Individualized Health Care Plan
See How It Works ↓Taft Hartley is just one of the health insurance solutions we offer for the employee benefit challenge
Here are the 4 in which we specialize and why 70% of clients who request a quote say yes.
Taft Hartley is a multi-employer health insurance arrangement that pools businesses and sole proprietors together to improve rates through shared risk pooling. The money people pay for their health coverage goes into a trust and is regulated by ERISA laws. This requires that money in the fund only go out for medical claims and administration — not for executive profits. The main advantage of this plan is its premium stability where every business gets the same premium increases whether they are healthy or sick. Many clients report smoother claims administration and an enhanced customer service experience. Some clients have saved over 50% on their health premiums.
PEOs are a total business solution that help assist in 5 areas — payroll, HR, compliance, employee benefits, and (sometimes) workers' compensation — which typically helps them outcompete comparable businesses not in a PEO. Due to their structure, they provide unmatched compliance risk management that cannot be duplicated outside of a PEO. For many businesses, they also provide unbeatable health rates and voluntary Fortune 500 employee benefits options without enrollment and participation requirements. Our recommended PEO partners all have client retention rates between 91.8 to 95% and do not interfere with how ownership wants to run their business. Some clients have saved as much as 52% on their medical through PEOs.
Over the last decade, the popularity of self-funded plans has grown significantly as fully insured rates have skyrocketed. For businesses considered small groups, self funded options allow businesses to be rewarded with lower health-based rates that tend to be lower than fully-insured options. What makes these plans so effective is their customizability. Employers can choose their own TPA, pharmacy benefit manager, specialty med carveouts, direct primary care, etc. This level of customization can slash annual premiums with typical savings of 10 to 30%. 50% of employers with 20+ employees enrolled can expect savings of at least 25%.
For small groups, fully insured options are based simply on zip code and date of birth. As a result of not being able to determine rates in any other way, the carrier has to assume below average health. This tends to make fully insured advantageous for unhealthy groups. For large groups (ie 50+ FTEs), rates are still health-based. That said, unlike self funded plans, claims data tends to be not shared at all or highly delayed. The advantage for large groups is that the network and claims administrator are the same.
Calculate Your Subsidy And Compare To BENEFITRA
| Characteristics | BENEFITRA | Traditional Health Plans |
|---|---|---|
| ACA Compliant Plan | ✔️ | ✔️ |
| No Profits Generated by Denying Claims (ERISA) | ✔️ | ❌ |
| Dedicated Account Manager | ✔️ | ❌ |
| Strong Incentive to Fix Medical Billing Errors | ✔️ | ❌ |
| Free Teledoc and Price Comparison Shopping | ✔️ | ❌ |
| Includes Comprehensive Dental and Vision | ✔️ | ❌ |
| Makes Ancillary Benefits Available (e.g., 401k & LTD) | ✔️ | ❌ |
| No Payroll and Workers’ Comp Requirement | ✔️ | ✔️ |
| Rates Are Not Medically Underwritten | ✔️ | ❌ |
| No Medical Health Questionnaires Required | ✔️ | ❌ |
| Renewal Increases Not Based on Claims History | ✔️ | ❌ |
| Enroll Dependents Without Certificates | ❌ | ❌ |
| Covers Pre-Existing Conditions | ✔️ | ✔️ |
| No Annual or Lifetime Maximums | ✔️ | ✔️ |
| Claim Denials Can’t Become Profits (ERISA) | ✔️ | ❌ |
| Dedicated Claims Representative | ✔️ | ❌ |
| Can Cancel Within 12 Months | ❌ | ✔️ |
| Can Cancel Month-to-Month | ✔️ | ❌ |
| Required to Pay Medical Bills (ACA) | ✔️ | ✔️ |
| Network Size | Blue Cross PPO | Variable |
| Enrollment Minimum and Participation Requirements | 2+w/50% | 1+w/50% |
| Valid Waivers Count | Yes | Yes (Except for NY and VT) |
| Multi-Plan Offering Available | No | Yes |
| Age-Based Rates | No | Yes |
| Typical Relative Price | $$$ | $$$$ |
Like Your Current Plan for Now ? Let’s Check Back When Things Change.
