FAQ / Glossary

Yes, plans are available in all 50 states.

To enroll in a ClearShare membership, only the primary member must have a Social Security Number. Dependents are not required to have a Social Security Number.

To enroll in a Major Medical plan, all members must have a Social Security Number.

No, you do not need a medical checkup to enroll, but you will be asked specific questions about your medical history on the enrollment form to ensure the membership or plan you are enrolling in will be a good fit for you.

Yes, you can enroll in dental and vision plans without bundling them with medical.

Find more information here:

Dental Plans

Vision Plans

To cancel your plan, contact members@clearwaterhealth.com. A 30 day notice is required to cancel your plan. The plan will be terminated as of the 1st of the month following the 30 day notice.

HSA plans from Clearwater com with a free Clearwater HSA! You can enroll in your Clearwater HSA when you enroll in the plan. With Clearwater’s HSA, you get:

• One card for all your healthcare-related needs
• Integration with Clearwater’s member portal
• Physical & virtual HSA debit cards
• Simplified claims process with online tools
• A platform that supports English and Spanish languages
• Integrated investment tools for accounts over the minimum threshold

Learn more: 

• Clearwater HSA
• Funding your HSA Account

If you already have an HSA plan and don’t want to switch, you can opt-out of the Clearwater HSA at enrollment.

Contact us at members@clearwaterhealth.com

Clearwater Benefits offers ClearShare memberships and Major Medical plans.

ClearShare is a great fit for individuals and families who are looking to lower their monthly costs and out-of-pocket expenses as much as possible. Because ClearShare is not insurance, some administrative work will fall on members and some limitations apply, as outlined in the Member Guidelines. These guidelines keep costs low for the whole community.

Advanced ClearShare Membership:
Enjoy low out-of-pocket costs for common services like doctor visits, prescriptions, and tests. Perfect for families looking to make the most out of their healthcare.

Basic ClearShare Membership:
Low costs for doctor visits and prescriptions, plus no visit limits or maximum payouts.

HSA + ClearShare membership:
Pairs an HSA Minimum Essential Coverage (MEC) plan with a ClearShare membership. This plan is for those interested in having and contributing to a Health Savings Account.

ClearShare memberships:
A healthshare-only plan that helps provide members a safeguard against unexpected medical expenses including accidents or illnesses. It does not provide any day-to-day coverage such as preventive or primary care doctor visits, diagnostics, and drugs.

Major Medical are all-insurance plans, offering lower costs and better benefits than most plans found in the Marketplace. Agents can enjoy a range of deductible options, low copays, lower max out-of-pocket, and affordable premiums. These plans have no limitations, such as pre-existing conditions or age, and have the most robust coverage of all our products. All major medical plans require members to be an active participant in their care by engaging with our care coordination team. 

Major Medical Copay 3500, Major Medical Copay 4500, Major Medical Copay 8000:
These plans are best for those who expect to utilize healthcare services more frequently. Enjoy copays for common services like doctor visits and prescriptions, plus a range of deductible options to control your out-of-pocket costs. If members stay within our Tier 1 Preferred Network they can access $0 care for many services. 

Major Medical HSA 5000:
This plan is for those interested in having and contributing to a Health Savings Account.

Major Medical Minimum Value Plan (MVP):
This plan is best for those who do not expect to go to the doctor frequently and want to have coverage for large unexpected medical costs.

Clearwater Benefits is a healthcare vendor. Clearwater Benefits offers a wide variety of high quality, highly affordable healthcare solutions tailored to meet individuals’ unique needs via traditional insurance plans, healthshare-based solutions, and supplemental insurance offerings.

ClearShare is healthshare; a membership-based community of individuals established for the purpose of sharing eligible healthcare expenses between Members as described in the Member Guidelines. ClearShare is not insurance.

For ClearShare memberships, your effective date is on the first of the next month, or the first of a future month.

Members can only change their ClearShare plan during membership renewal, March 1 through April 30 each year, with changes effective on May 1.

At the age of 18 a child is eligible to enroll in their own individual membership. However, a child can stay on a parents plan until the age of 26. At the age of 26 or when a child gets married, a child must enroll in their own membership. If someone is 65 or older they are not eligible for a ClearShare membership.

Yes, however, conception that occurs prior to membership is not eligible for sharing. ClearShare requires notes from the first provider visit in order to verify the conception date.

