PLANS
We create tailored plans from our comprehensive suite of benefit solutions.
These strategies are designed to yield significant cost savings and ensure optimal results for our clients. For groups of up to 100 employees, we offer multiple plan options which can be quoted and delivered within minutes. For larger groups, we offer additional flexibility, allowing employer groups to control their benefits through customizable options that suit their specific needs and preferences.
Be in control of cost and coverage
We help employers manage their Level-funded and Administrative Service Only (ASO) plans, combining the cost savings and flexibility of a self-funded plan with the financial safety and predictability of a traditional plan. This integration ensures that employers can navigate the complexities of healthcare benefits with confidence, optimizing both financial efficiency and stability for their workforce.
Additionally, our employee-facing mobile app uses an AI-driven chatbot that incorporates the quality and cost data with the underlying schedule of benefits. This empowers employees to understand the average cost of a procedure and what their out-of-pocket costs will be.
Level Funded Plans
With a level-funded plan, employers pay a set amount each month. After all claims are paid, the employer retains 100% of any unused funds.
Administrative Service Only (ASO) plans
Under an ASO plan, an employer pays for claims only when they are incurred.
Reference Based Pricing (RBP)
It ensures employers pay a set price for certain medical or prescription services. When our RBP is incorporated into a plan design, we negotiate with health systems before care is given to ensure the provider accepts the responsibility and there are no surprise bills.
- Save 20% to 30% compared to Medicare benchmarks
- Understand the cost of care before the bill arrives
Be confident in our quality and our process
Our Medical Management plan combines experienced team members and our industry-leading proprietary software to follow each member’s claim as it comes into our system. This approach guarantees a thorough and efficient handling of every claim.
Medical Management plans
From initial contact to evaluation, any issues are automatically referred to our case management team for a timely and high-quality response, and recommendations are made to improve the quality of care and overall cost.
- Each case is followed to ensure members receive appropriate and quality care
- Board-certified physicians and experienced registered nurses conduct each review
- Our Utilization Management plan is accredited by the Utilization Review Accreditation Commission (URAC), an independent and nonprofit accreditation program for healthcare organizations
Be connected to top-tier networks and new solutions
We contract and credential healthcare providers in tailored network arrangements for our clients and their members. We also engage cutting-edge groups that bring innovative solutions to members to improve care as well as cost. Our seasoned team of industry professionals is ready to create custom, integrated, and effective solutions for exemplary health plan and claims management.
Be protected with alternatives to insurance
We offer access to and the administration of Share programs, which are alternatives to traditional insurance. These programs can provide healthcare for people who may not otherwise have access. Members contribute and collectively share the financial responsibility for other members’ eligible medical needs. Many of these programs are faith-based and ask members to share in a set of religious beliefs.