We get it — if you’re one of the lucky ones with a solid plan or a generous subsidy, it might not be time to switch yet. But here’s the thing:
Subsidies can disappear if your income goes up or if the government does not extend the subsidies past 2025
Your current premiums could increase and become worse than BENEFITRA
Some plans may no longer be available next year
That’s why smart people like you have a backup plan ready
Let us remind you when it’s time to compare.
Schedule a Future Consultation to Compare
Proud Physician Organization Vendor
Like Your Current Plan for Now ? Let’s Check Back When Things Change.
We get it — if you’re one of the lucky ones with a solid plan or a generous subsidy, it might not be time to switch yet. But here’s the thing:
Subsidies can disappear if your income goes up or if the government does not extend the subsidies past 2025
Your current premiums could increase and become worse than BENEFITRA
Some plans may no longer be available next year
That’s why smart people like you have a backup plan ready
Let us remind you when it’s time to compare.
Schedule a Future Consultation to Compare
Proud Physician Staffing Organization Vendor
Health, Vision, Dental, Life and Benefits.
Let’s Build an Individualized Health Care Plan That Works for YOU
Protects You More than Standard Health Benefits Plans
Human-Centered Claims Managment
Approximately 80% of medical bills have errors such as wrong codes and duplicate charges. With BENEFITRA, you will have a dedicated representative committed to helping bring your costs down by identifying and eliminating these errors and finding you discounts and savings. Say goodbye to never-ending phone trees, transfers, and having to explain your situation over and over.
Your Premiums Work for You
Unlike traditional plans, BENEFITRA doesn’t profit from claim denials or premium hikes—ERISA laws make it illegal. We only earn from admin and union fees, so our focus stays on your care, not squeezing your wallet.
Cost Transparency & Affordable Renewals
At BENEFITRA, keeping costs low is the goal. That’s why we offer free Teledoc visits and let you compare procedure prices before scheduling. Over the past 5 years, our rates have increased less than 16%, while others jumped 30%+ in just one year. We stay transparent so you can stay protected.
BENEFITRA = Faster, Smarter, Affordable Healthcare
No Delays. Fewer Unnecessary Denials. No Wasted Dollars. Experience Healthcare Built for You
Proactive Claim Protection
Traditional health plans often deny claims to increase profits. BENEFITRA is different. ERISA laws prohibit claim denials from turning into corporate profits. Instead, we partner with Valenz to streamline approvals and protect your access to care.
Fewer Denials, Faster Approvals, Less Stress
- 90%+ claim denials prevented before they even happen.
- Real-time coverage verification for faster approvals.
- Data-driven cost savings to lower out-of-pocket expenses.
Fast-Tracked Savings on Your Medical Bills
Valenz's advanced cost-man- agement technology proactively reduces medical expenses, ensuring you pay less for the same high-quality care. Whether it's a hospital visit or routine checkup, your costs stay lower compared to traditional plans.
Know Your Health & Wellness Benefits
Medical
See Health Plan Outline for More Details
| Deductible: | $1,000 |
|---|---|
| Coinsurance: | 80/20 |
| Out-of-Pocket: | $3,800 |
| Primary Care Co-pay: | $25 |
| Specialist Co-Pay: | $50 |
| Medications: | Generic 10%; Brand 35% (see SBC for more details) |
| Wellness & Teledoc Visits: | No Charge |
Dental
Max benefit: $2,000 per calendar year
New Benefit: Implant coverage (see SBC for details).
