A Common challenge
The reality is most small businesses can't afford traditional benefit plans.
We’re changing that. Discover level-funded health plans developed specifically for businesses with 1-499 employees with no penalty for smaller group sizes. We offer a full array of major medical coverage packaged as cost-effective solutions for clients and employees.
While the 5.3M small business owners in the US would love to be able to offer health benefits to their employees, the simple fact is that they can’t afford the start-up costs or the risk of a self-insured plan nor the premiums and likely annual increases of a traditional insurance plan.
Our core plans are specifically designed for the unique needs of small businesses. We offer the following level-funded plan types.
Deductible 3000Business Growth Plan
Deductible 5000Business Growth Plan
HSA 3000HSA Compatible Plans
HSA 5000HSA Compatible Plans
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Why Detego Health?
An Employer & Employee Friendly Platform
Our experience in all aspects of healthcare provider-based services allows us to design and develop a platform that is both employer and employee-friendly while allowing us to continuously provide you with the analytics necessary to help you make smarter decisions about your business and how to operate it most cost-effectively.
First, it’s important to understand the competitive landscape of health benefits.
At its most basic, the marketplace for health benefits consists of three offerings: But what’s really the difference?
Traditionally, when people talked about insurance, it was “Fully Insured”. The employer or its employee pays a premium to the insurance company in return for paying future “covered” medical claims that are beyond the “out of pocket” maximum (the amount that employees and their families will pay for that service). The totality of risk for the medical claims is borne by the insurance company. As insurance is a for-profit industry, the insurance company must cover its risk and make money. As the cost of medical care increases, so too do the premiums. In fact, according to the latest Kaiser Family Foundation Report, average annual employee contributions to premiums and total premiums for single coverage have risen nearly 22% over the past 5 years.
On the other end of the offering spectrum from traditional insurance are self-insured plans. These health benefits plans are created by and for the employers that fund them. In most instances, an employer will then hire professional actuaries, a plan administrator (a third party administrator) to manage the plan and contract with a reinsurance (or Stop-Loss) carrier to cover claims above a certain cost. This Stop-Loss insurance comes at a premium for the employer. In almost all instances, small businesses (those with less than 499 employees) find it difficult to predict with any accuracy.
Over the past 15 years, a middle ground between “self-funded” plans and “traditional” insurance has emerged. These “level-funded” health plans are a fairly simple type of self-funding that are designed for small businesses. Plan providers (such as Detego Health) establish a Third Party Administrator and get approved by a stop-loss carrier who agrees to cover claims above a certain amount. As these plans don’t need to be rated at a community level (as is the case with traditional insurance), level-funded health plans generally cost less and minimize the risk to employers, but only if the TPA knows how to balance cost-control with excellent healthcare and customer service.
Level-Funded Health Plans are where Detego Health shines!
Why spend more money on a traditional healthcare insurance plan to only lose your top talent to a competitor with better benefits? Detego Health provides a higher quality plan at a lower price. Detego Health is a health care platform that empowers small business owners to control and predict costs, save money and attract and retain the top talent. Let us give you the edge you need to win the talent arms race.
The “secret sauce” to our success (it’s actually no secret) is the composition and management of our partners that allow us to offer the best possible care at the lowest possible price.
As a TPA with our own brokerage, we’re incentivized to contain costs for our direct clients in the same way we are for those clients who come to us through other brokers, consultants, and agents.
Case Study 1
An employee of one company required a hip replacement surgery after years of pain in his joints. Through his primary care doctor, he was referred to a local Texas hospital for his procedure, a surgery that would have cost $50,000, not including rehabilitation. The patient’s co-pay for the procedure would have been $3,000. Through Detego Health, the employer was able to access a nationally regarded specialty hospital that saved the employer $30,000 on the cost of the procedure and waived the co-pay for the patient.
Case Study 2
After a visit to their local primary care physician, an employee diagnosed with plaque psoriasis was given a script for a well-known drug for its treatment. Without any intervention, the employer plan would have been saddled with the cost of the $30,000/year drug. Through Detego Health intervention, we were able to enroll the employee in a patient assistance program that lowered the cost of the drug to the employer by 90% and saved the plan nearly $25,000 in payouts.