Solutions

EXEMPLAR’S ROYALTY SERIES

The Exemplar Royalty Series gives many employers a dynamic solution to the rising costs and limitations of today’s health insurance market.  We are excited to offer affordable and comprehensive coverage for small employers down to as little as 5 lives and large employers with 100’s of lives.

With twelve different Metallic Health Plan offerings, we have a wide variety of options for groups of all sizes and needs:

• Available for employer groups domiciled in 47 states
• Reinsurance provided by one of the top Reinsurers in the world, AM Best “A” Excellent
• Available to groups as small as 5 enrollees
• Level Funded Program
• Consistently the most competitive rates in the industry
• Traditional PPO networks
• Reference Based Pricing options without all the “hassle”
• Quick Turn Around Times
• 0%, 50%, 100% of the remaining claim fund returned to the employer after contract period
• No Employer contribution requirement
• No Group participation requirements
• ACA Compliant Plans

Group Guidelines

– Minimum Group Size: 5
– Participation: No Participation Requirements
– Cobra Participation: No more than 10%
– Retirees: Not Covered
– Employees outside US: Not Covered
– 1099 Employees: Not Covered
– States that are ineligible: New York, Hawaii & Washington

We have two standard network options. One option is a traditional PPO offering through the First Health Network and our second option is using the PHCS practitioner network and a Reference Based Pricing Model for facilities. The way EHBA and Hi-Card approach the RBP model has revolutionized RBP and the way healthcare is utilized and paid for. We have all but eliminated the traditional challenges with RBP.