We are a team of seasoned insurance professionals, all with a common goal to help employers regain control of their healthcare cost and eliminate diminishing benefits. We will bring creative and innovative solutions that make sense and allow employers to give richer benefits while controlling/reducing cost. Through Security, Community, and Containment we construct a plan that works for employers. We are not creating a Revolution but rather an evolution for employers to be armed with correct knowledge and tools to create better solutions.
Our goal is to find new ways to help employers/brokers and their employees with their health insurance needs. We have decreased the number of unnecessary add-ons as well as excessive fees to keep pricing as low as possible.
The Total Package
We have the ability to be your one stop compliance shop. Helping you and your clients with their Affordable Care Act administration compliance needs (1094/1095, 5500’s, PCORI).
The current health insurance model is a great model for the large insurance companies. But most of the time it is not the best model for the employer and their employees. Let us show you our creative and innovate approach which puts the employer back in control of their health insurance future.
Our industry partner are some of the most creative and innovative thinkers in the insurance market place and they all have the same common goal. Reduce cost without reducing benefits.
Medical Stop Loss Captives
Employers that participate in a medical stop-loss captive maintain their own self-funded health benefit plan separate from that of the other members. The employer can dictate its own plan rules, including levels of coverage such as copays and deductibles. They obtain factual date in real-time about their overall health of their employees. The participating self-funded employers also can choose their own third-party administrators and provider networks. Complete flexibility, control and transparency which allows this to regain control of their spend.
Our national major medical captive health plan has been running for 14+ years with great success for those employers involved. The program puts the employers back in the driver seat. Allowing employers to regain control of their cost, clear vision of their true cost, supplied current data about employees health which results in eliminating TREND, unnecessary taxes and the larger carriers profit margins.
Daily Usable Benefits
Are benefits for the everyday employee that is cost conscious. These employees are seeking healthcare benefits for the most commonly encounter day-to-day basis illnesses. Some of our benefit plans do not coverage hospitalization, emergency room or major surgery or illnesses. Complies with the Affordable Care Act individual mandate requirement.
These plans include Minimum Essential Coverage benefits, they also meet the Minimum Value and Affordability requirements outlined in the Affordable Care Act. They comply with both employer mandate penalties outlined in the ACA.
Eliminates the need to distribute paper forms, reduces errors, gives real-time updates on the open enrollment progress and increases employee engagement.
Takes a collaborative approach to provider payments, rather than a PPO discount for billed charges. The pre-authorization conversation begins with a transparent Medicare benchmark of actual cost and value, and then adding a significant margin for reasonable provider profit.
Major Medical Pricing Stability
spread risk for large claims across a large group of employers, all of which are financially motivated to promote lower risk. Projected maximum costs, in a worst-case scenario, are only about 15% above what you’d be paying in a fully insured market.
The Captive Cake Layer
All about identifying risk, knowing your exposure and minimizing it. Self-funded Medical Stop Loss employers pay for all small claims up to a cap, captive layer handles all medium claims up to a cap and the reinsurance layer handles all large claims with no caps.