CapCare was founded on the premise of providing a single-source, turn-key employee healthcare solution to businesses seeking innovative alternative risk management solutions for their employee healthcare programs that are affordable and more transparent.
The CapCare team understands the many complexities with the healthcare marketplace, and can expertly guide business owners in understanding the alternatives to fully-insured medical programs.
CapCare specializes in the designing, implementing, and servicing of healthcare benefit solutions, on a “white-label” basis, to businesses and organizations seeking alternatives to the traditional health insurance marketplace with a focus on creating a friendly employee/member experience by reducing the friction between patient and healthcare provider – all at a lower cost with access to data-driven analytics.
Health insurance challenges
- Excessive premiums
- High deductibles and out-of-pocket costs
- Uncontrolled inflation with no solution
- Confusing benefit design & process for employer and employee
- Lack of options for small groups
- Pricing disparity between large and small groups
The high cost of our multi-payer system is at the heart of our unsustainable healthcare costs – costs that can be predicted to lead to even more dramatic changes in the years ahead
CapCare large group strategy
A comprehensive health-benefit program for groups as low as one
The primary advantage of offering health insurance through large groups, such as associations and PEO’s, is the ability for a large group to aggregate multiple employers so that the resulting health plan: (a) operates under large group health plan rules – which can save money on administrative and overhead costs as compared to small groups; (b) leverage its scale for more favorable rates when negotiating with; (i) insurers, (ii) health providers, and (iii) other vendors assisting with the provision of health benefits; (c) uses its flexibility to explore health plan designs that may reduce costs further through an exemption from premium taxation and state-specific benefit mandates; and (d) explores whether a fiduciary PBM manager could save money on prescription drug expenses.
The CapCare solution
- Coverage cannot be denied
- Groups as low as one, including 1099 contractors
- Large group rates nationwide
- Deductible options range from $0 to $10,000
- Concierge customer service
- Custom built advanced technological platform for enrollment, provider lookup, and much more
- Fully branded ‘white-label’ offering
- Ability to add specialized networks (i.e. vision, dental, imaging, etc.)
- Supplemental benefits – can be coordinated through technology portal
- Opportunity for customer to add new source of revenue
Reversing the healthcare trend
|National network||Yes||Yes, BCBS BlueCard|
|Concierge customer service||Add-on only||Included|
|Plan designs||Fully-funded & insured||Fully-funded & insured|
|Medical underwriting||Almost always||No, individuals enrolling cannot be denied coverage|
|Large group rates||Only for large groups||Always, even for groups as low as one|
|Age rating||Most likely||No, the rates are the rates|
|“White label” branding||Only for very large groups||Included|