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Self-Funded Medical Plans with ClaimChoice allow employers to create plans that meet the specific needs of their organization. It allows more control over healthcare spending and eliminates the need to pre-pay for coverage. ClaimChoice will help your organization manage this risk more efficiently than fully insured carriers, resulting in the most positive financial impact to your organizations bottom line.

Also referred to as Partially Funded Plans, these solutions combine all the cost-saving and flexible benefits of Self-Funding, with added financial safety and predictability due to fixed administrative costs and stop loss deductibles. It’s an ideal solution for small businesses looking for greater control of their healthcare spend from that of fully
insured plans.

Also referred to as Partially Funded Plans, a health reimbursement arrangement (HRA) is an employer-funded account that is designed to reimburse employees for qualified medical expenses that are paid for out-of-pocket. There are no annual contribution limits on HRAs. However, an employer usually sets the contribution below the annual deductible. ClaimChoice’s HRA administration is seamlessly coordinated with high deductible health plans (HDHPs) to curtail the cost of premiums, while encouraging employees to spend wisely.

A Captive Solution Program is wholly owned and controlled by its insureds–it provides smaller employers with the advantages often given to larger employers. They reduce volatility while improving cost efficiency. It’s ideal for businesses that may have previously felt too small to self-fund.

Reference Based Pricing (RBP) is a cost-containment strategy with a fixed limit that reduces employer healthcare costs and out-of-pocket expenses for employees. The approach typically has no in-and out-of-network payments, making it ideal when members need more flexibility when it comes to care.

Minimum Essential Coverage (MEC) Plans and Medical Value Plans (MVP) meet the coverage and individual responsibility requirement for employers under the Affordable Care Act. They cover preventative care and routine illness without a deductible and are a good fit for hourly employees.

ChoiceCareworks directly with the member engaging with them to offer options for their healthcare needs. Offering the highest quality of care for cost far below what the PPO networks and carrier networks offer for “discounts”.Incentivizing the member through reduced or waived cost sharing for these procedures.

Self-Funded Prescription Plans with our Pharmacy Benefit Management (PBM) partner ChoiceScripts allow employers the same flexibility they enjoy by self-funding their medical plan(s). to create plans that meet the specific needs of their organization. It allows more control over healthcare spending and eliminates the need to pre-pay for coverage. ClaimChoice will help your organization manage this riskmore efficiently than fully insured carriers, resulting in the most positive financial impact to your organizations bottom line.

Combining these solutions has helped reduce our self-funded client’s health insurance cost up to 25%, while maintaining the highest level of benefits for their employees. Cost shifting is not the solution to reducing healthcare cost, cost management is.