The ClearShare Member Guidelines are available here: https://clearsharehealth.org/member-guidelines/

Yes!  Preventive services are shareable with $0 cost to members on our Advanced + ClearShare, Basic + ClearShare, and HSA + ClearShare plans.  To learn about the services covered visit https://www.healthcare.gov/coverage/preventive-care-benefits/.

Needs that arise from conditions that existed prior to membership are only shareable if the condition was regarded as cured and did not require treatment for 12 months prior to the effective date of membership. Any illness or injury for which a person has been examined, taken medication, had a diagnostic test performed or ordered by a physician, or received medical treatment is considered a pre-membership medical condition.

High blood pressure, high cholesterol, diabetes (types 1 and 2), hypothyroidism, and hyperthyroidism will not be considered pre-membership medical conditions as long as the member has not been hospitalized for the condition in the 12 months leading up to the effective date and is able to control it through medication and/or diet, as evidenced by lab results/readings within the normal range.

Cancer, heart disease, stroke, and chronic obstructive pulmonary disease (COPD) are only shareable if the condition was regarded as cured and did not require examination, medication, testing, or any other medical treatment for five (5) years prior to the effective date of membership.

If you think you may have a pre-membership medical condition, we encourage you to schedule a call with one of our Expert Benefit Consultants who can help assist you in recommending the best plan based on your needs. Just because you have a pre-membership condition doesn't mean you can't enroll in the Clearwater plans, but further information will be required to determine whether a plan is a good fit for you. 

If you think you have a pre-membership medical condition, we recommend booking a consultation with one of our Expert Benefit Consultants.

Pre-membership medical conditions have a phase-in period wherein sharing is limited. Starting from the initial enrollment date, members have a one-year waiting period before pre-membership medical conditions are shareable. After the first year, pre-membership medical condition needs are eligible for sharing on a limited basis, with the amount increasing each membership year.

Shareable amount for pre-membership medical conditions:

Year One: $0 (waiting period)
Year Two: $25,000 maximum per need
Year Three: $50,000 maximum per need
Year Four: $125,000 maximum per need
After year four of membership, expenses related to pre-membership medical conditions will remain shareable at a maximum of $125,000 in a 12-month rolling period and resetting each membership year.

Advanced + ClearShare, Basic + ClearShare, and ClearShare memberships are not insurance and do not meet ACA requirements.

The HSA + ClearShare plan includes a Minimum Essential Coverage (MEC) plan and does meet the requirements of the ACA.

If you live in a state with an individual mandate requirement and are interested in a ClearShare membership, we can pair a MEC plan with the membership to help you meet the requirement:

• California
• D.C.
• Massachusetts
• New Jersey
• Rhode Island
• Vermont
  
  

Book a meeting with a consultant to learn more.

To find a list of providers in your area you can go to this website: PHCS Network

When selecting a provider, contact the provider's office to verify that they are still in-network with PHCS and that the provider's billing NPI# is contracted through the PHCS/Multiplan network.

For emergencies, there are no restrictions on providers you can access and you can go anywhere for care. 

Start with Care Coordination when scheduling major procedures. Care Coordination can help you find a high-quality, lower cost provider. If you use the provider we recommend, your care can be $0. Our team can work with your provider before your appointment to help them understand billing and ensure your appointment runs smoothly.

Use of Care Coordination is required for any pre-planned and non-emergent procedures for the following conditions: Cancer, orthopedic surgeries, cardiac procedures, neuro surgeries, dialysis, transplants, specialized wound care, GI procedures, and prosthetics.

For prompt payment, providers should submit medical bills directly to ClearShare using the information on a member’s ID card.

• Payer ID: DCRSS
• Medical bill address: PO Box 3616, Portland, ME 04104
• Fax: 877-405-3639

If a provider cannot or will not submit bills to us directly, members should contact ClearShare prior to scheduling a procedure, or as soon as possible.

A healthshare, also known as medical cost sharing, is a nonprofit program that provides an organized structure for a community of members to contribute toward each other’s medical costs.

You can enroll in a ClearShare membership at any time.

Members can make changes to their ClearShare plan during membership renewal, March 1 through April 30 each year, with changes effective on May 1.

Otherwise, your membership continues until you cancel or if you no longer meet the requirements outlined in the Member Guidelines.

To cancel your membership, contact members@clearwaterhealth.com.  The request must include the reason for cancellation, and the requested month in which the cancellation of the membership is to be effective. ClearShare requires a 30-day notice to cancel a membership. ClearShare does not prorate cancellations or give refunds. Cancellations become effective on the last day of your monthly billing anniversary following the timely receipt of your membership cancellation request.

