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Types of Self-Funded Plans
The Group Medical Plan and additional health benefits are often included, such as Dental, Vision, Free standing Prescription Drug, and Short-Term Disability (up to 26 weeks).
Minimum Essential Coverage (MEC)
Under the ACA, all individuals must have Minimum Essential Coverage, beginning January 1, 2014. MEC provides 100% coverage for 63 preventive services. The minimum essential coverage will avoid federal tax penalties under the new law.
Level Funded Plans
These are designed to fund a fixed amount of premium, claim funding and administrative expenses every month and only varies by enrollment. These plans typically leverage an Aggregate and/or Specific Stop Loss product to cap financial exposure.
Reference Based Pricing (RBP) Plan
An alternative to PP)’s for Self-Funded employers, they are designed to provide logical, fair, and transparent reimbursements for medical services.
Concierge Self-Funding Health Benefits
Concierge Level Funding Plans provide the flexibility and savings of a self-funded plan while having the stability and coverage of a fully insured plan.
The 3 Components of the Level Funded Plan
Concierge Level Funded Program Design Benefits
Benefit Management Return on Unused Claims/Reserve Funds
Your plan, your way. If claims are lower than expected, you receive
Benefit plans utilizing nationally a return on unused funds after the claim run out
recognized Networks. period.
Medical Management National Networks
A suite of services to help members We provide you with multiple, national Networks
take control of chronic conditions. from which to choose.
Pharmacy Management 100% ACA Compliant
Transparency and advocacy Concierge Level Funded Plans are fully
designed to save costs for the Employer compliant with ACA Requirements and include
and member. mandated coverage to protect you from costly
penalties.
ACA Fees Included
ACA fees are included with your predetermined
monthly payments
24/7 Telehealth
Members can call a doctor any time, at no additional cost.
Built-in COBRA Administration
COBRA administration is included in Concierge Level Funded Plans at no additional cost to you or Employees.