Team up with Decent

You know your clients, we know Decent.

Let’s get to know each other.

First things first: What is Decent?

Decent is the exclusive third party administrator for a trust with structured multiple employer welfare arrangements under it. Decent has worked exhaustively with it’s partner trust to enable access to benefits previously reserved for large companies, to smaller institutions using this brand new structure.

Due to our plans being built around Direct Primary Care, fully insured-esque benefits at closer to self insured pricing, and a curated (narrow) network - we’re able to offer great coverage at a substantial discount for those who qualify.

Introducing Decent for small business

Starting in October 2020, Decent will begin offering plans for small businesses - same great pricing, same great service, now finally for the meat of your book.

For qualifying companies, Decent will have a full suite of ACA compliant plan options priced at 40% below market rate (complete with our trademark DPC centerpiece). We can’t wait to tell you more.

Zero Plans

$0 medical deductibles with some of the lowest premiums of any ACA compliant plans in Texas

Saver plans

The lowest premiums on any ACA compliant, HSA compatible plans in Texas.

What you’ll love about us:

Direct primary care at the center of major medical plans

Imagine pitching your clients on concierge primary care options at no additional cost.

Austin based customer support team

Our customer support team is the best in the business (we’re biased but still…) and it’s right in your backyard.

HSA compatible and $0 medical deductible options

Our plan designs are as unique as they are needed in the market today. Don’t believe us? Try showing them to any of your clients and see what they say.

Where you can sign up for Decent

Starting October 1st, 2020, everyone in the great state of Texas can enroll in a Decent plan if they qualify.

Useful documents

Quick Formulary

Service area

Trailblazer (Silver) pricing and plan summary

Trailblazer (Silver) SBC

Trailblazer (Silver) plan full plan details

Pathfinder (Bronze) pricing and plan summary

Pathfinder (Bronze) SBC

Pathfinder (Bronze) full plan details

Lonestar (Bronze) pricing and plan summary

Lonestar (Bronze) SBC

Lonestar (Bronze) full plan details

Provider directory

Broker FAQs

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!

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.

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).

We can offer coverage to small businesses with 1099 contractors.

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.

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.

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.

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.

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

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

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.

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.

No.

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.

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.

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.