If you are on an Advanced MEC, Basic MEC, or HSA MEC plan, you must have a Qualifying Life Event (QLE) in order to change or cancel your plan outside of Open Enrollment (November 1-December 31). You have 31 days from the date of your QLE to notify us of the QLE in order to change or cancel your plan. Changes take effect the first of the following month, and cancellations take place at the end of the month.

Yes, to add or remove dependents to or from your existing membership, please email members@clearwaterhealth.com. Add/remove dependents by the end of the month to be effective the first of the following month. Please see the ClearShare member Guidelines for more information about timelines, monthly contribution changes, and Family Annual Max status.

No, a referral is not needed. However, we do recommend making sure your provider is in-network.

If you have a major procedure you are going to schedule, please contact Care Coordination at members@clearwaterhealth.com or 877-405-2926. Care Coordination can help you find a provider and waive your out-of-pocket costs.

For any accident or ER visits, there are no restrictions on providers you can access and you can go anywhere for care. Tell your provider to send bills to us using the information on your member ID card.

Simply reach out to your provider's office and let them know you would like to confirm their in-network status. Inform them that your new insurance is a self-funded plan that utilizes the PHCS Network for Value Driven Health Plans.

For Major Medical plans, open enrollment is November 1 through December 31. Your plan effective date during open enrollment is January 1. For those that enroll outside of open enrollment, your effective date is on the first of the month following a full 60-day waiting period.

You will keep your healthcare plan until the end of the calendar year, regardless of when you enroll. If there is a qualifying life event, you may be eligible to update or cancel your plan before Open Enrollment.

At the age of 18 a child is eligible to enroll in their own individual plan.  However, a child can stay on a parents plan until the age of 26.  At the age of 26, a child must enroll in their own plan. If someone is 65 or older they are eligible, however, Medicare will likely be a cheaper option with a broader network.

Yes.

On the Major Medical HSA 5000 and Major Medical MVP plans, yes. On the Major Medical Copay plans we HIGHLY recommend utilizing care coordination to ensure you are directed to quality providers at a lower cost.

Yes! To learn about the services covered at $0, visit https://www.healthcare.gov/coverage/preventive-care-benefits/.

Yes.

Find a participating practitioner/doctor through the PHCS Network for Value-Driven Health Plans. To find a provider, visit: www.hstconnect.com/PHCS. 

When selecting a provider, contact the provider's office to verify that they are still in-network with PHCS and that the provider's billing NPI# is contracted through the PHCS/Multiplan network.

You can enroll during open enrollment from November 1 through December 31, or if you have a qualifying life event during the year. If you enroll outside of open enrollment, you will be subject to a 60-day waiting period.

You can switch plans during Open Enrollment. To switch before then, you must have a qualifying life event.

To cancel your plan, contact members@clearwaterhealth.com. In order to cancel your plan, you must have a qualifying life event. You have 31 days from the date of your qualifying life event to notify us of the qualifying life event in order to cancel your plan. Your policy will terminate at the end of the month from the date we receive your qualifying life event documentation.

Yes. However, your current providers, treatments and medications may not be covered under the plan. To ensure continuum of care and avoid treatment disruption, schedule a meeting with one of our expert Benefits Consultants before enrolling.

Seek care and show your member ID card. For ER visits we request that you notify us within 48 hours of discharge or when reasonably appropriate. If you visit the ER and it is not an emergency you will be subject to a penalty.

Major Medical Copay 3500, Major Medical Copay 4500, Major Medical Copay 8000 plans provide access to Tier 1 In-Network Preferred Benefits. In order to access these benefits for no out-of-pocket cost, you MUST call our care coordination team BEFORE obtaining services. Our Care Coordination team will find you high-quality, lower cost providers for these services. When you use a provider we recommend, your care is completely free.

Your plan offers out-of-network coverage. Refer to your plan documents to see how much you'll pay depending on the service. This thoughtful approach ensures that your relationships with longstanding healthcare providers remain uninterrupted—offering the benefits of out-of-network services with the convenience of in-network experiences!

Need more reassurance? Clearwater can assist by contacting your provider to inquire about getting contracted. Simply fill out the form by clicking here!

Please keep in mind that response times may vary among providers, and this process can take up to 30 days. Clearwater will keep you updated once they receive information from your provider.

TIP: To expedite the process, consider calling your provider in advance to inform them that they will receive a request regarding your in-network status, and express your desire to continue seeing them.

