Limited-Day Health Plans for Employers
FOR THE EMPLOYER
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Requires only a $50 employer contribution
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Level funded with stop loss insurance for excess claim risk protection and refund potential based on utilization
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Minimum of 5 enrolled lives or 10% of eligible employees
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An affordable core plan for small employers and carve-out option for larger companies
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Meets ACA “Minimum Essential Coverage” definition
FOR THE EMPLOYEE
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Preventative Services covered 100%
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60-70% of the cost of HDHPs
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NO deductible
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Low copays
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No health questions
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Telemedicine with NO copay
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EAP with 5 face to face counselor visits covered
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Online Wellness tools
WHAT IS LEVEL FUNDING?
Level funding allows small employers to manage¹ the risk for large claims, while enjoying the cost savings and refund² potential of self-funding a health plan.
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Twelve level monthly payments each year covers¹ the costs for your plan, with the potential for earning a refund² at the end of the year.
¹Large claim risk managed by stop-loss insurance with run-out coverage, subject to policy exclusions, solvency of insurance carrier, policy effective dates, mid-year Plan termination, and other policy terms and conditions.
²Refund subject to claims experience, run-out claims, mid-year Plan termination, and the terms and conditions of the administrative agreement.
THE AFFORDABILITY CRISIS​​
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Millions of employees can’t afford the employee contribution on their employer-sponsored medical plan.
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Many employees who can, realize that they could never come up with the $2,000 to $6,000 necessary to meet their deductible.
THE SOLUTION
Our expense-incurred plans make it easier for employees to budget for their healthcare expenses. Since there is no deductible, they simply pay a copay for covered services. Our plans take care of the rest. For employers, the built-in level-funding also means predictable costs. As a result, these plans are unlike any other health plans in the market today.
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LEVEL-FUNDED LIMITED-DAY PLANS INCLUDE:
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Preventative Services
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Outpatient care
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Inpatient Hospitalization (3 Days)
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Surgeries
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Generic Rx
EXPENSES COVERED AT 100% AFTER COPAY
The Fundamental Care Limited-Day Plans are ideal for small groups who can’t afford major medical coverage for employees or even large, national organizations that need a carve-out solution for hourly workers.
These plans include more comprehensive benefits than indemnity-based limited-benefit plans. As a result, employers that can’t offer Minimum Value Plans (MVPs) to their entire employee population will still have a valuable tool to recruit and retain high-quality employees.
WHAT ARE THESE PLANS DESIGNED TO ACCOMPLISH?
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Give large employers a carve-out solution for key employee classes within their part-time and hourly workforce.
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Meet the needs of smaller employers as a core plan when they cannot afford to offer their employees an ACA-compliant MVP.
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Give employees the freedom to choose the types of benefits that meet their needs and budget.
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Provide an affordable, group health insurance solution that is ideal for industries like restaurants, retailers, staffing firms, construction companies, and security guard firms.
