Introducing the future of the employer health plan...
We'll take you through our optimized health plan below, you'll get the best of the best member experience while gaining cost economies as you "share" the common chassis with many others while managing your own risk & cost.
Step 1: Engagement
Build a relationship with the member, improve the experience, and health improves and costs are reduced
A customer service experience like nothing you've ever had, every employee (and dependent) has 24/7 access to a medically licensed nurse & doctor team in a virtual-first environment to be a true partner in their health care journey. Everything from care coordination and case management to script refills, appointment scheduling, primary care, and health plan/benefits guidance - our incredible nursing staff is there to serve the member.
Step 2: Technology
Unprecedented access to all things health care represents an opportunity to drive value for employees and employers
Our licensed nurse concierge service is only the beginning; we also offer a member experience platform (mobile app) that allows members to chat with a live human 24/7 with a <60 second response time. They're equipped to answer any question a member could imagine, but will also reach out (if desired) with valuable health related options. The platform also provides a self-serve provider search, digital ID card, full insights into deductible & claims, and much more.
Step 3: Compliancy
Between ERISA, ACA, CAA, and more regulation and mandates, compliancy requires a full time focus
Our 30+ years as an independent Third Party Administrator (TPA) speaks for itself. We keep up with the latest compliance requirements for level and self funded health plans so you can focus on running your business. We're always available for questions and provide unmatched value to members and clients.
Step 4: Network
A broad, national network designed specifically to drive value for members & employers
Going above and beyond is our middle name, and our network solution is a perfect example. We have the largest direct contract base in the US and add new contracts on a daily basis, but that's only the beginning. We also offer access to regional and wrap networks, a single case agreement service, and a cash-pay option when appropriate. We do all of this for an access fee less than half of your typical network - now that's value!
Step 5: Pharmacy
Easiest way to save money is within your pharmacy spend. Same drugs, same pharmacies, 30%+ minimum savings opportunity
The true cash cows of the health care industry are OptumRx, Express Scripts, and CVS/Caremark owned (in order) by United, Cigna, and Aetna. Together, they make up 90% of the employer pharmacy spend, and unfortunately for employers, these companies grossly overcharge for generics, brand name, and specialty drugs. We have yet to see less than a 30% reduction in total pharmacy spend by switching to our Rx solution. Since Rx makes up 25% of your plan spend, that's an immediate 10% total plan spend savings opportunity.
Step 6: Analysis/Reporting
A level of analysis and reporting available beyond anything you've ever seen, and that's just the beginning
Over 65% of employers in the US are self-funded and less than 25% don't use data to identify opportunity for savings, plan improvement, network utilization, or reduction of future risk. Our data analytics approach is to optimize the opportunity through insights, predictive analytics, and behavioral trends.
Step 7: Risk Management
Managing plan risk is critical to the success of a self-funded health plan, and there is no room for error
A+ rated carriers only. We could stop there, but we use our incredible plan design and buying power to negotiate the most favorable rates possible from the nation's largest reinsurance/stop loss entities. We're flexible on your appetite for risk, but always guide based on what's best for you.
And that's just the high level overview..
Our packaged, "Easy Button" health plan is optimized for member experience & cost efficiency
"Easy Button"
We're built and ready to go, our vetted partners have decades of experience in their area of expertise and they're ready to serve you and your members.
Save Money
Save money by leveraging a common approach to a high value health plan. You won't bear the risk of other groups, but you will gain economies.
Member Experience
An experience second to none, it's important that members are treated like humans, and we have an opportunity to deliver unmatched value.
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The possibilities are endless, let's improve health care together!