ClaimChoice
We believe in better.
When it comes to healthcare plans, better options lead to better choices–and better choices lead to better outcomes. We help brokers and employers choose the plans that strengthen the wellbeing of the whole organization, making people and businesses happier and healthier. Learn more about our company.
What Makes Us Different
Self-Funding with ClaimChoice.
As the traditional, fully insured approach to healthcare coverage grows more expensive and restrictive, employers are unable to enjoy the wide range of benefits available for fear of heavy taxation. That’s why we help brokers and companies navigate the many options that come with self-funded insurance and choose the best combination of savings and benefits.
Agile Solutions
We craft custom plans for companies of every shape and size.
Experienced Partners
We’ve watched the industry change–we know better when we see it.
Proactive Drive
We don’t wait for better. We bring our clients the next best thing first.
Dedicated Support
The right choice only makes a difference with the right people behind it.
Why Self-Funding?
Self-funded insurance plans not only save money, but they offer customization and flexibility that traditional healthcare plans don’t. Our self-funded solutions are not regulated by plan design restrictions–we help employers enjoy more comprehensive and cost-effective solutions than ever before.
Our Solutions
Self-Funding
If you’re looking for an alternative to your current Self-Funded or Fully Insured plan that gives you more control over healthcare spending and risk management, a Self-Funded plan through ClaimChoice is the option you’re looking for.
Level-Funding
If you’re a small to mid-sized employer looking for greater control and cost-savings with added financial safety and predictability, look no further, our Level-Funded plan is right for you.
MEC
Our WorkChoice Benefits MEC plan is the most enhanced Minimum Essential Coverage (MEC) solution offered in the marketplace. WorkChoice provides ACA compliant coverage while delivering best in class virtual access to primary, specialty, mental health, and orthopedic care.
Stop-Loss
We provide access to leading MGUs, direct writers, and captives to help you find the right stop-loss match. Our partnerships ensure pitch-perfect pricing and contracts. Options for transplant carve-out and CGT solutions are also available.
Direct Contracting
Our partnerships with Nomi Health and navces deliver access to high quality, low cost providers and facilities to ensure the best member care. Our advocacy team works directly with members to help them understand their care options and guide them every step of their journey.
Data Analytics
We give you access to detailed reporting to help you understand your claims spending and provide insights into high cost claims, utilization, and trends. Our analytics platform gives you the tools to improve efficiency, optimize plans, reduce costs, and drive innovation.
Pharmacy Benefit Management
We’ve partnered with ChoiceScripts as our preferred pharmacy benefit manager and consultant. Our partnership offers seamless data integration for operations and advanced data analytics. ChoiceScripts provides a holistic approach to plan optimization and pharmacy savings through their in-house team of expert pharmacists and medical claims managers. Exclusive discounts are also available for clients who utilize ChoiceScripts for their pharmacy benefit needs.
PPO & Reference-Based Pricing
Whether you’re looking for access to top PPO networks or the unique cost savings solutions of a Reference-Based Pricing plan, ClaimChoice gives employers and members the flexibility they need.
Our Services
Leave the details to us.
Being tied to a single network can be costly and limiting. We create plans that leverage multiple networks to best support employers. We offer an unmatched access to a variety of networks, from major national PPOs to industry-leading pharmacy service providers, and we help employers identify the right providers based on their geographic and care needs.
- On-Demand Reporting
- On-Demand Rx Reporting
- PCORI Reporting
- Medical Bill Review
- Eligibility Management
- Coordination of Benefits
- Utilization Management
- Case & Care Management
- Out-of-Network Repricing
- PPO Connectivity
- 24/7 Online Portal Access
- Dedicated Customer Service
Our Network
Expand your network.
Being tied to a single network can be costly and limiting. We create plans that leverage multiple networks to best support employers. We offer an unmatched access to a variety of networks, from major national PPOs to industry-leading pharmacy service providers, and we help employers identify the right providers based on their geographic and care needs.
Our Technology
Your time is valuable. Our online tools help you save more of it.
Healthcare information should be accessible anywhere, anytime. Our healthcare portals are designed with the needs of their specific audience in mind, so our clients and partners can find the information they’re looking for as quickly as possible.
