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PHMP's Benefits & Savings Plan

Providing benefits so you can overcome healthcare deficits.

SAVING MONEY MAKES A LOT OF CENTS


PHMP is the complete solution. As a limited benefit health insurance plan, PHMP provides FICA savings through beneficial health measures ultimately improving employee health to reduce medical spending and allow you, the employer to enhance benefit offerings at surprisingly low costs to your employees.


With preventative measures meant to offset doctor visits,urgent care, unexpected lab expenses, or a surprise trip to get an X-ray, PHMP is designed to be proactive about healthcare costs everyone inevitably faces. Under the PHMP plan you can see any doctor or specialist you like, with no referral requirement. Whether you choose to receive care from one doctor or collect opinions from multiple physicians, the PHMP plan doesn’t constrain you to one primary care physician. The PHMP plan provides indemnity payments to offset medical expenses you and your family might have.


The most unique and revolutionary aspect of PHMP is that in addition to long-term savings, PHMP also creates immediate savings for both participants and their employers:


By interacting with PHMP healthcare professionals on a monthly basis, many employees realize increases in spendable income of 2-3%.

Employers receive approximately $453/net annual savings in FICA taxes per participating employee.

With these immediate savings, the PHMP helps reduce financial barriers preventing entry into the healthcare system. This is how PHMP is changing the game – by giving more benefits for less.

A Comprehensive Array of Benefits
— brought to you by the Proactive Health Management Plan

Savings Today, Tomorrow, And in the future.

Net Savings

For every participating employee, employers may receive an annual average savings of $330 through reduction in payroll tax liability.

Attract new employees, retain current talent

By offering a competitive and profitable benefits plan, your business can attract better employee candidates and retain current talent, ultimately setting you apart from other employers.

Additional benefits, affordable costs

With online coaches, doctors and health and lifestyle programs, PHMP brings down the costs associated with high healthcare bills while providing the care you and your employees need.

Fewer high-cost medical visits

Our telemedicine program provides a nurse hotline and physician consultation that can decrease physician visits, urgent care visits and trips to the emergency room – all of which can reduce medical costs. With $0 telemedicine co-pay you can receive the care you need now, not tomorrow.

Lifestyle prevention and care

Using our Health Risk Assessment and online health coaches, the Proactive Health Management Plan enhances employee’s lifestyle by adding healthy alternatives and offering instruction to safeguard high-risk employees.

Reduced claim utilization

According to the National Center for Biotechnology Information, as employees see improvements in their health and lifestyles, employers may see a reduction in employee-filed claims. PHMP is here to help you stabilize the costs of your core medical plan offerings.



Predicting risk and risk-reduction

PHMP helps you prepare for the future by analyzing current and potential health risks afflicting your staff. Our program features include dietary assistance and online health coaches to provide alternative lifestyle plans helping you achieve your health goals. DNA and biometric screenings will test for risk factors to inform and suggest future risk-reduction strategies.



Be prepared for the future

Provide preventive medicine while saving money in overall health expenses. Create a healthier work environment while offering employee's tangible options for living a healthier lifestyle. 

Savings employers need today. Healthcare wants now.

With savings that average $450 per employee, per year, your business will be saving hundreds in the future. With PHMP enrolled at your company, not only do you receive the immediate payroll tax reduction but your prospective medical expenses may be slashed as well. Preventative care has been proven to reduce illness, injury and disease which can lower healthcare costs quickly over time.


Monetary incentives aside, encouraging healthier lifestyle choices for employees makes for increased productivity. Every office needs healthy and happy individuals to retain talent and make recruiting a breeze. Enjoying the benefits health pros can provide for you and your employees makes crafting individual health plans and screenings that much easier. By making an investment today, you ensure high rewards in the very near future.

Telemedicine Savings

Our online doctors are available 24/7, whether you have a question on dosage or need immediate assistance. Using the latest in clinical online medicine, patients can access healthcare faster, saving much needed time and creating happier customers. Our doctors can diagnose, treat and often prescribe for an array of medical issues right over the phone from the comfort of your home. Telemedicine is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care. Most states have the flexibility to determine whether to cover telemedicine, what types of telemedicine to cover and where in the state it can be covered. With PHMP there is a $0 co-pay, compare this to the average cost of an ER visit, $1,200.

PHMP Taxes and Legal Information Q & A

Q: Will the PHMP have client specific reporting?


A: PHMP’s comprehensive reporting systems allow employers to understand the utilization, actions, and engagement for each member.


Q: Is the indemnity benefit that the member receives considered taxable income?


A: The PHMP is a fully insured accident and health indemnity policy. A portion of the indemnity benefit may be taxable, as miscellaneous income.