Out-of-Network Coverage Available (Click Here to See Claim Example)
| Annual deductible network | Coinsurance network pays | |
|---|---|---|
| Preventative | $0 | 100% |
| Basic | $50 | 80% |
| Major | $50 | 50% |
Vision
| Exams: $10 copay, 1 exam every 12 mo |
|---|
| Glasses: $25 copay for single lenses |
| Frames: Up to $250 every 24 mo |
| Contacts: Up to $250 every 12 mo |
LIFE
10K Death Benefit
Links of Interest
Find a Provider in our BCBS PPO Network
Real Out-of-network Dental Claim
EAP (Employee Assistance Program)
Links of Interest
Find a Provider in our BCBS PPO Network
Real Out-of-network Dental Claim
EAP (Employee Aassistance Program)
H&W, Dental, Vision and Life benefits are Part of a Benefits Package
6 year average renewal of less than 3% – Trust established in 1958 – BCBS network since 2004 – Enrollment available year round.
Scroll right to view the full chart.
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Explore alternative health coverage
| Features | H&W 125 | DENTAL 125 | VISION 125 | ACCIDENT | LIFE 10K | ADMIN 125 | Union | Processing Fee | Total |
|---|---|---|---|---|---|---|---|---|---|
| Individual | $746.00 | $75.00 | $15.00 | $12.00 | $10.00 | $100.00 | $27.00 | $33.00 | $1,018.00 |
| Couple | $1,530.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $33.00 | $1,992.00 |
| Parent + Child(ren) | $1,169.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $33.00 | $1,628.00 |
| Family | $1,669.00 | $220.00 | $45.00 | $12.00 | $10.00 | $200.00 | $27.00 | $33.00 | $2,216.00 |
Our proven workflow
Better Benefits for Independent Contractors and Companies
Freelancers
Freelancers often face high costs for individual health plans. BENEFITRA offers group plans with comprehensive benefits, making it easy and affordable to get quality coverage that suits your flexible lifestyle.
Independent Contractors
Independent workers can struggle to find affordable health benefits. BENEFITRA helps by providing access to group plans with great coverage options, offering peace of mind and financial stability without the need for a traditional employer.
Individuals
Navigating health benefits alone can be tough. BENEFITRA simplifies it with tailored group plans that lower costs and provide reliable coverage, ensuring you have the support you need without
Compare PEOU4YOU vs Traditional Health Plans
Our services provide comprehensive solutions for individuals and independent workers seeking reliable and affordable coverage. By offering group health plans, we ensure access to essential benefits like preventive care, specialist visits, and prescription coverage, along with additional options for dental and vision care. Our services also include life benefits to help you plan for the future and protect your loved ones. With streamlined enrollment and personalized support, we make it easy to find coverage that meets your needs without the high costs often associated with individual plans.
| Characteristics | BENEFITRA | Traditional Health Plans |
|---|---|---|
| Covers the 10 Obamacare/ACA* Essential Health Benefits | ✔️ | ✔️ |
| Covers Pre-Existing Conditions (ACA) | ✔️ | ✔️ |
| No Annual or Lifetime Maximums (ACA) | ✔️ | ✔️ |
| No Specialist Referrals Needed | ✔️ | ❌ if HMO, ✔️ if PPO/EPO |
| Claims Denials cannot Become Profits (ERISA) | ✔️ | ❌ |
| Dedicated Claims Representative | ✔️ | ❌** |
| Free Teledoc and Price Comparison Shopping | ✔️ | ❌** |
| Includes Comprehensive Dental and Vision | ✔️ | ❌** |
| Can Cancel Month-to-Month | ✔️ After 12 Months | ✔️ |
| Network Size | Blue Cross PPO | Variable |
Health
Protect your well-being with flexible and affordable health coverage. Get peace of mind knowing you’re prepared for any situation. Find the best plan for you today!
Life
Customize your benefits with add-on benefits to cover every aspect of your life. From wellness perks to extended coverage, we have you covered. Explore our benefits now!
Dental
Smile confidently with our comprehensive dental benefits. Cover routine check-ups, procedures, and more. Enroll now and keep your dental health in check!
Vision
Take care of your eyes without breaking the bank. Our vision benefit offers extensive coverage for exams, glasses, and contacts. Start saving on vision care today!
Director, Clinic Operations at Cambridge Biotherapies
Sam worked with us to decrease our health costs by nearly 50% without rasing the deductible on employees or limiting the doctor network. These savings enabled us to add additional, valuable benefits. He was always willing to take a call or zoom meeting to explain anything we had questions about. The insurance landscape can be complicated and hard to navigate, but he helped us make great, informed choices.