To determine whether prior authorization is necessary for your specific service, please consult your plan’s Summary of Benefits and Coverage (SBC). For obtaining prior authorization, you may contact Care Coordination at 855-759-0684.

Occasionally, pharmacies may encounter difficulties with the "person code" (the last two digits following the dash) on your member ID. If such an issue arises, we recommend asking your pharmacist to contact the pharmacy benefits provider, EHiM, while you are present. You can reach EHiM at 800-311-3446.

Your employer is offering a self-funded plan managed by Clearwater, which utilizes the PHCS Network for Value Driven Health Plans. This may differ from the insurance models you are accustomed to, however, this tailored approach allows us to introduce innovative, money-saving benefits, including having 100% of your liability waived when accessing care through your Tier 1 benefit, available in the Copay 3500, 4500, and 8000 plans!

As indicated on your ID card within Health Wallet, your pharmacy benefits are managed by EHiM. To check the coverage status of specific medications and any applicable copays, please visit EHiM’s website and access your member portal. Alternatively, you may contact EHiM directly at 800-311-3446 for assistance.

No, Care Coordination works to find and recommend you a fair-priced, high quality provider.

If you want to choose your own provider, you can use your plan’s applicable in-network or out-of-network services.

Yes, Care Coordination must be contacted and a provider must be recommended for each service in order to be eligible for waived out-of-pocket costs.

If you have commonly bundled services such as, but not limited to, maternity or oncology, Care Coordination can coordinate all services in advance. Tell your care coordinator about the services you may need so they can coordinate effectively.

Orders from your doctor are required for Care Coordination to determine the correct imaging/radiology center to recommend you to. 

Care Coordination access depends on the plan you have selected.

On ClearShare plans, you can use Care Coordination to find providers for imaging tests, surgeries, and other major procedures. In addition, Care Coordination can help you find local providers if the primary network doesn’t provide the coverage you need in your area, but these costs would not be waived

On Major Medical Copay 3500, Copay 4500, and Copay 8000 plans, Care Coordination is embedded in the plan as a Tier 1 Preferred Provider. Services like imaging tests, surgeries, and major procedures are eligible, and you can reference your plan documents for a complete list.

On plans with Tier 1, when Care Coordination is able to find a provider in your area that we recommend, your care is completely free. Our team will work diligently to find you a recommended provider, however there are instances where no provider is available. Care Coordination benefits are not guaranteed.

On Major Medical HSA 5000 and MVP plans, Care Coordination can be used for imaging tests, surgeries, and major procedures to pay significantly less out-of-pocket. Costs are not completely waived on these plans.

When you need a service that is eligible for Care Coordination, we recommend contacting us at least 21 days before obtaining services. When you choose to see the provider we recommend, your care can cost significantly less, and on some plans will be completely free.

Our team will work diligently to find you a recommended provider, however there are instances where no provider is available. Care Coordination benefits are not guaranteed.

You can use Care Coordination by contacting our team or submitting the Care Coordination request form online in your member portal.

Care Coordination does not have a doctor lookup. The providers we recommend depend on a variety of factors. 

Yes, we can recommend providers for a second opinion.

Use of Care Coordination for lower cost care is an added benefit and is not required. If you want to choose your own provider, you can use your plan’s applicable in-network or out-of-network services.

Contact Care Coordination to find out what specific documents are required for the service(s) you need. Medical records may be required.

Submit a request online in your member portal, call 877-405-2926, or email members@clearwaterhealth.com

No. We are not able to apply care coordination for services that have already been rendered. You MUST contact us before obtaining service. We can help you with future eligible services you may need.

Holistic plans are available now! You can enroll in a Holistic plan and/or ClearShare membership at any time. Your membership then begins on the first of the next month, or another month of your choosing.

Your effective date is on the first of the next month after enrollment, or the first of a future month.

To cancel your membership, contact members@clearwaterhealth.com.  The request must include the reason for cancellation, and the requested month in which the cancellation of the membership is to be effective. ClearShare requires a 30-day notice to cancel a membership. ClearShare does not prorate cancellations or give refunds. Cancellations become effective on the last day of your monthly billing anniversary following the timely receipt of your membership cancellation request.

If you are on an Advanced, Basic, or HSA MEC plan, you must have a Qualifying Life Event (QLE) in order to change or cancel your plan outside of Open Enrollment (November 1-December 31). You have 31 days from the date of your QLE to notify us of the QLE in order to change or cancel your plan. Changes take effect the first of the following month, and cancellations take place at the end of the month.

