Levels: 60, 70, 80, 90

These numbers indicate the actuarial value of the plan. The higher the numbers, the richer the plan is. We've built our 60 plans to correspond to the estimated value of a standard bronze plan, the 70 roughly equals a silver plan, ect.

Zero

• "Zero" refers to a $0 Medical deductible.
• These plans have a separate deductible for Specialty Pharmacy (Tier 4 & 5) prescriptions.
• Specialty Pharmacy (Tier 4 & 5) drugs account for 1.9% of all prescriptions, and are used by about 2% of the US population.
• Tier 1 (Generic), Tier 2 (Preferred) and Tier 3 (Brand Name) drugs do NOT count towards the Specialty Pharmacy Deductible.
• You can find a complete listing of Tier 1, Tier 2 and Tier 3 drugs in our formulary.

Remote

• "Remote" plans feature Virtual Direct Primary Care.
• Instead of travelling to an office, with Virtual Direct Primary care a mobile app allows you to securely connect to your personal Primary Care Doctor.
• Virtual Direct Primary Care enables the treatment and diagnosis of over 1,500 conditions, as well as writing prescriptions and creating referrals.
• If members are on a Remote plan and their Virtual Direct Primary Care doctor thinks they need to see a primary care doctor in person, they'll need to pay the specialty copay on their plan.
• Plans without the "Remote" designation feature in-person Direct Primary Care, where your personal Primary Care Doctor has a physical office you can visit.
• ALL PLANS feature $0, unlimited access to your personal Primary Care Doctor.

Saver

• "Saver" plans can be used with a Health Savings Account (HSA), and are considered High Deductible Health Plans (HDHP).
• HSAs allow you to save pre-tax dollars to use towards qualifying medical expenses, can earn interest over time, and do not expire at the end of the year.

Direct Primary Care & Virtual Direct Primary Care doctors can address many medical questions and issues remotely, even when you're travelling out of state. Wherever members are, if they need Urgent or Emergent care, they should go get it - it's covered.

Consider what you have now:

Employees who currently have Gold-level plans may expect something similar.

Consider which 2-3 plans to offer as a set:

Consider a set of plans that have a range of benefits so that each employee can find something that fits their specific health needs.

40% of eligible employees must enroll.

Generally, the more an Employer contributes to premiums, the more likely the company will reach the participation minimum (40%).

Employee premiums:Employers must contribute between 50% and 100% to Employee-only premiums.

Dependent premiums:While Employers are not required to contribute to dependent premiums, greater contributions generally result in a higher participation rate (and higher satisfaction) by Employees.

All Decent plans include a subscription to a members only Direct Primary Care or Virtual Direct Primary Care Clinic. Members get the same doctor for every visit, so they can build a trusting relationship with their doctor. Direct Primary Care (DPC) is about focusing time and care on the patient instead of the traditional fee-for-service revenue model. This allows the DPC to spend more time with their patients and conduct comprehensive care management, while reducing the overhead and negative incentives associated with fee-for-service third-party-payer billing. As a Decent member, that translates to more savings and more access to their physician than the traditional primary care physician (PCP) model.

Age-Banded rates are simple and predictable. Blended/Composite rates are more common for companies with 5 or more employees.

Age-Banded rates:These pre-established rates are based on age and location. Employee premiums are looked up by age, the age of their dependents, and where they live.

Blended/Composite rates:Blended/Composite rates include four rate tiers: Employee Only, Employee and Spouse, Employee and Children, and Employee and Family. These rates are calculated using the total of the Age-Banded rates for the company's employees and dependents.