I got a big health insurance rate increase, and I didn't like the recommendations from my large, nationally recognized employee benefits agency, so I decided to speak with other agencies. None of them could provide the same level of solutions that Sam was able to. Now, we are saving 40% on both medical and overall costs while massively upgrading the health insurance benefits.
Without changing payroll or undergoing medical underwriting, Sam helped reduce my business's health insurance rates by nearly 50%, all while improving the plan's benefits and network. He made the process effortless.
Medical Sinai Healthcare PC, NY
The PEO4You plan lowered my family's cost substantially while improving my coverage. I've been so happy with it that friends, family, and colleagues have since joined the plan as well.
Founder & CEO, Nationals Scope Investigations
We were able to save almost 50% on our medical rates while fulfilling everything we were looking for
Sam was able to take my family and business's situation and pull through where others failed. I am saving significantly while increasing my access to doctors.
Sales Associate at RE/MAX Partners
We are loving the BENEFITRA plan. It is a much smoother experience with claims getting approved quickly. Just a much smoother experience and at a lower price than the alternative. I’m already telling friends and colleagues about it!
Absolutely loving the plan! Better than all other health insurance plans I have had. They have been flexible with my needs and it feels like I am getting a VIP, concierge treatment from customer service. I come from many years working in the health insurance industry. I didn't think my experience could be this good.
Operations Manager at FOUR PAWS
Sam Newland is a valuable asset to our company. Thanks to his expertise and guidance, FOUR PAWS USA has made informed decisions to increase coverage and benefits while reducing costs for both employees and the company. We truly appreciate his efforts to provide our employees with high-quality, affordable plans.
Co, Founders, Tailored Industry
Without changing payroll or going through underwriting, we saved over 50% on our medical plan while upgrading to a PPO, improving benefits, and reducing expected renewal increases. The savings allowed us to add dental and vision coverage and hire a new full-time employee to support our business growth.
Operations Manager, Matthew Cunningham Landscape Design
MCLD has been working with Sam for many years. As we have grown and evolved as a company, they have been providing expert advice for our changing needs to help keep things simple and effiecient for the business and keep our employees happy. If and when anything comes up, we can always be confident that they will be there to help.
Founder, Managing Partner at Seaport Consulting
Sam is an incredible asset to a small business like ours. He was able to balance simplicity with inclusivity and completeness so that we were able to make choices that make our employees happy, and for much less than we expected. In addition to their deep knowledge, they have provided exceptional service by responding quickly and providing thoughtful business solutions.
Manager, People Operations, Brio Systems
Sam is an expert in HR and Benefits. He took our preferences and guidelines to provide design solutions for both savings and growth strategies. He also spent time ensuring we understood every aspect of the healthcare plans we were considering, which can be challenging. With Sam’s help, we offered great benefits to our team, saved money, and grew quickly by attracting and retaining top talent.
What Our Clients Say
Read how Clever has transformed productivity for our users
and hear their success stories.
Sam Newland is a valuable asset to our company. Thanks to his expertise and guidance, FOUR PAWS USA has made informed decisions to increase coverage and benefits while reducing costs for both employees and the company. We truly appreciate his efforts to provide our employees with high-quality, affordable plans.
Chrystin Comeau
Director, Clinic Operations at Cambridge Biotherapies
I got a big health benefits rate increase, and I didn't like the recommendations from my large, nationally recognized employee benefits agency, so I decided to speak with other agencies. None of them could provide the same level of solutions that Sam was able to. Now, we are saving 40% on both medical and overall costs while massively upgrading the health benefits.
Jameson Reeves
Without changing payroll or undergoing medical underwriting, Sam helped reduce my business's health benefits rates by nearly 50%, all while improving the plan's benefits and network. He made the process effortless.
Jack Bazarbachian
The PEO4You plan lowered my family's cost substantially while improving my coverage. I've been so happy with it that friends, family, and colleagues have since joined the plan as well.
