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Affordable Healthcare Solutions: Fundamental Care® and Employee-Centric Benefit Plans



Affordable Healthcare Solutions


In the ever-evolving landscape of healthcare, balancing affordability with quality is a perpetual challenge. Employers grapple with the task of providing their hourly and part-time workforce with valuable health plan options while managing costs effectively. This is where Fundamental Care steps in as a game-changer in healthcare solutions. In this article, we'll delve into how Fundamental Care, in collaboration with insurance brokers, is transforming the healthcare arena by offering Affordability-Based Medical Plans that cater to both employers and employees.


Addressing the Healthcare Gap


Recognizing the Challenge


Offering comprehensive healthcare options to employees has long been a complex puzzle for employers, particularly those with a significant hourly and part-time workforce. The quest for cost-effective yet high-quality health plans often leaves employers and employees with limited choices and rising expenses. Fundamental Care, with its innovative solutions, serves as the bridge to address the affordability gap in healthcare.


Level-Funded Plans: Affordable Healthcare Solutions


Fundamental Care's level-funded plans stand as a testament to their commitment to affordable healthcare. These plans are meticulously designed to cost 30-40% less than High Deductible Health Plans (HDHPs) and, significantly, they eliminate the burden of deductibles. This affordability factor is a game-changer for employers who aim to provide comprehensive health coverage to their employees while maintaining strict control over their budgets.


The Fundamental Care Advantage


Fundamental Care's offerings encompass a range of benefits that set them apart:


1. Level-Funded Plans


Central to Fundamental Care's approach are its level-funded plans. These plans offer a sustainable way for employers to provide top-tier healthcare coverage to their employees without the financial strain typically associated with traditional health plans.


2. Employer-Sponsored Plans


Fundamental Care's commitment to empowering employers is evident in its employer-sponsored plans. These plans empower employers to tailor healthcare coverage to meet their employees' unique needs, ultimately strengthening their recruitment and retention strategies.


3. Copay Plans with 100% Coverage


A distinguishing feature of Fundamental Care's offerings is its copay plans, which provide employees with the convenience of copayments for medical services, ensuring 100% coverage for essential healthcare needs.


4. NO Deductible


Bid farewell to deductibles with Fundamental Care's NO Deductible plans. This means employees can access healthcare services without the obstacle of meeting a deductible threshold.


5. Guaranteed Issue


Fundamental Care's guaranteed issue policies ensure that employees can access coverage without facing the barriers of medical underwriting, regardless of their health status.


6. Benefits Without Dollar Amount Limits


Fundamental Care plans have no dollar amount limits on benefits, ensuring that employees can receive the care they need without arbitrary limits.


7. High Potential Coverage (Not Fixed-Indemnity)


Unlike fixed-indemnity plans, Fundamental Care's offerings provide high-potential coverage, ensuring that employees receive comprehensive healthcare solutions that align with their needs.


8. Comprehensive Coverage


Fundamental Care's plans cover the full spectrum of healthcare needs, including preventative, outpatient, and inpatient care. This comprehensive approach ensures that employees have access to a wide range of medical services.


9. ACA Qualified MEC & MVP Plans


Fundamental Care's plans are ACA qualified, providing employers with the assurance that their healthcare offerings meet regulatory requirements.


10. Core and Carve-Out Plans


Fundamental Care offers core plans tailored for small businesses and carve-out plans designed for larger organizations. These options ensure that healthcare solutions are scalable and customizable to meet specific employer needs.


Embracing the Employee-Centric Approach

Beyond Decision Makers: Prioritizing Employees


One of the critical shifts in the healthcare landscape is the move from focusing solely on decision-makers to prioritizing employees' needs. Too often, those who make decisions about healthcare offerings fail to fully grasp what their employees truly want and need in health plan options. Understanding the real needs of the workforce as a whole can result in reduced healthcare costs for the entire organization.


Stewardship of Clients' Needs


Forward-thinking benefits brokers have a unique opportunity to become stewards of their clients' needs. By gaining a deeper understanding of their clients' employees' needs, brokers can design plan options that align with the genuine healthcare requirements of the entire workforce.


Learning for More Customers


A crucial realization in this paradigm shift is that employees are not a monolithic group with rigid healthcare preferences. Their wants and needs vary based on demographics, primarily revolving around three main areas of plan selection: choice, cost, and brand.


CHOICE

Fundamental Care acknowledges that available benefits play a pivotal role in plan selection. Not all benefit offerings are created equal, and employees are keenly aware of this. From those seeking comprehensive platinum plans to those looking for basic coverage, a range of choices is essential.


Flexibility is another key aspect of choice. Employees vary in their tolerance for plan restrictions, and offering flexibility can cater to a broader audience.


COST

The cost is a significant factor in healthcare decisions. The richness of benefits and cost-sharing arrangements are crucial considerations. Employees fall along a spectrum, from those seeking the lowest total cost to those prioritizing the abundance of coverage. Most employees find themselves in the middle, carefully balancing their healthcare needs with their budget constraints.


Contributions, in the form of paycheck deductions, are a critical component. Employees differ in their willingness to pay for the plan they want, making it essential to provide options that align with various budget preferences.


