Purpose
A comprehensive employer sponsored medical plan removing most financial barriers to health care at unit costs significantly lower that traditional health care plans.
Benefits
No member financial responsibility if Plan rules are followed. Members who do not follow the rules are subject to $3,000 front end Plan year deductible, 50% co-insurance up to the maximum allowable under the Affordable Care Act (ACA).
Structure
DPC, Cash Pay Centric, Reference Based Pricing wrap, Specific Stop Loss (in-patient charges only), Specialty Drug risk transfer, Self-funded, Excess Cover, Catastrophic condition risk transfer.
Cost
Fixed Cost no more than $200 pepm, Claim Cost no more than $500 pepm
Maximum Cost = # employees X $700 = __________Monthly Cost
Minimum Cost = # employees X $200 = __________ Monthly Cost
Expected Cost = # employees X $375 = __________ Monthly Cost