Dr. Hoorbod D, DO
Medical Sinai Healthcare PC, NY
We were able to save almost 50% on our medical rates while fulfilling everything we were looking for
Patrick Therrien
Founder & CEO, Nationals Scope Investigations
Sam was able to take my family and business's situation and pull through where others failed. I am saving significantly while increasing my access to doctors.
Dr. Elion Krok, MD
We are loving the BENEFITRA plan. It is a much smoother experience with claims getting approved quickly. Just a much smoother experience and at a lower price than the alternative. I’m already telling friends and colleagues about it!
Krystal Solimine
Sales Associate at RE/MAX Partners
Absolutely loving the plan! Better than all other health benefits plans I have had. They have been flexible with my needs and it feels like I am getting a VIP, concierge treatment from customer service. I come from many years working in the health benefits industry. I didn't think my experience could be this good.
Karen M.
Sam Newland is a valuable asset to our company. Thanks to his expertise and guidance, FOUR PAWS USA has made informed decisions to increase coverage and benefits while reducing costs for both employees and the company. We truly appreciate his efforts to provide our employees with high-quality, affordable plans.
Alexandra Estrada
Without changing payroll or going through underwriting, we saved over 50% on our medical plan while upgrading to a PPO, improving benefits, and reducing expected renewal increases. The savings allowed us to add dental and vision coverage and hire a new full-time employee to support our business growth.
Alexander Kady Tschopp
Co, Founders, Tailored Industry
MCLD has been working with Sam for many years. As we have grown and evolved as a company, they have been providing expert advice for our changing needs to help keep things simple and effiecient for the business and keep our employees happy. If and when anything comes up, we can always be confident that they will be there to help.
Scarlett Bartlett
Operations Manager, Matthew Cunningham Landscape Design
Sam is an incredible asset to a small business like ours. He was able to balance simplicity with inclusivity and completeness so that we were able to make choices that make our employees happy, and for much less than we expected. In addition to their deep knowledge, they have provided exceptional service by responding quickly and providing thoughtful business solutions.
Chelsea Curtis
Founder, Managing Partner at Seaport Consulting
Sam is an expert in HR and Benefits. He took our preferences and guidelines to provide design solutions for both savings and growth strategies. He also spent time ensuring we understood every aspect of the healthcare plans we were considering, which can be challenging. With Sam’s help, we offered great benefits to our team, saved money, and grew quickly by attracting and retaining top talent.
Jacqueline Bellan
Manager, People Operations, Brio Systems
My wife's medical emergency resulted in $300,000 in medical bills and over 90 claims - not one of them was denied and all costs covered by our $3800 per year max. She is still going to PT after 140 visits and we don't need to call and get more approvals. The rehab staff rave about our coverage. Also, I was the first patient in over eight years whose PRP treatments were covered, saving me over $3900. This plan really works.
Vin Cannistraro
Director, Clinic Operations at Cambridge Biotherapies
Sam worked with us to decrease our health costs by nearly 50% without rasing the deductible on employees or limiting the doctor network. These savings enabled us to add additional, valuable benefits. He was always willing to take a call or zoom meeting to explain anything we had questions about. The landscape can be complicated and hard to navigate, but he helped us make great, informed choices.
I got a big health benefits rate increase, and I didn't like the recommendations from my large, nationally recognized employee benefits agency, so I decided to speak with other agencies. None of them could provide the same level of solutions that Sam was able to. Now, we are saving 40% on both medical and overall costs while massively upgrading the health benefits.
Without changing payroll or undergoing medical underwriting, Sam helped reduce my business's health benefits rates by nearly 50%, all while improving the plan's benefits and network. He made the process effortless.
Medical Sinai Healthcare PC, NY
The PEO4You plan lowered my family's cost substantially while improving my coverage. I've been so happy with it that friends, family, and colleagues have since joined the plan as well.
Founder & CEO, Nationals Scope Investigations
We were able to save almost 50% on our medical rates while fulfilling everything we were looking for
Sam was able to take my family and business's situation and pull through where others failed. I am saving significantly while increasing my access to doctors.
