Limited-Day Health Plans for Employers

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Level-funded copay plans with NO DEDUCTIBLE

Benefits pay on an Expense-Incurred basis

Follow the links below to register for our webinars.  Webinars are on Tuesdays.

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FOR THE EMPLOYER

  • Requires only a $50 employer contribution

  • Level funded with stop loss insurance for excess claim risk protection and refund potential based on utilization

  • Minimum of 5 enrolled lives or 10% of eligible employees

  • An affordable core plan for small employers and carve-out option for larger companies

  • Meets ACA “Minimum Essential Coverage” definition

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FOR THE EMPLOYEE

  • Preventative Services covered 100%

  • 60-70% of the cost of HDHPs

  • NO deductible

  • Low copays

  • No health questions

  • Telemedicine with NO copay

  • EAP with 5 face to face counselor visits covered

  • 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.

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​

Millions of employees can’t afford the employee contribution on their employer-sponsored medical plan.

Many employees who can, realize that they could never come up with the $2,000 to $6,000 necessary to meet their deductible.

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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.

LEVEL-FUNDED LIMITED-DAY PLANS INCLUDE:

  • Preventative Services

  • Outpatient care

  • Inpatient Hospitalization (3 Days)

  • Surgeries

  • 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?
  • Give large employers a carve-out solution for key employee classes within their part-time and hourly workforce.

  • Meet the needs of smaller employers as a core plan when they cannot afford to offer their employees an ACA-compliant MVP.

  • Give employees the freedom to choose the types of benefits that meet their needs and budget.

  • Provide an affordable, group health insurance solution that is ideal for industries like restaurants, retailers, staffing firms, construction companies, and security guard firms.