The Exemplar Royalty Series
A dynamic answer to the rising cost and limitations of today's health insurance market — affordable, comprehensive coverage for employers from five lives to several hundred.
With twelve metallic plan offerings, we have a wide variety of options for groups of all sizes and needs.
The plan
- Available for employer groups domiciled in 47 states
- Available to groups as small as 5 enrollees
- Level-funded program
- Consistently competitive rates
- Traditional PPO networks
- Reference-based pricing options, without the usual hassle
- Quick turnaround times
- 0%, 50% or 100% of the remaining claim fund returned to the employer after the contract period
- ACA compliant
Group guidelines
- Minimum group size: 5
- Participation: no participation requirements
- Employer contribution: none required
- COBRA participation: no more than 10%
- Retirees: not covered
- Employees outside the US: not covered
- 1099 employees: not covered
- Ineligible states: New York, Hawaii and Washington
Networks
We have two standard network options. The first is a traditional PPO offering through the First Health Network. The second uses the PHCS practitioner network with a reference-based pricing model for facilities.
The way EHBA and Hi-Card approach reference-based pricing has changed how it works in practice, and has all but eliminated the traditional challenges with the model.