Simple Benefits Package
A Suite of ACA Compliant plans built on a proprietary structure to allow small groups the buying power of a large group.
The ability to join a health plan that empowers small groups of any size the benefits and rates of a larger group and utilize economy of scale to leverage lower rates.
Highlights
- Down to (2) eligible (1) enrolled - 1099s are eligible
- Participation and contribution requirements waived
- 6 Copay plan and 2 HDHP plans
- Cigna PPO or (PHCS with Referenced Based pricing for facilities)
- Benefit Administration System for enrollment, adds/terms, and payroll deduction reports
- Compliance package includes ACA compliance, PCORI, RxDC, and COBRA administration
RBP & Network Plans
Groups have the choice between a Cigna network based (PPO) model or a reference based pricing (RBP) model. Claim cost will be inherently driven down substantially in a RBP model. However, it will require more employee education.
RBP
- Utilizes bottom up pricing with Medicare as a baseline
- Averages between 60-70% off billed charges
- Requires member and provider education
Cigna PPO Network
- Utilizes top down pricing with providers billed charge and network discount as a baseline
- Averages between 20-40% billed charges
