Overview

We are pleased to introduce WellNet Health Plans, the first medical insurance product tailored to the unique need of small-to- medium businesses (SMBs) defined as 10-500 employees.  WellNet Health Plans combines the money saving opportunities and flexibility of self-funded health insurance, previously only reserved for the largest employers, with the minimal risk and predictability of fully insured health insurance.  WellNet has been innovating benefits for over 15 years lowering costs for employers and improving health outcomes for employees and their families.  WellNet Health Plans is the culmination of this work, integrating the economies of scale from our over 180,000 member lives with our innovative products and services.

How WellNet Health Plans Works

Employers pay the same amount to WellNet Health Plans every month per covered employee and covered family unit .  Less than half of that amount is used to cover stop-loss protection, administrative fees, network access fees, and other fixed plan expenses.  The majority of the contribution is available to pay claims which accrue in a "claims pool".

For example, assume company ABC contributes $20k/month to the claims pool.  When ABC needs to pay a claim, they use the funds in the claim pool.  If ABC does not use all the money contributed, the claims pool builds through the plan year.  If at any point, ABC needs more funds to cover an eligible claim than are currently available, stop-loss insurance covers the excess.

At the end of the plan year,  ABC will have contributed $240k into the claims pool.  If ABC's claims paid are less than $240k, the company is refunded their savings within 90 days (less any stop loss reimbursement throughout the year).  If ABC's claims paid are more than $240k, ABC is not responsible for any additional liability (stop loss coverage picks up the excess).

Advantages of WellNet Health Plans

Wellnet Health Plans offers a variety of plan designs that are comparable to the most popular HMO, PPO, and HDHP plans on the market today.  Furthermore, our Point2Point software permits SMBs' - for the first time - to understand their health expense trends, prevent future large expenditures, and save money through real time access to their medical and Rx claims data .  Our unique predictive modeling tools helps our team of RNs to identify high risk plan members, improve their health, and prevent costly and catastrophic medical outcomes before they happen.  And customer service calls are always answered by a live representative, with dedicated account management teams to each client's account. 

With WellNet Health Plans SMBs can finally measure, manage and save their health expense while limiting liability beyond a predictable monthly expense.