business. Premiums for these plans include both co-pays, deductibles and HSAs. 

The plans are based solely on one demographic, the age of the eligible employees within the business. The plan cannot evaluate rates based on the health risk of the group of employees.

The ACA removed the ability for Fully-Insured insurers to evaluate the health risk of an employer group therefore increasing the monthly premium costs for the plans the insurer offers employers.  

Referred to as "Level-Funded" or "Self-Funded" health insurance. Insurers that offer this type of plan are able to evaluate the health risk of an employer group and the benefit eligible employees that is based on age, sex, tobacco use, and individual health history.

The insurer requires the completion of a simple health questionnaire, usually 10-20 questions. 

The advantage of this process is the potential for significant monthly premium cost savings compared to non-underwritten plans. Many of our clients have reduced their monthly premium cost by 20-40% saving them thousands, if not ten's of thousands in annual premium cost.  

Designed to be a more affordable version of health insurance for employers to provide or offer to employees and their families.  

Some limited medical plans are designed to work identical to full coverage plans but with co-pays and coinsurance for doctor visits, hospital stays, and prescriptions, as well as outpatient lab, diagnostic exams, and procedures. While others are designed to be simply co-pay based or reimbursement based plans.  

Regardless of the plan structure, they all have limitations in their coverage of care.  

Designed to be ACA compliant to fulfill the basic levels of preventive care coverage however most do not provide any additional benefit for healthcare services. MEC plans are typically offered by medium to large employers as a solution for part-time employees or for high turnover industries. 

Pricing on these plans vary by the demographics of the employer group but can be 60-80% less than full coverage health insurance plan premiums.