Q: Does the PHMP require voluntary products to be included with the offering?


A: There is no requirement for supplemental, voluntary products to be bundled in the PHMP. However, the PHMP offers a full array of voluntary products that may help reduce underlying major medical out-of-pocket member expenses.

Additional Indemnity Benefits

Indemnity plans exist to allow your employees to be in charge of their health. The PHMP offers a daily in-hospital indemnity benefit which is paid for the days the employee is confined in a hospital for illness or injury. Wellness indemnity benefits include seven programs: telephonic counseling, health and risk assessment tool, telephonic wellness coaching, online health program coaching, telemedicine, biometric screening, and DNA screening. Lastly, PHMP offers health screening benefits including tests like chest x-rays, breast ultrasounds, thermography, stress tests and more.

Daily In-Hospital Indemnity Benefit

Benefit payable per day: $100
Maximum number of days of confinement per covered person per policy year: 5 (up to 31 in certain states).


Health Screening Indemnity Benefit

Benefit payable per day: $50
Maximum number of days payable per covered person per policy year: 5 (up to 31 in certain states).

Facts & Questions

Coverage under the PHMP is available to employees only. Dependents are not eligible to be covered. Benefits provided by the PHMP are hard-coded and cannot be changed or customized. As a fully insured limited medical plan of benefits, PHMP is restricted according to the insurance company state filings and compliance. The limited medical policy incorporated into the PHMP is not approved in every state so please check with your sales representative to confirm availability in your state.

Employers must enter into a supplemental agreement with the exclusive company providing the PHMP premium transfers from the employer.



Billing

There will be no third-party billing or third party servicing permitted for the PHMP other than those originally approved by administrators and originally integrated into our administrative system. A monthly billing cycle will be the only billing cycle accepted for the PHMP. All monthly billing cycles will begin on the first of the month only.


There will be no retroactive premium credits for terminated employees for the PHMP. Since the PHMP insurance policy is a fully insured limited medical indemnity plan, employers must pay as billed, in full and on or before the due date. If premiums are not paid as billed, in full or on time, all coverage will be terminated as of the past paid to date, and notifications will be sent to participating employers, which have the responsibility to notify participating employees of such termination of coverage.


Employers’ payroll systems must be able and willing to interface with the exclusive company providing the PHMP premium transfers from the employer to the program and be able to add the PHMP wellness indemnity payment to a covered employee’s payroll payment.

Additional Insurance

COBRA Health Insurance is not offered or necessary to offer for the PHMP limited medical plan. If you, the employer, chooses to purchase, or make available, additional fully insured supplemental products as a result of the PHMP sale, only approved products will be administered and enrolled by us. If non-approved products are sold, these products will have to be administered outside of PHMP sales.


If you, the employer, choose to purchase MEC and/or MEC Preferred and/or MEC Preferred Plus coverage during the time of the PHMP purchase or any time thereafter, the MEC and/or MEC Preferred and/or MEC Preferred Plus coverage must be with us to purchase or continue the PHMP. If the employer already has a MEC/MEC Preferred/MEC Preferred Plus type product with the competitor, the employer must terminate the MEC/MEC Preferred/MEC Preferred Plus and replace it with our products to purchase or maintain the PHMP. When you purchase PHMP limited medical indemnity plan you will receive a producer guide for proper instruction on requirements for implementing PHMP in your business.


If your business already has telemedicine in its major medical core benefit package, the telemedicine incorporated within the PHMP will not be allowed to be carved out of the PHMP.

Enrollment Numbers and Guidelines

The only enrollment tool permitted to be used for the PHMP will through Proactive Risk Solutions (PRS) electronic enrollment system.The administrators have the sole and complete authority to determine the enrollment system or systems to be used concerning the enrollment of the PHMP.


In order to assure a smooth business onboarding experience, strict compliance to the new business submission process must be maintained. Please refer to the new business submission process rules and schedules in the PHMP Implementation Guide. Given the importance of the payroll process connected to the PHMP, a case cannot be effective if the completed case submission is not received by us within the proper time periods set out in the PHMP Implementation Guide. These time periods must be strictly adhered to.


During the enrollment process, employees will be executing a document which assigns the primary wellness indemnity benefit. This document must be executed by the employee in order to assure the proper flow of the benefit dollars and premium dollars. The hospital daily indemnity benefit and all the other benefits should not be assigned at the time of enrollment.


A minimum of 15 employees must be enrolled and maintained in the PHMP in order for the case to be issued. If a case drops below the minimum of 15 enrolled employees, that case may not be offered a PHMP renewal at its next anniversary. An exception to this minimum is applied to Professional Employment Organizations (PEO) where the employee count will be based on the cumulative number of client employees within the PEO.