CHOICE Plan

 

“The Employer’s CHOICE Plan”

General Information

  • The Employer’s CHOICE Health Plan is a customized group health product based on PHPC’s Hybrid Plan and is an ERISA-based product, while ensuring a consistent healthcare budget like a traditional policy.
  • Based on the Hybrid Plan design, the employer will pay an equivalent rate structure for each employee based on their coverage election (EE, ES, EC, EF).  The amount paid will encompass all administrative fees, carrier premium fees and the claims funding amount. No EOB’s for employees to file with PHPC.
  • If at any time during the plan year the employer’s claims exceed the amount in their claims account balance, a sweep from the carrier’s account will be performed to cover the deficiency. No additional funds will be requested from the employer.
  • At the end of the year, if any funds are remaining in the employer’s claims account, the balance will be refunded to the employer 100%.  If the employer’s claims exceeded the claims account at the end of the plan year, a sweep from the carrier’s account will be performed to cover the deficiency.  No additional funds will be required from the employer.
  • The employer simply needs to complete and sign a group disclosure statement.  This form is to be completed with the understanding that the employer is completing the form based only on information known to them and is completed to the best of their knowledge.  No individual applications are required.
  • As a client of PHPC, the employer will enjoy access to comprehensive plan data, including web-based reporting tools and periodic on-site claims reviews.  This will allow the employer to effectively manage their health plan, as well as proactively adjust their programs needs based on their individual claim results.

 

 

PREFERRED HEALTH PLAN OF THE CAROLINAS
PO BOX 749 MATTHEWS, NC 28106
LOCAL: 704.847.2321     Toll Free: 866.636.0239     FAX: 704.847.3014