Limited-Day Health Plans for Employers

Level-funded copay plans with NO DEDUCTIBLE

Benefits pay on an Expense-Incurred basis

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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

  • Meets ACA “Minimum Essential Coverage” definition

FOR THE EMPLOYEE

  • Preventative Services covered 100%

  • 60-70% of the cost of HDHPs

  • NO deductible

  • Low copays

  • No health questions

  • Tele-medicine 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.

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 plans’ 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, even 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, including those that offer MVPs to full-time employees, a solution for their part-time, seasonal and temporary workers.

  • Meet the needs of smaller employers that cannot afford to offer their workers an ACA-compliant MVP.

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

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

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Coterie Advisory Group, Inc.

 

www.coterieadvisors.com

 

Phone: 602-884-8096

This website is for marketing and illustrative purposes only to licensed insurance agents and brokers as an invitation to inquire, and is not intended to solicit insurance. For specific plan details, rates, exclusions, limitations, and state availability please contact Coterie Advisory Group using the online form, email, or phone listed above.

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