How It Works for Small Employers
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.
This is particularly evident in the small business market. Rising premiums have made it increasingly difficult to offer healthcare benefits. Even when businesses provide health insurance premium support, a significant portion of the payment still often falls upon employees. This financial burden is worsened by insurance products with high co-pays and deductibles. These factors have led many to drop insurance altogether and move their employees to the insurance exchanges. However, as premium prices in this environment continue to escalate and the viability of the exchanges comes into doubt, few options remain. With the competitive nature of business, this makes it difficult for small businesses to compete for and retain top talent.
We have changed this dynamic. Our innovative approach removes the valueless excess costs that come from the interaction between health insurance and the delivery of most outpatient healthcare services. Doing so frees us to provide an unparalleled level of care at a significantly reduced cost. In our transformed healthcare delivery system, each employee has a personal physician-led medical team working to improve their health, provide care when sickness strikes and help navigate the healthcare system when complex medical issues arise. We have paired our innovative healthcare delivery product with a unique health insurance product offered by our partner, New Era Health. This partnership allows us to deliver low-cost, high quality and impactful care while helping your employees pay for this less costly care and protecting them against those potential worrisome health events. This solution gives small businesses the opportunity to offer a tremendous healthcare benefit at a manageable cost.
What is HIPnation-PrimaryCarePlusSM?
HIPnation-PrimaryCarePlusSM is a healthcare solution built around a membership model – like joining a gym—for all your employee’s primary care needs. This is our foundation. HIPnation-PrimaryCarePlusSM also removes the health insurance interaction and its associated increased costs from much of outpatient 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?
Membership is available for a low monthly fee of $100 per person. Larger families receive discounts described below.
|No. of Family Members||Subscription price|
|1 – 3||$100.00 per month per person|
|4 – 5||Additional $75.00 per month per person|
|6 +||Additional $50.00 per month per person|
It is important to note that membership in HIPnation-PrimaryCarePlusSM is for a minimum of 6-months for each employee. Membership will renew automatically monthly. Please see the Membership Agreement for more information.
Provided by New Era Health
We have partnered with New Era Health to deliver, to HIPnation members who qualify, an indemnity product that matches perfectly with our healthcare delivery solution. With our approach, your employees, as HIPnation members, will contract directly with New Era Health. New Era Health does not tell your employees how to spend their money or run up the costs of their healthcare. New Era provides a product that pays your employees every time they touch the healthcare system. When you visit your doctor, fill a prescription, get lab work, need something bigger like surgery, or are hospitalized, the indemnity plan pays a fixed, pre-determined amount to your employee member to help cover a portion of the bill.
What does the indemnity product provide?
This can vary depending upon the indemnity level purchased.
Our recommended brokers can provide detailed information to you, but one of the most commonly purchased plans, Health Choice Select from New Era, pays individuals:
|Primary care reimbursements from New Era||$125 for annual wellness exams|
$80 for each additional office visit
|Specialty care consultations||$80 per office visit|
|Ambulatory surgery under general anesthesia||variable based upon surgical procedure but never less than $3,000|
|Ancillary service expenses||Lab work – $40|
Prescriptions – $30 brand, $15 generic
Advanced Imaging – $350 MRI, CT, Nuclear
X-rays, Ultrasound – $80
Mammography – $125
Your employees have 100% access to their personal primary care physicians. Great primary care generally addresses 80% or more of a person’s medical needs. When your employees visit their primary care physicians, they submit the visit to New Era Health and receive the pre-determined payment directly from New Era Health. If they do need healthcare services outside of their primary care physician’s office, since our negotiated cash rates are so much lower than those in the current insurance-based system, then the indemnity payment they receive typically covers a much larger percentage of the cost.
Indemnity insurance is underwritten and can require a health screening questionnaire. For groups larger than ten employees, this product is guaranteed issue. Please contact us for more details regarding the cost of the indemnity options. We will put you in touch with licensed brokers for New Era who will explain the products and provide pricing information. New Era products can be tailored to meet your employees’ desired levels of protection and reimbursement.
New Era offers a Critical Illness Insurance Policy and Accident Expense Insurance Policy for those desiring additional protection. These additional policies add more robust indemnity to further protect against catastrophic financial loss resulting from unforeseen events. Again, please contact us for more details regarding the various options, and we will put you in touch with licensed brokers for New Era.
While the insurance system is built upon a one-size-fits-all model, this approach allows individuals to choose their desired level of reimbursement.
No. The indemnity insurance product pays a fixed amount. If an employee stays within the low-cost healthcare community of HIPnation-PrimaryCarePlusSM, then the reimbursement dollars will cover more of the cost of care, but employees are free to see whomever you choose.