PFSI works with all major insurance carriers to provide you with the best option for your business.
We offer self-funded plans, traditional Co-Pay Plans and traditional HSA Plans (also known as Qualified High-Deductible Health Plans), which allow for greater tax savings. All Small Group health plans are guaranteed issue to groups of 2-100 employees with no pre-existing exclusions. This guarantee allows you to shop for the best value without worrying about pre-existing conditions.
HSA Plans (Qualified High-Deductible Health Plans) meet the HSA requirements and allow an insured to contribute before-tax dollars to an HSA bank account (medical IRA). These plans generally provide preventive care before a deductible but all other types of claims go toward a higher-deductible lower-premium plan. Claims are paid by the insured from the HSA account until the deductible is met. Generally, these plans provide 100% benefit after the deductible and they have a MAX OOP from $3,000 individual to $12,000 family.
With Traditional Co-Pay Plans, you generally receive benefits before deductible for office visits, ER, Urgent Care, or prescriptions via small co-pays by the insured. These plans usually have lower deductibles for hospital service. diagnostic or facility charges and co-insurance or patient-sharing after deductible. Generally, these plans have a Maximum Out-of-Pocket (MAX OP) cost from $2,000-$5,000 per person per year.
Self-Funded Plans are typically utilized by groups of 50 or more employees. However, recent changes to the self-funded marketplace, driven by increased plan costs and ACA regulations, provide opportunities for smaller groups of 10 or more employees access to these plans. Although they can be a great product for healthy employee groups, they don’t make sense for just any group. PFSI can help you evaluate your specific group and help you understand the costs, risks, and benefits that may be available to you through self-funded plan options.
Round out your group health coverage by adding affordable dental and vision plans. There are many different carriers and options available--many group health plans offer discount programs or stand-alone coverage. PFSI can help you understand the networks, benefits, and costs with a side-by-side comparison of carriers and plans.
Let us help you find the right group health plan for your business needs.