At the age of 18 a child is eligible to enroll in their own individual membership. However, a child can stay on a parents plan until the age of 26. At the age of 26 or when a child gets married, a child must enroll in their own membership. If someone is 65 or older they are not eligible for a ClearShare membership; however, they can enroll in a Holistic Essentials plan.

Members can only change their ClearShare plan during membership renewal, March 1 through April 30 each year, with changes effective on May 1.

Any plan bundled with ClearShare includes maternity coverage, including for midwives, home births, and birthing centers.  For more information about maternity, see the Maternity Guidelines.

Holistic Essentials plans without a ClearShare bundle do not include maternity coverage.

Many services on the Holistic Premium plan are part of the PHCS Specific Services network. To find a list of providers, go to the PHCS network website. When selecting a provider, contact the provider's office to verify that they are still in-network with PHCS and that the provider's billing NPI# is contracted through the PHCS/Multiplan network.

Some services on the Holistic Premium plan are not part of any network, and members can go to any properly licensed provider for this type of care. This includes chiropractic, acupuncture, hospital, and ER visits. See the member guidelines for more details.

The Holistic Essentials plan does not utilize traditional networks. To see a covered provider, just make sure they are properly licensed in their field.

Holistic Premium plan:

On the Holistic Premium plan, if you use a service on the PHCS Specific Services network, whether you have seen an in-network or out-of-network provider, you should hand your ID card to the provider and request the follow the instructions to bill ClearShare directly. If they refuse or have issues, please call us at the time of service.

Holistic Premium or Holistic Essentials plans: 

Most holistic providers will only accept cash payments at the time of service. Please tell your provider you are a cash pay patient. Request an itemized superbill that lists  each service or procedure, as well as the cost of each. 

If you expect multiple treatments, ask your provider for a bundled price or package for services. 

Then, you can submit your bill(s) and proof of payment directly to ClearShare at ClearShareHealth.org/holistic-need-request. ClearShare will then reimburse you for your covered services.

ClearShare services:

If you have an ER visit, major procedure, or accident, tell your provider to send bills directly to us using the information on your member ID card. If you have a pre-planned procedure, reach out to Care Coordination in advance for help and to get your costs waived. 

No, the Holistic Premium and Holistic Essentials plans are not insurance and do not meet ACA requirements.

This means our members in California, the District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont risk paying the penalty for ACA compliance. The good news is that if you’re asked to pay the penalty, it can still add up to far less than what you’d pay to be on a traditional plan. Consult with your tax adviser for more information about how this could impact you.

For members who need to meet ACA requirements, we also sell MEC plans and Major Medical insurance plans. Book a call with a benefits consultant to learn more.

Currently, we don’t have preferred providers for our holistic plan, although we hope to create that community in the future. 

If your provider takes insurance, you can attempt to give them your ID card and request that they bill ClearShare. You could also request the bill from the provider and say you’ll be submitting it to ClearShare for payment.

Most holistic providers will only accept cash payments at the time of service, and won’t want to wait on a third party for payment. If this is the case, please tell your provider you are a cash-pay patient, and request an itemized superbill with each service or procedure listed, as well as the cost of each. If you expect multiple treatments, ask your provider for a bundled price or package for services. You can submit your bill(s) and proof of payment directly to ClearShare at ClearShareHealth.org/holistic-need-request.

On both the Holistic Premium and Holistic Essentials plan:

You can be reimbursed for any purchases made on or after your plan’s effective date. To get reimbursed, submit your receipts on the Holistic Need Request form: ClearShareHealth.org/holistic-need-request. 

In order to be shared, Holistic Need Requests must be submitted within 30 days of the date of sale. To expedite your monthly reimbursement for qualifying wellness expenses, submit all your receipts together.

Yes, to add or remove dependents to or from your existing membership, please email members@clearwaterhealth.com. Add/remove dependents by the end of the month to be effective the first of the following month. Please see the ClearShare Member Guidelines for more information about timelines, monthly contribution changes, and Family Annual Max status.

Both people are eligible for the Holistic Essentials plan, but only the person under 65 is eligible to join ClearShare.

The person who is under 65 should enroll in the Holistic Essentials-only plan as the primary member and add the older spouse as the dependent.

Once they are enrolled, the person under 65 should sign up for a ClearShare-only plan just for themself.

The Holistic Premium + ClearShare plan is currently only available as a bundle and to individuals under 65 years old.

