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L & C Insurance Broker Training The Hybrid PlanGeneral OverviewSession 1Bravo Broker Development
Same Rate. Every State.Partially Self-FundedACA Compliant (Part A & B) An ERISA PlanMEC and EverydayCARE meet HSA, EDCH, EDCH PLUSBravo MEC and EDC Meet Penalty A Requirement
Same Rate. Every State.Cost ContainmentFirst Dollar BenefitsLow DeductiblesMajor MedicalLow MOOP
Same Rate. Every State.•bravo MEC•bravo EDC•bravo HSA•bravo HOSP•bravo HOSP +Bravo National Plans
Same Rate. Every State.PHCS Network Practitioner Only (Or add a Doctor) This is the cost containment tool1. Schedule through the App - First Dollar Benefits can be $0.2. Schedule a routine appointment without 48 hours notice. $20 Copay3. Member schedules appointment and does not use the app. $50 Copay
Urna SemperStart with the AppVirtual Care $0 CopayUrgent Care $0 CopayPCP $0 Copay(Primary Care Physician)Same Rate. Every State.Same Day Sick Visits
Same Rate. Every State.2 - 19 employeesAHP (alternative health plan)20 - 200 employeesERISA mutual50 - 2,500 employeesERISA mutualMultiple SolutionsEmployer Covers 100% of EDC Employer Covers 100% of MEC Employer Minimum Contribution 50% Employee Only Minimum Employee participation is 50% of all eligible full-time employees10+ Enrolled in HOSP20+ Enrolled in HOSP
Same Rate. Every State.ChallengeSolutionUnexpected Rate IncreasesAffordable PremiumsUnaffordable DeductiblesConfusing PlansLimited AccessEffective Cost ContainmentLow Deductible PlansNo Deductible PlansAvg < 5% Annual IncreasesEasy to Use and UnderstandHigh UtilizationHigh Retention
Urna SemperSame Rate. Every State.ExclusionsEverydayCARE with Hospitalization Newpath ERISA Mutual 10+ Enrolled Organ Transplant, Dialysis, Skilled Nursing, Advanced Psychiatric Care, Non-Formulary & Specialty Drugs Statesman ERISA Mutual 20+ Enrolled PlansEverydayCARE with Hospitalization Plus Statesman ERISA Mutual 20+ Enrolled Organ Transplant, Advanced Psychiatric Care, Non-Formulary & Specialty Drugs EverydayCARE with Hospitalization Newpath Alternative Health Plan Newpath 2-19 Employees Less than 10 Enrolled in ESC HOSPOrgan Transplant, Dialysis, Skilled Nursing, Advanced Psychiatric Care, Non-Formulary & Specialty Drugs Pre-Existing Conditions Not Covered (12 month look back) iEverydayCARE with Hospitalization The Individual PlansOrgan Transplant, Dialysis, Skilled Nursing, Advanced Psychiatric Care, Non-Formulary & Specialty Drugs Pre-Existing Conditions Not Covered (12 month look back) Formulary - Best Price Option - No Rx Copay Benefit
Same Rate. Every State.1. Always start with the Redirect Health APP2. If the primary care physician wants to schedule tests, a specialist visit, in-patient or out patient procedure. All those will need pre-approval from Redirect Health, just like any other health insurance plan. STOP.STOPREDIRECT HEALTH CARE COORDINATION TEAMREDIRECT THEM TO3. Very simple. Have the person scheduling the procedure contact Redirect Health. The number is on the digital insurance card. Redirect will then start the process of getting a Single Case Agreement with the Facility. Our plan will Steer & Tier. This is another cost containment strategy. For example, in Moberly, MO a knee orthoscopy on average is $17,800. In Columbia, the average price is $3,500. The plan will steer them to a facility in Columbia.
Urna SemperSame Rate. Every State.Quotes & Enrollment1. Submit a quote request to RFP@bravohealthpartners.com2. Contact Larry Thexton to fill out group application. (Employee Census)4. Schedule a Pre-Enrollment meeting with the group and Redirect Health3. If you are using Redirects Employee Navigator Portal, send completed employee census to the assigned CSA. (Client Success Advocate)5. Open a 30 day enrollment window. All plans start on the 1st of the month. Best practices: For a 6/1 start, close the enrollment on the 15th of the previous month. The 30 day window would be 4/15 - 5/15.6. Employees will start the activation process about three business days after open enrollment ends. This will include them downloading the Redirect APP.