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Products
OptiLife XP Plans
OptiLife EBS Plans
OptiLife SD Plans
OptiLife HRA Solo Plans
OptiLife ADD-ON Programs
| | OptiLife's plan designs give an employer more choices while emphasizing extra protection, enhanced benefits, and controlled risk. Our products utilize partial self-funding with High Deductible Health Plans, wrap-around benefits with Basic and Saver PPO plans, and fully self-funded plans.
Based on your company's needs, you may choose your funding vehicle of an HRA (Health Reimbursement Arrangement) or a MERP (Medical Expense Reimbursement Plan) with the products listed below.
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| | The OptiLife XP Plan designs allow for simple plan structure to complex, customized benefits.
To keep things simple and maximize cost-containment, the OptiLife XP Standard Plan is based on straight coinsurance benefits. For example, you may choose to provide benefit for 80% of a $2,000 deductible health plan for your employees for a maximum employer benefit of $1,600. You may choose to provide coinsurance benefit of 50% up to 100% of the deductible depending on your employees' needs and your company's goals.
The OptiLife XP Advanced Plan allows an aggregate "plan deductible" built into the benefit structure as well as co-pays. For example, you may choose a $2,000 high deductible health plan and want to fund no more than $1,400 annually but want your employees to be responsible for the first dollar benefit; you can choose a $250 deductible with office visit copays of $20 and remaining benefits at 80% (eg. $2000 - $250 = $1,750 x 80% = $1,400)
The OptiLife XP Custom Plan allows for "per employee plan deductibles," special exclusions, complex rules and other specialized designs. For example, you may choose to have a medical deductible and a separate prescription benefit deductible, you can also choose different coinsurance rates for various benefits. With the Custom XP Plan, annual employer maximum benefits levels are still established to manage employer risk while providing the most coverage options.
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| | The OptiLife EBSPlan is designed as an Enhanced Basic and Saver "wrap-around" benefit plan customized for the employer's needs. Utilizing a primary carrier basic or saver PPO plan, we work with you and your client to fill in the holes in the primary carrier plan for outpatient and limited services. This keeps the plan affordable, while augmenting benefits to meet the needs of the company and their employees.
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| | OptiLife SD Plans are fully Self-Funded Dental Plans with the maximum annual benefit defined so employers control the cost. According to the American Dental Association, the average employee uses approximately $400 annually on dental care and 40% of employees won't even go to the dentist each year. The American Dental Association actively promotes Direct Reimbursement Dental Plans to dental providers. The OptiLife SD Plans are customized for each employer's needs.
· The OptiLife SD Dollar Plan is based on actual dollars spent on dental care, not the type of treatment received. It allows the patient the freedom to choose any dentist. For employers, instead of paying monthly insurance premiums, they pay a percentage of actual treatments received. For example, one option is to reimburse 100% of the first $100 of dental expenses and 80% of the next $500 and 50% of the next $1000 resulting in a total annual maximum benefit of $1,000 per covered individual. There are many options with the employer always knowing the maximum potential cost and the employees obtaining the dental care they need, when and where they choose.
· The OptiLife SD Service Plan is based on the type of dental service obtained. For example, employers may choose to provide 100% for Preventive services, 80% for Basic services and 50% for Major services. The employer still defines a maximum annual benefit, again maintaining control on costs while the employee has freedom of choice of dentists and services. | |
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| | OptiLife HRA Solo Plans offer employer fully self-funded medical, dental and vision HRA administration. Employers on a tight budget who want to provide some level of benefits to their employees but are unable to make the commitment to insurance premiums have found the OptiLife HRA Solo Plan a great alternative to standard health benefits. The employer defines the maximum annual benefit and determines whether the benefit will accrue on a monthly basis or annual basis. This plan provides the option for carry-over benefits of unused benefits to subsequent years.
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| | Add-On Benefits include options for self-funded dental, vision, and Employee Assistance Program (EAP). Add-On benefits are available only in conjunction with OptiLife XP or OptiLife EBS Plans.
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