The McPherson Chamber is pleased to introduce NexUS Health Plans as a unique health benefits program designed for our Chamber members. NexUs Health Plans, a comprehensive and affordable benefit program, effective March 1, 2020 is available to those with an employee base of 2-500.
The McPherson Chamber recognizes that recruiting and retaining talent is vital for business and industry of all sizes, and health insurance benefits are a crucial piece to that success.
As a benefit of McPherson Chamber membership, our members will receive preferred pricing (a 5% discount on premiums) for their group health coverage through ProviDrs Care’s NexUs Health Plans program.
Health benefits too costly? Let us help. With NexUS Health Plans, McPherson Chamber of Commerce members can take advantage of economies of scale pricing through ProviDRs Care’s NexUS group health program. The NexUS Health Plans program offers the flexibility of level-funded group health coverage with the key features of cost containment, integrated wellness, value-based payments, care coordination, & disease management.
It’s time to navigate beyond traditional group health products for a more strategic approach to managing healthcare costs — one that addresses employee health behaviors while still providing great benefits!
Were held for employers who are interested in learning more about the NexUS program, the plan offerings, and the next steps for enrollment as well as a meeting for licensed insurance agents February of 2020. An additional informational meeting was held via Zoom on December 22, 2020.
If you have interest in seeing a proposal please contact Bret Emberson, with ProviDrs Care Network: firstname.lastname@example.org (800) 801-9772 ext. 256. or (316) 221-9106
Q: Is Chamber membership required to enroll? A: The NexUS program is available to all McPherson area employers. However, McPherson Chamber members receive preferred pricing (a 5% discount on premiums) for their group health coverage as a benefit of their membership. NexUS will confirm that employers are McPherson Chamber members in good standing prior to completing enrollment and renewal.
Q: What is value-based healthcare? A: Value-based healthcare focuses on improving quality and outcomes for patients by changing the way a patient receives care. It is a system that is proactive instead of reactive by preventing problems before they start (real health care and not sick care). NexUS Health Plans enhances the primary care physician and patient relationship, ensuring coordinated access at all points of the care continuum. Primary care physicians are rewarded with value-based payment by actively managing the patient’s care, increasing quality and lowering costs.
Q: Because this program is technically a ‘Self Funded’ Program, does that mean our group has to have reserves set aside to cover the claims in case of a bad month (or year)? A: NO. Because of the insurance components of the program, we have taken the best aspects of a self-funded program and the best aspects of a fully insured program and blended them together. This is a fixed cost, level funded program. Your rates are your rates, period.
Q: What does Level Funded mean? A: The NexUS Health Program is ‘level funded’ meaning that by design, any risk to the sponsoring employer has been removed beyond the 12 months of premium paid. Based on employer size, we can offer a unique, self-funded health benefits program that maximizes the benefits to employees, while implementing cost-saving opportunities for employers to stabilize benefit costs without reducing benefits.
Q: If our claims exceed the allotted amount, what happens? Do we have to come up with the difference at the end of the year? A: NO. The NexUS Health Program is level-funded by your monthly premiums. Regardless of what your claims experience is in any given plan year, you will never pay more than the monthly cost quoted to you.
Q: If we choose to leave the program at the end of the plan year, is there a termination cost associated with the plan? A: NO. All run out costs are accounted for in the quoted monthly premiums.
Q: During our plan year, what if our claims run better than expected? A: Once all claims have been paid for the plan year, any unused dollars in the claims fund will be used to reduce future premium rate increases. In the event of plan termination, each employer is eligible to receive back any unused dollars in the claims fund after the runout period.
Q: Will our employees and administrators have to do more work on this type of program? A: NO. By partnering with a Third Party Administrator (TPA), administrative burdens are removed from both the employee and the employer. Employees play their usual role including seeing providers within their PPO Network, using their ID card at the provider’s office, paying a copay and then paying their shared responsibility. The employer simply pays their monthly premiums. The TPA and ProviDRs Care then handles the rest! No claims filing, no separate accounting, no extra work!
Q: What are the program’s eligibility requirements? A: Participating employers will need to have a minimum of 2 full-time employees and a maximum of 500 enrolling and will need to be a member in good standing with the McPherson Chamber of Commerce.
Q: Who is ProviDRs Care? A: ProviDRs Care is Kansas’ only physician owned and managed PPO network in the state. Formerly known as WPPA and operational since 1985, ProviDRs Care is owned by the Medical Society of Sedgwick County.
Q: I am an insurance agent or broker and would like to enroll my clients in the Chamber’s NexUS program. Is Chamber membership required to sell the NexUS program? A: Yes. Brokers and agents must be McPherson Chamber members to enroll employers in the McPherson Chamber NexUs program.
Q: My employees travel for work. Does the NexUS program provide coverage beyond the McPherson area? A: Yes, NexUS utilizes the ProviDRsCare network, which includes the vast majority of physicians within the state of Kansas. The NexUS program also includes a national “wrap” network to provide coverage out of state.
To learn more about the NexUs Health Plans solutions and take advantage of our exclusive program-negotiated rates contact your local agent or contact Bret Emberson at (316) 221-9106 or email@example.com