Sales Associate at RE/MAX Partners
We are loving the BENEFITRA plan. It is a much smoother experience with claims getting approved quickly. Just a much smoother experience and at a lower price than the alternative. I’m already telling friends and colleagues about it!
Absolutely loving the plan! Better than all other health benefits plans I have had. They have been flexible with my needs and it feels like I am getting a VIP, concierge treatment from customer service. I come from many years working in the health benefits industry. I didn't think my experience could be this good.
Operations Manager at FOUR PAWS
Sam Newland is a valuable asset to our company. Thanks to his expertise and guidance, FOUR PAWS USA has made informed decisions to increase coverage and benefits while reducing costs for both employees and the company. We truly appreciate his efforts to provide our employees with high-quality, affordable plans.
Co, Founders, Tailored Industry
Without changing payroll or going through underwriting, we saved over 50% on our medical plan while upgrading to a PPO, improving benefits, and reducing expected renewal increases. The savings allowed us to add dental and vision coverage and hire a new full-time employee to support our business growth.
Operations Manager, Matthew Cunningham Landscape Design
MCLD has been working with Sam for many years. As we have grown and evolved as a company, they have been providing expert advice for our changing needs to help keep things simple and effiecient for the business and keep our employees happy. If and when anything comes up, we can always be confident that they will be there to help.
Founder, Managing Partner at Seaport Consulting
Sam is an incredible asset to a small business like ours. He was able to balance simplicity with inclusivity and completeness so that we were able to make choices that make our employees happy, and for much less than we expected. In addition to their deep knowledge, they have provided exceptional service by responding quickly and providing thoughtful business solutions.
Manager, People Operations, Brio Systems
Sam is an expert in HR and Benefits. He took our preferences and guidelines to provide design solutions for both savings and growth strategies. He also spent time ensuring we understood every aspect of the healthcare plans we were considering, which can be challenging. With Sam’s help, we offered great benefits to our team, saved money, and grew quickly by attracting and retaining top talent.
My wife's medical emergency resulted in $300,000 in medical bills and over 90 claims - not one of them was denied and all costs covered by our $3800 per year max. She is still going to PT after 140 visits and we don't need to call and get more approvals. The rehab staff rave about our coverage. Also, I was the first patient in over eight years whose PRP treatments were covered, saving me over $3900. This plan really works.
Sam worked with us to decrease our health costs by nearly 50% without rasing the deductible on employees or limiting the doctor network. These savings enabled us to add additional, valuable benefits. He was always willing to take a call or zoom meeting to explain anything we had questions about. The landscape can be complicated and hard to navigate, but he helped us make great, informed choices.
Chrystin Comeau
Director, Clinic Operations at Cambridge Biotherapies
I got a big health benefits rate increase, and I didn't like the recommendations from my large, nationally recognized employee benefits agency, so I decided to speak with other agencies. None of them could provide the same level of solutions that Sam was able to. Now, we are saving 40% on both medical and overall costs while massively upgrading the health benefits.
Jameson Reeves
Without changing payroll or undergoing medical underwriting, Sam helped reduce my business's health benefits rates by nearly 50%, all while improving the plan's benefits and network. He made the process effortless.
Jack Bazarbachian
The PEO4You plan lowered my family's cost substantially while improving my coverage. I've been so happy with it that friends, family, and colleagues have since joined the plan as well.
Dr. Hoorbod D, DO
Medical Sinai Healthcare PC, NY
We were able to save almost 50% on our medical rates while fulfilling everything we were looking for
Patrick Therrien
Founder & CEO, Nationals Scope Investigations
Sam was able to take my family and business's situation and pull through where others failed. I am saving significantly while increasing my access to doctors.
Dr. Elion Krok, MD
We are loving the BENEFITRA plan. It is a much smoother experience with claims getting approved quickly. Just a much smoother experience and at a lower price than the alternative. I’m already telling friends and colleagues about it!
