As fully insured group health plans increase in premium.  Captive health plans are becoming a very attractive option.   In many cases.  If claims are high, the premium for our plan is the same or even a little less than the fully insured plan.  But if claims are normal or low, the company saves money.  Our Program is designed for companies 25 employees and up.

Why our Plan is Better!

  • Only Pay Claims as they Occur
  • Independent Claims Administrators
  • Rx Manager
  • Broad Nationwide Network
  • Detailed Claims Data
  • Flexible Plans
  • In-House Health Coach
  • Wellness Program

How it Works

Layer 1 – Each employee has a limit to how much of their claims can be paid by the employer.  That limit is for each employee’s total claims per year.  There is also an aggregate limit.  That is the most a company can pay in one year.

Layer 2 –  The next layer, claims are paid by all companies in the program proportionately to their total premium.  This allows a medium or small company to have the strength of a very large corporation.  If a severity claim occurs, it won’t send your costs through the roof.  The amount a company can pay toward Layer 2 is also capped.

Layer 3 – Claims that exceed the second layer are paid by reinsurance.  Companies pay a flat rate for reinsurance based on their size.

Penn Freedom vs Standard Carriers

  • Penn Freedom has independent claims administrators.  Their only job is to pay accurate claims and provide detailed claims data.  Standard Carriers own the hospitals and pay themselves.  They don’t pay claims accurately. 

  • Penn Freedom has humans checking each claim over $15,000 for accuracy, double payment, and discounts.  Standard Carriers have computers checking claims over $100,000.

  • Penn Freedom allows you to keep your money in your pocket and passes 100% of discounts on to you.  Standard Carriers that charge a fixed monthly premium, hide discounts and show you inflated claims numbers.

  • Penn Freedom will manage your Rx spend.  Our Rx manager looks at each script and offers generic or lower cost alternatives.  We also exclude unnecessary costly dugs.  All Rx coupons are returned to you.  We also check for government programs that pay for high-cost drugs.  Standard Carriers don’t evaluate scripts and don’t return coupons. 

  • Penn Freedom uses Cigna’s nationwide network.  Most doctors and hospitals are in network.  Standard Carriers fight with each other and have limited networks.

Health & Wellness

Objectives:

  1. Discover all health problems and have Employees doctor for them.
  2. Communicate health issues and topics directly with Employees through Health Coaching.
  3. Provide a path for employees to improve their healthy lifestyle.

Health Testing:

  • Health Risk Assessment
  • Comprehensive Blood Work
  • Executive Physical

Wellness Activity Platform – Sprout At Work:

  • Challenges
  • Rewards
  • Positive Interactions with Co-Workers
  • Easy to Use App