A Mid-Market Plan Mirroring 60 Fortune 500® firms

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Value-based design:

• No Copays and No Deductibles for Elective Surgery and Primary Care (Tier 1).
• Access cost-saving healthcare solutions reserved for businesses with 7,000 employees.

Growth in Fiduciary Responsibility: In addition to ERISA, new federal laws broaden business owners' fiduciary liabilities to employees regarding healthcare, prescription selection, and cost management.

• Liability insurance does not cover the full cost of a fiduciary violation.  
• One unhappy employee can lead to a class action lawsuit. Want Proof? J&J Class action lawsuit.

Many Problems: Healthcare is too expensive, complicated, stressful and it is not transparent. 

Intermediaries increase cost and complexity, Carriers have too much power.

10 Solutions When Combined Fundamentally Re-Engineer Healthcare

1. Access to purchasing power of 60 Fortune 500® companies. Using Best Practices from Fortune 60  Health Plans to create better Middle-Market performance. Minimum 150 FT employees to qualify. 
2. In advance of non-emergency care, members receive clinical support to identify high-quality/low or reasonable-cost providers. Best practices adopted from jumbo employers
3. Eliminate unnecessary stakeholders (middlemen that add little value).
4. Since you can only manage healthcare if you measure it, we provide detailed healthcare reports on how funds are used and metrics (KPIs) to minimize cost and risk. 
5. Pay hospitals/providers in 30 days instead of 90 days. By paying providers sooner, costs are lowered. In healthcare speak, this is referred to as “Improving Revenue Cycle Management.”
6. Shared Savings – both employer & member participate in cost efficiencies which lower premiums.
7. We make it easier and less stressful by re-engineering self-funded integrated architecture, eliminating inefficiencies, minimizing employer risk, and allowing employer participation in savings. 
8. Further, it reduces costs by limiting risk exposure from optimal captive stop-loss/ aggregated pooling.
9. Ease of employer adoption and implementation.
10. High-performance clinical bundles create better value. 
    • Next-generation infrastructure with a digital front door
    • Best-in-class integration single source of employer