Krystal Solimine
Sales Associate at RE/MAX Partners
Absolutely loving the plan! Better than all other health benefits plans I have had. They have been flexible with my needs and it feels like I am getting a VIP, concierge treatment from customer service. I come from many years working in the health benefits industry. I didn't think my experience could be this good.
Karen M.
Sam Newland is a valuable asset to our company. Thanks to his expertise and guidance, FOUR PAWS USA has made informed decisions to increase coverage and benefits while reducing costs for both employees and the company. We truly appreciate his efforts to provide our employees with high-quality, affordable plans.
Alexandra Estrada
Without changing payroll or going through underwriting, we saved over 50% on our medical plan while upgrading to a PPO, improving benefits, and reducing expected renewal increases. The savings allowed us to add dental and vision coverage and hire a new full-time employee to support our business growth.
Alexander Kady Tschopp
Co, Founders, Tailored Industry
MCLD has been working with Sam for many years. As we have grown and evolved as a company, they have been providing expert advice for our changing needs to help keep things simple and effiecient for the business and keep our employees happy. If and when anything comes up, we can always be confident that they will be there to help.
Scarlett Bartlett
Operations Manager, Matthew Cunningham Landscape Design
Sam is an incredible asset to a small business like ours. He was able to balance simplicity with inclusivity and completeness so that we were able to make choices that make our employees happy, and for much less than we expected. In addition to their deep knowledge, they have provided exceptional service by responding quickly and providing thoughtful business solutions.
Chelsea Curtis
Founder, Managing Partner at Seaport Consulting
Sam is an expert in HR and Benefits. He took our preferences and guidelines to provide design solutions for both savings and growth strategies. He also spent time ensuring we understood every aspect of the healthcare plans we were considering, which can be challenging. With Sam’s help, we offered great benefits to our team, saved money, and grew quickly by attracting and retaining top talent.
Jacqueline Bellan
Manager, People Operations, Brio Systems
My wife's medical emergency resulted in $300,000 in medical bills and over 90 claims - not one of them was denied and all costs covered by our $3800 per year max. She is still going to PT after 140 visits and we don't need to call and get more approvals. The rehab staff rave about our coverage. Also, I was the first patient in over eight years whose PRP treatments were covered, saving me over $3900. This plan really works.
Vin Cannistraro
Frequently Asked Questions
What should I consider when choosing an individual health plan?
When selecting a health plan, consider factors such as cost (premiums, deductibles, and out-of-pocket maximums), coverage options (including preventive care, emergency services, and prescription drugs), and network restrictions. Make sure the plan covers your preferred doctors and healthcare providers.
Can I switch health plans after open enrollment?
When selecting a health plan, consider factors such as cost (premiums, deductibles, and out-of-pocket maximums), coverage options (including preventive care, emergency services, and prescription drugs), and network restrictions. Make sure the plan covers your preferred doctors and healthcare providers.
What are out-of-pocket maximums?
The out-of-pocket maximum is the most you’ll have to pay in a year for covered services. After you reach this amount, the plan covers 100% of the allowed amount for covered services. This includes deductibles, copayments, and coinsurance but not your monthly premium.
Is this ACA/Obamacare compliant?
Yes. This plan covers all of the essential health benefits that are required by the ACA. Below are the differences that might be different from plans in states like MA which have more coverage requirements than the rest of the country:
Does this plan provide the Massachusetts tax document showing that I have health benefits?
Can I only enroll in the health plan?
No. Plan enrollment is all – health, dental, vision, life – or nothing.
Are the rates the same for all ages and family size?
Yes. Whether you have 1 child or 10, you will pay the same family rate. The rates do not change based on age as well.
Does this plan require medical underwriting?
No. This plan is guaranteed issue and does not have pre-existing conditions and exclusions other than the below:
- No Bariatric Surgery
- No Acupuncture
- No GLP1 Drugs for Weightloss (Approved for Diabetes)
Ready to see what's possible?
Talk to an advisor who'll walk you through your options. No pressure, no obligation. Just the numbers and the plan that fits.
Schedule a free consultation →