If you have a Master Health Plan we know you must always look to use that first. We have no argument with that. We are not looking to replace it. But not every group will be a fit for your Master...or maybe the group wants a level-funded plan and instead of competing against them you now can offer them one! Don't miss out on offering "a PEO's best alternative to a Master Health Plan!"
Are you a PEO without a Master and just using local small group open market quotes? Keep doing that for the groups that should remain in the fully insured small group community-rated market. But also have in your arsenal a level-funded health plan that is private labeled to you. You too don't want miss out on offering "a PEO's best alternative to a Master Health Plan!"
There is a reason level-funded plans are the fastest growing type of health plan in the small group market over the last five years...and why every major carrier now offers them...in some markets it is the only type of plan they offer!
What is that reason?
Employers want them!
Are they for everyone? No!
But for those employer-clients of your PEO who want more than the "same old same old" from you every year you should have PEO Premier Health in your quiver. Think about being the PEO competing for new business (or working to retain a current client) that brings this to the table...even if they do not choose this but you still win the business with another health plan option you provided...now you are truly standing apart from your competition by showing them all of their options!
That's right! If the group has a good claims year, they will have 100% of the unused claim dollars returned to them at year end...either as a direct return of the money or as an offset to the upcoming year's admin costs, depending on the size of the group. Either way, the group gets their money back!
Three Tier Plan Designs provide the best experience for members!
Tier I-Direct Contract Providers: Rewards members with NO OUT-OF-POCKET EXPENSE when engaging with our Care Navigators and when possible, using "Tier I Providers" where we have Preferred direct contracts-even more cost-effective for both the plan sponsor and member than traditional PPO In-network Providers!
Tier II PPO Network Providers: Members pay copays when using PPO network providers.
Tier III Non-Network Providers: Members will have a deductible & coinsurance when using non-network providers.
One good thing (ok the only good thing) coming out of the Covid pandemic has been the comfort with which people now use telehealth.
We bring it to the next level.
Yes, we have "traditional" zero copay/no cost telehealth 24/7/365.
Cooler than that (you're right, that is no longer considered cool) is the Virtual Complete Care our virtual care partner provides. Members get to use the same primary care physician!
This is so cool you want to talk to us even if just to learn what the future of healthcare looks like...but is here now!
Most telehealth plans only provide for short-term mental healthcare. Our virtual care provider provides for ongoing mental healthcare, including counseling and psychiatry treatment.
The healthcare system can be intimidating and confusing...even for those of us in the benefits business. That is why our truly compassionate and kind Care Guides engage with every member when they are trying to "figure this all out."
Our Care Guides also interact with the healthcare provider so they know how to maximize the benefits available for their patient.
Many "alternative health plans" are designed to "satisfy the ACA penalties" and are purposefully very limited in scope of coverage to hit the lowest price point. Those plans serve the purpose intended for employers just looking for a minimal compliance play. They actually work to dissuade employee enrollment! Ugh!
That is not us. Our plan designs will be competitively priced, but not "bargain basement." We have designed and market plans that are intended to help employers attract and retain the best employees, so they have a successful company!
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