How It Works for Employers with 25 or more employees
A Healthcare Community Focused on Your Business and Your Employees
The current health insurance-based system is failing both employers and their employees. Premiums continue to compound yearly while the costs of accessing healthcare rise as well. This negatively impacts the bottom line of businesses and inhibits their employees from receiving valuable healthcare services. Despite the increased annual spending and attempts by employers to use health and wellness programs, care coordinators, telemedicine, and the multitude of other “offerings” to impact their cost curve while improving the health of their workforce, little value has been returned.
We have changed this dynamic. We have realigned the healthcare ecosystem to allow each employee access to personalized primary care. Each employee has a physician-led medical team aligned to improve their health, provide care when sickness strikes, and help navigate the healthcare system when complex medical issues arise. Through our innovative product, we improve the health and wellness of your employees while protecting your bottom line. Our healthcare delivery ecosystem paired with a self-funded insurance plan allows us to provide low-cost, high quality, and impactful care while maintaining our focus on the employer and employee as our customer.
What is HIPnation-PrimaryCarePlusSM?
HIPnation-PrimaryCarePlus is a healthcare solution that removes the burden of insurance from the delivery of routine medical care. This is our foundation. HIPnation-PrimaryCarePlus also removes the health insurance interaction and its associated increased costs from much of outpatient care.
This simple move leads to drastic cost savings and improvement in the quality of care.
What makes the HIPnationSM solution special?
HIPnation–PrimaryCarePlusSM is built upon a simple belief—that healthcare should be between individuals and their doctor. With our innovative approach, your employees will receive personalized primary care with a physician who will partner with your employees to maximize their health and wellness. Great patient care and improved health outcomes happens when a doctor knows a patient well and has time to spend with each patient. This is what we mean when we talk about putting you and individual members at the center of healthcare. Your employees can enjoy a doctor focused exclusively on them and not distracted by the insurance industry. You can provide a concierge doctor for every employee, giving you a competitive advantage.
What services are provided in your Primary Care Doctor’s office?
- History and Physicals
- Prevention and Wellness
- Acute Care Needs
- Minor Office Procedures
- Chronic Disease Management
- A team of wellness coaches, dieticians, and others assisting in the care of your employees
- A community of specialists surrounding personal physicians to answer more specialized medical questions
What does the “Plus” in HIPnation-PrimaryCarePlusSM mean?
To further drive down the cost of healthcare, we have contracted with additional service providers your employees may need at significantly reduced cash rates including:
Imaging, labs, and
Specialty office-based procedures and outpatient ambulatory surgeries
What does HIPnation-PrimaryCarePlusSM cost?
The cost of membership is $100 per person per month, which provides members 24/7 access to a personal HIPnation Primary Care Physician—available by phone, secure message text, or video. This simple concept of removing insurance can then be applied to the rest of outpatient care with similar remarkable results—labs, imaging, medications, specialty consultations, and surgical procedures now become significantly less expensive.
We then take our high quality, low cost, patient-centered healthcare ecosystem and pair it with insurance products to offset the cost of care and protect against those rare, high-cost catastrophic events that worry us all. Since most of healthcare can be managed in primary care and is no longer under the constraints of insurance, the cost of these insurance products decreases significantly as well.
The effect of this approach: reduce your total healthcare costs by as much as 50% while providing members access to concierge-level primary care.
It is important to note that membership in HIPnation-PrimaryCarePlus is for a minimum of 6-months for each employee. Membership will renew automatically monthly. Please see the Membership Agreement for more information.
As an employer, we have been purchasing products like health and wellness programs, telemedicine, and care coordination in addition to health insurance for my employees. Are these still necessary?
In the traditional insurance scheme, physician office resources and time are wasted on interacting with the insurance industry. With our more efficient model, these services are now part of the primary care office. This is where these services provide the best results—being delivered by physicians and their care team members to employees with whom they have a personal relationship.
We have transformed the healthcare ecosystem around your business. Our model is about giving your employees unmatched access to personalized healthcare while reducing the overall cost of that care.
An Insurance Solution Provided by Our Partner:
Excess Reinsurance’s Controlled Aggregate Protection (CAP)
Founded in 1989, Excess Reinsurance is one of the pioneers of the self-funded medical benefits industry. As one of the nation’s longest-standing managing general underwriters, Excess Reinsurance is one of the most reliable and respected players in the stop loss marketplace.
CAP is Excess Reinsurance’s exclusive aggregate only stop loss insurance product. CAP simplifies the self-funding process by covering all eligible medical claims under a single aggregate attachment point. There is no need for separate specific stop loss coverage. CAP is designed for groups that are currently fully insured or self-funded with 25-250 participating employees.
With the Controlled Aggregate Protection solution:
- Claims account is funded each month based on an aggregate attachment point
- Attachment point is lower than traditional aggregate attachment points
- Monthly aggregate accommodation stabilizes cash flow
- Monthly aggregate accommodation protects plan from claims volatility
- Other features, such as unlimited annual maximums and built-in terminal liability, further insulate the self-funded plan
- Best of all, the employer, not the insurance company, retains any funds that remain in the claim’s account at the end of the policy year
Both fully-insured groups and CAP groups pay a fixed cost each month and generally nothing more. However, because CAP groups are self-funded, they enjoy many advantages over groups that are fully insured such as:
- Retention of year-end claims account balance
- Lower administrative cost structure
- Improved services of top-tier TPAs
- Full access to plan’s claims experience
- Customization of benefits, eligibility, and contributions
- Federal ERISA preemption of state mandates