Traditionally, when employers provide group health insurance benefits, employees receive little more than an insurance policy which pays certain medical expenses in the event of illness or injury. The so-called "health plan" is really nothing more than a process of treatment, claims, and payments. Medical insurance is not a health plan. Health Options PlusTM is not simply another insurance product, it is a comprehensive and integrated Health Assurance Plan that is designed to do what a health plan should do – keep employees healthy and keep health care costs low for everyone - typically 10-30% lower! Health Options PlusTM is designed to help keep those costs low year after year.
Health Options PlusTM is a whole new way of thinking about self-funded health plans. Based upon proven actuarial and clinical evidence, Health Options PlusTM plan designs are structured to provide comprehensive Affordable Care Act compliant health care services including coverage for all Essential Health Benefits.
As with all self-funded health plans the employer, not an insurance company, bears the risk for paying claims. Stop-Loss insurance is used to limit the employer’s risk so that the maximum amount that an employer could be required to pay is always known in advance.
A Health Options PlusTM plan is the employers own plan, therefore, the amount paid by employers and employees does not include the taxes, fees and high administrative costs that are contained in fully insured plans. The employer’s total costs will typically be 10-30% lower than fully insured plans.
What really sets Health Options PlusTM apart from other self-funded plans is that employees are rewarded for staying healthy and helping keep the employers health care costs low.