Plans

WHY IT WORKS:

  • 46% OF EMPLOYEES DON’T USE THE INSURANCE PLAN, CREATING “LOST PREMIUM”
  • 48% OF EMPLOYEES ONLY USE THE PLAN FOR AN OCCASIONAL DOCTOR VISIT OR RX
  • LESS THAN 8% OF EMPLOYEES REACH THEIR HEALTH PLAN MAX OUT OF POCKET

HOW IT WORKS:

Step 1:

Replace current high-cost traditional fully insured medical plan with a premium-savings HMO/PPO deductible

  • Save on premiums

Step 2:

Deposit premium savings into a claim spending account with Benefit Advantage, a certified Third Party Administrator (TPA)

  • Savings are deposited tax-free
  • Savings are safe and secure in claims account with TPA

Step 3:

Implement one of Benefit Advantage’s proven and easy-to-use “shared-funded” benefit plans to mirror current employer group plan benefits

  • 72% of Americans spend $500 or less annually ($42/mo) on healthcare
  • Savings used to cover benefit differential if and when claims occur, up to plan limits, then carrier pays 100%
  • Plan members issued Benefit Advantage medical ID card

Step 4:

Benefit Advantage ties everything together with expertise and proven claims processing system that is transparent to employee

  • Benefit Advantage administers and processes employee claims for the employer, with quarterly reporting
High 15/500 Medium 25/1000 Low 35/1500
Deductible $0 $0 $0
Max Out of Pocket (Family x2 $1,500 $2,000 $3,000
Office Visit $15 $25 $35
Lab/Xray $15 $25 $35
CT/MRI/PET $150 $150 $150
Inpatient Hospital - Hospital Services $500a $1,000a $1,500a
Inpatient Hospital - Physician/Prof. Services $0 $0 $0
Outpatient Hospital/Surgery - Hospital Services $150 $250 $350
Outpatient Hospital/Surgery - Physician/Prof. Services $0 $0 $0
Emergency Room $100 $100 $100
Urgent Care $50 $50 $50
Ambulance $100 $100 $100
Prescription Drug $10/$20/$40 $10/$25/$50 $15/$35/$50
Brand Deductible $0 $0 $0
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