The ClearShare Member Guidelines are available here: https://clearsharehealth.org/member-guidelines/

Additional members guidelines are available on that page for Holistic Premium and Holistic Essentials.

The Holistic Premium plan includes $0 preventive care, as defined by the Affordable Care Act. It also includes wellness services, such as acupuncture and chiropractic care for low costs.

The Holistic Essentials plan includes $20 preventive care office visits and $0 preventive care prescriptions.

Yes! You can enroll anytime and they will be added and effective the following month.

No, children don’t need to live at home to be on their parent or legal guardian’s plan. They just need to be under the age of 26.

You may see all licensed medical providers and functional care doctors such as Licensed Naturopathic Doctors (ND), Doctors of Chiropractic (DC) with a DABCI certification, Doctors of Medicine (MD), Doctors of Osteopathic Medicine (DO) specializing in functional medicine.  For chiropractic, you must see a licensed DC.

Holistic Premium: For acupuncture, you must see a licensed LAc.

Members can only change their ClearShare plan during membership renewal, March 1 through April 30 each year, with changes effective on May 1.

ClearShare plans include therapeutic massage if the therapy is related to an eligible need and prescribed by a licensed medical provider. Massage therapy is shareable for 25 sessions per need, up to $3,000. Learn more in the ClearShare Member Guidelines.

On the Holistic Premium plan: If your chiropractor or acupuncture offers massage, it can be included in those visits under the applicable costs and limits.

The Clearwater Elevate Program is a unique opportunity for brokers to earn revenue share and equity awards. Brokers and referral agents attract other producers and hit enrollment milestones to add to their earnings. The program empowers brokers with the tools and resources needed to grow their businesses and benefit from our company’s success.

Brokers and referral partners can apply through our website. Once we review and approve your application, you’ll receive a contract to sign digitally. You’ll also receive an onboarding email with all the necessary tools, resources, and referral links to get started.

As a member of the Clearwater Elevate Program, you can earn competitive commissions, revenue share from enrollments by producers you attract, and equity awards as you or your recruits reach certain production milestones. Additionally, you’ll have access to a variety of resources like social media templates, marketing tools, and business coaching to help grow your business.

Clearwater offers a range of innovative and cost-effective products, including major medical insurance, healthshare plans, and supplemental products. These products reduce out-of-pocket costs, have lower premiums, and offer comprehensive benefits, making them an attractive option for your clients. (Self-funded/Level-funded, Fully-insured MM Plans) 

First, you attract other brokers and referral partners to the program. Then, when those members gain enrollments, you earn a portion of the revenue that the enrollments generate. This system rewards your influence and builds a collaborative community of brokers.

The equity award system allows you to build long-term wealth by earning equity in Clearwater. When you or the producers you sponsor meet specific enrollment milestones, you will be granted equity awards, giving you a stake in the company’s growth.

Clearwater provides access to a comprehensive suite of resources, including social media templates, marketing materials, business coaching, and consulting services. These tools are designed to help you grow your business and succeed as a Clearwater broker.

To maintain active status in the Elevate Program, members must make a good faith request for a group quote for all renewals and new companies they represent, exclusively offer Clearwater healthshare products if they offer healthshare, and meet minimum production standards.

Yes, Clearwater’s products are designed to meet the needs of both individuals and small businesses. By partnering with Clearwater, you can offer your small business clients robust benefits and cost savings that are typically reserved for larger corporations.

To learn more about the Elevate Program, you can visit our website, watch our introductory videos, or contact us directly for more information. We’re here to help you empower your clients and elevate your business.

We can work with groups of any size, but some plans require at least 5 employees.

We have access to Gerber, Companion, Nationwide, Crum & Forster & The North River Insurance Company

We need basic census data, including dependent details: First/Last Name, Age/DOB, State, Zip Code, and Tier: Employees, Dependents, Spouses.

We utilize the PHCS VDHP Network and also contract directly with additional providers.

We typically aim for 50% participation for Group plans, but can still offer benefits even if that requirement isn’t met.

Our carriers include Radion, ExcessRe, Arlo, BRM, Accurisk, TacticalRe, and Breckpoint Insurance.

We generally expect a 50% contribution from owners toward the plans.

We provide savings through competitive premiums, renewal rates, member network cost-savings, care coordination, reduced churn, virtual primary care services, and customized plan designs.

The typical terms range from 12/15 to 12/18 but can vary depending on the case. The group has full control over their preferences.