Affordable health insurance is here

You know your clients, we know Decent. Let’s get to know each other.

What is Decent?

Decent is administering ACA compliant association health plans for self-employed individuals. Our individual plans cover 1099 contractors, freelancers, business owners, and many more. We’ve launched in Austin and are expanding quickly throughout Texas.

 

Our goal is to offer your clients better plans with lower premiums.

Here are some things you’ll like about us:

Free primary care:

All of our plans are built around Direct Primary Care, so your clients get unlimited access to same or next day half-hour appointments, 24/7 telemedicine with their doctors, and any procedure performed by a primary care physician—all for $0 out of pocket payment.

What you’ll love about us: 

A path forward for companies looking to contribute towards their 1099s' premiums

Year round open enrollment

We offer year-round open enrollment so your clients can switch at any time. There’s just a brief waiting period of first of the month following 30 days.

Through our Defined Contribution, companies can make ongoing payments towards policies owned by their 1099 contractors without disrupting what they’re currently doing for their W2s. The best part? No required contribution amount or participation threshold.

Tax deductible premiums

Health insurance for self-employed individuals is tax deductible. We’ll help your clients' money go further.

Lonestar Plan

The lowest monthly premium on any ACA-compliant $0 medical deductible Bronze plan. By a lot.

Trailblazer Plan

Our ACA-compliant Silver level plan covers 10% more annual medical expenses than the standard silver plan, while being priced at 20% below market rate.

Pathfinder Plan 

Our ACA-compliant Bronze level plan has the lowest monthly premiums of any Bronze level plan offered anywhere in our service area, while still including all the benefits of direct primary care.

Broker FAQs

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How can I become a broker for Decent plans?

To become a broker with Decent please fill out the form found at the bottom of this page. We’ll reach out to you with our broker agreement!

 

Can I sell Decent plans all year long?

Yes, we offer year-round enrollment. We offer year round enrollment with a one month waiting period before the effective date (which will always be on the first of the month).

 

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Who are Decent plans for?

Decent plans are designed specifically for self-employed business owners, freelancers, and independent contractors (1099s) living in and around Austin, TX.  Enrollees must attest to two things: that they work at least 20 hours a week and that they make at least enough from their self-employment to pay for their monthly premiums.

 

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Does Decent sell plans to small businesses?

We can offer coverage to small businesses with 1099 contractors.

 

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How does Decent track and pay commissions

for health brokers?

That’s such a good question we made a whole handout for it. Please check out Decent’s guide to broker commissions to see how your commissions will be tracked and paid.

 

A:

Q:

How do I calculate a quote for a shopper?

You can either use our one-page pricing grid for each individual plan (Trailblazer, Lonestar, and Pathfinder), or pull them a quote yourself at app.decent.com/quote.

 

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Do Decent plans offer coverage outside of Austin?


Most of Decent’s network is in Austin.  If you received a referral to go out of network, then it will be considered a covered service and would apply to your deductible and out-of-pocket limit.  Referrals are always required, so you want to make sure you speak with your primary care provider before going to see a specialist, whether inside or outside of Austin, to ensure you get the best price for service.

 

Out of network care received without a referral may be covered in some cases after deductible has been met.  There is no out-of-pocket limit for out of network services. 

 

Urgent and Emergent care out of area will be covered in network. For example, if you were on vacation in Florida and were stung by a jellyfish scuba diving and had to go to urgent care - we have you covered.

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If I buy a virtual DPC plan from Decent, what happens if I want to see an in-person primary care doctor?

The process is similar to seeing a specialist.  Members should seek a referral from their virtual Primary Care Provider to see an in-person primary care doctor.  Copay or Coinsurance costs for seeing the in-person primary care doctor would apply.

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What drugs, at what rates, are in Decent’s formulary?

Decent’s Formulary can be found here

 

Coverage is at the following rates for the following tiers:

  • Pathfinder and Virtual Pathfinder Plans

    • Preventive Drugs: $15 Copay

    • Tier 1 : 0% after deductible

    • Tier 2 : 0% after deductible

    • Tier 3 : 0% after deductible

    • Specialty Drugs: 0% after deductible
       

  • Lonestar and Virtual Lonestar Plans:

    • Tier 1 : $5 Copay

    • Tier 2 : $25 Copay 

    • Tier 3 : $200 Copay

    • Specialty Drugs: 50% after deductible
       

  • Trailblazer and Virtual Trailblazer Plans

    • Tier 1 : $15 Copay

    • Tier 2 : $35 Copay 

    • Tier 3 : $100 Copay

    • Specialty Drugs: $150 Copay

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A:

Is there a coverage cap on Decent’s plans?

No, there is not a lifetime cap on any of Decent’s plans.

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How soon does coverage start after a Decent plan is purchased?

Coverage begins on the 1st of the month at least 31 days after the date of enrollment.  For example, if you sign up on January 15th, 2020, coverage would begin March 1st, 2020. 

Enrolling during the annual Open Enrollment period (November 1st through December 15th) will result in coverage beginning January 1st.

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If you’re on a virtual plan and you have your Preventive Medicine visit - does it have to be with your selected DPC?

If you are on a virtual plan, you should have your preventive medicine visit virtually.  Almost all of the things providers evaluate during a preventive or a wellness check have to do with checking things like your blood pressure, cholesterol, etc. and most of these do not need to be done by seeing a doctor in person. 

If you are a woman and would like to have your well-woman exam performed by your OB/GYN, you may do so.  We encourage you to connect your provider to your DPC, so that they may discuss your clinical results. This way your DPC can continue to work with you to quarterback your care.

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If two family members are on different plans, does money spent by one apply to the other’s family deductible?

No.

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What are Decent’s expansion plans?

Decent plans to expand to Houston and San Antonio in 2020, with  Dallas / Ft. Worth and the rest of Texas being served by the end of 2021.

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How is emergency care defined?

If a member goes to an emergency room for services the patient deems an emergency, Decent will apply the health plan ER copay or coinsurance as prescribed by the member's plan.

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How can new doctors get added to the network?

New providers and clinics wishing to join Decent’s network should fill out and submit this Authorization Request Form to support@decent.com To help speed up future payment, include an EFT Authorization Form with your request.

As a member, if your specialist is not covered and you see them, the service would be covered under out-of-network benefits (less coverage). However, we are happy to reach out to add them to our provider network!  Feel free to share your doctors information with us (
support@decent.com), and we will have our contracting team reach out to them.

 

How to get appointed with Decent

Easy - simply complete the following form and we'll be reaching out with additional resources to get you started.

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Call us at: (512) 643-4173

We are open 9am - 5pm CST, Monday - Friday

1145 W 5th Street, Austin TX 78703

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