We will assist in customizing your employee benefit plan to meet the unique needs of your group. You deserve more than a one-size-fits-all approach.
More than ever before, many employers are discovering they need to get more creative with their health insurance plans to be able to afford to continue to offer a competitive employee packet.
Our cost management team shows you how to remove the middlemen and unnecessary costs to these services and get the wholesale advantages that big companies get.
Fully insured group medical plans
Level Funded group medical plans
Self-funded group medical plans
Captive medical programs
Health reimbursement accounts, Health Savings Accounts, Flexible Spending Accounts
Group Dental/Vision plans
Group Life Insurance
Group Disability
Telehealth- (voluntary)
Medical Transport Solutions (MASA)
Third Party Administration-(TPA)
Direct contract with your Pharmacy Benefit Manager (PBM)
Pharmacy saving programs
Level Funding: Level Funding products are designed to allow the group to benefit from the advantages of self-funding, while limiting the disadvantages. As the name implies, groups with a Level Funding product will have fixed or level monthly costs associated with the funding of its members’ health coverage.
Partially Self-Funded: The employer assumes the financial risk for providing health care benefits to its employees under a certain cost, once this cost is exceeded the cost is transferred to a third party. In practical terms, partial self-Insured employers pay for claims out-of-pocket as they are presented instead of paying a pre-determined premium to an insurance carrier for a Fully Insured plan.
Reference Based Pricing: Reference based pricing refers to pricing outside of those set by traditional insurance carriers or rented networks. Traditionally, these carriers or networks negotiate discounts from provider-billed charges resulting in a ‘contracted-rate’ or ‘allowed amount’ that the health plan pays the provider. With reference-based pricing, provider reimbursement is based on a percentage of what Medicare would typically pay the provider which often ranges from 120 to 170 percent of Medicare reimbursement.
Direct Primary Care or (DPC): Direct Primary Care (DPC) is an alternative payment model allowing access to a Primary Care Physician with a flat membership fee. Much like a gym membership. No fee-for-service payments. No third-party billing.
Captive: A captive is a health insurance pool formed by companies joining together to reduce the cost of their medical spend. Here are some of the benefits group captives can offer companies:
Medical Transport Solutions (MASA): MASA offers comprehensive coverage since MASA is a PAYER and not a provider when it comes to ground ambulance and air ambulance. They offer US/Canada coverage and Worldwide packages should an unexpected emergency occur.
Lyric Health TeleHealth: Round-the-clock access to our National network of licensed board-certified physicians and behavioral health professionals.