BRAND

While some employees may be influenced by well-known brand names, the majority prioritize affordability and usability over brand recognition. However, there are exceptions, and some may prefer specific brands but remain open to alternatives if their needs are met.


Tailoring Solutions to Employee Priorities


Successful brokers, agents, and TPAs must recognize the dynamics at play and understand what clients' employees value most. What are they unwilling to sacrifice, and what trade-offs are they willing to make? Matching options to employees' top priorities enhances the effectiveness of recommendations, ultimately benefiting both employees and employers.


Generational Differences


To gain a deeper understanding of employees' healthcare preferences, consider the impact of generational differences. For instance, Gen X and Baby Boomers often exhibit more traditional perspectives on healthcare plans and benefits. Millennials and Gen Z, on the other hand, are increasingly cost-conscious, making affordability a top priority.


Beyond Generations: Socioeconomic Factors


Apart from generational differences, other factors such as socioeconomic status, household income, and location play a pivotal role in healthcare decisions. These factors can significantly influence employees' expectations and requirements, necessitating a flexible approach to benefit plan design.

The Imperative of Adaptation


Understanding and anticipating these dynamics is invaluable. At any given time, approximately 10% of a client's business is in flux. Brokers, agents, and TPAs who adapt to this changing and diverse landscape will outperform those who do not.


The Fundamental Approach: Empowering Employees with Choices


Fundamental Care's approach goes beyond simply comprehending an employee-centric approach to building benefit plans for healthcare coverage. It's about recognizing that this approach is not a take-it-or-leave-it proposition, nor is it as disruptive as some may fear.


Great brokers, agents, and TPAs position themselves as industry experts with the data, modeling, and decision support necessary to navigate the evolving terrain. This leads to plan options that employees genuinely want, can afford, and will use.


The Value of Choice


The message that employers and decision-makers need to hear is clear: Employees value choices. Some employees want a broad selection of benefits and are willing to pay for it, while others prioritize affordability over flexibility. By offering a range of options, employers can ensure that their employees appreciate the value of their health plan benefits.


Fundamental Care® Programs: Tailored Solutions for Diverse Markets


Fundamental Care® programs by Coterie Advisory Group are Affordability-Based Medical Plans designed to meet the unique needs of various niche markets, including:


- Small businesses and their employees

- Part-time, hourly, and seasonal employees at enterprise-level companies

- Independent contractors

- Gig-economy workers

- Association members


Fundamental Care is designed to serve the underserved by providing access to unique and affordable health insurance benefits on a guaranteed issue basis. These programs include Limited-Day and Limited-Benefit Indemnity plans that can be customized and structured with affordable premiums and no deductibles. Additionally, Coterie Advisors offer Minimum Essential Coverage (MEC) and bronze-level Minimum Value Plan (MVP) options for clients needing solutions for their full-time equivalent employees. The combined offering of Fundamental Care plans is unique in the marketplace, providing both needed healthcare for insured employees and offering companies a strategy to enhance recruiting and reduce turnover by rewarding carve-out classes or more-tenured employees.


Exploring Affordability-Based Medical Insurance Options


Fundamental Care offers two Affordability-Based Medical insurance options that can assist both small and large employers:


1. Level-Funded, Limited-Day Health Plan


Designed for small to midsize employers and carve-out classes of large employers, this plan is a cost-effective alternative to traditional health plans. With costs that are 30-40% lower than HDHPs and no deductibles, it strikes the perfect balance between affordability and comprehensive coverage.


2. Limited-Benefit Indemnity Plan


Tailored for large employers with part-time, hourly, and seasonal employees, as well as associations and affinity groups, this plan provides an affordable option for the uninsured. It offers coverage for basic medical expenses, ensuring that even those without traditional health insurance have access to essential healthcare services. These plans are available with or without Minimum Essential Coverage (MEC) and Minimum Value Plans (MVP) and can be customized to meet specific needs. They provide high-potential coverage, guaranteed issue policies, and upfront, day-one benefits.


Your Partner in Healthcare Strategies: Coterie Advisory Group


Coterie Advisory Group, Inc. is a national insurance program manager and consultative advisor that delivers Affordability-Based Medical Plan Strategies. We assist benefit brokers, consultants, employers, and associations in the benefits industry, empowering them to provide cost-effective and tailored healthcare solutions to their employees and members.


By incorporating these innovative solutions, brokers can enhance their client offerings, ensuring that their employees have access to choices that align with their needs and budgets. The message is clear: Employees deserve healthcare options that cater to their diverse requirements, and Fundamental Care and Coterie Advisory Group are leading the way in making this a reality.


In conclusion, the landscape of employee-centric healthcare is evolving rapidly, and Fundamental Care is at the forefront of this transformation. By focusing on affordability, choice, and employee empowerment, Fundamental Care and its partners are rewriting the rules of healthcare provision, making quality healthcare accessible to all. Embracing this paradigm shift is not just a wise business decision; it's a commitment to the well-being of employees and the overall success of organizations. The future of healthcare is here, and it's fundamentally different.


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