Millions of small businesses in America want to provide health insurance for their employees. But, In some cases, these small employers must choose to either offer insurance to their employees or stay in business. With recent changes to healthcare regulations, many small employers can join an association health plans (AHP) which may allow employers to band together to purchase health insurance. A rich benefit package is a tool that many employers need so they can recruit and retain the best talent. 

Association Health Plans

Association health plans (AHPs) are giving relief to thousands of businesses nationwide with greater access to health coverage, leveraging the buying power of larger groups. Our plans have been approved in all 50 states and use large, national Preferred Provider networks and industry-leading administration partners.

The Problem

The health insurance lobby along with many other powerful lobbies wrote the healthcare reform bill passed in 2010.  As a consequence, the law is slanted heavily in the insurance carriers favor.  Here are a few examples of how the bill actually benefits the insurance industry and works against employers.  
 
Who Rules? 

CVS runs the healthcare system. You might also be surprised to know that each insurance carrier including Humana, Blue Cross, Signa, and United also follow a similar system. These companies own each part of the healthcare system from the drug stores to the physicians groups and even to the drug manufacturers. As you can see in the interactive representation to the right, CVS is an example of how our healthcare system works in the United States. 

CVS, one of America’s favorite drug stores, is one of the many companies that run the healthcare system. In short, CVS is in control of the Rx costs that you have to pay. Find out how by continuing through this interactive map. 

CVS owns the well known health insurance company Aetna. When CVS bought Aetna in 2018, it created a healthcare powerhouse. 

Not only does CVS own a health insurance agency, they also own one of the largest physician groups in the United States, Minute Clinic. This means that you get to pay CVS for both your health insurance and what that health insurance doesn’t cover when you visit Minute Clinic.

On top of that, CVS owns CVS Health Payor Solutions, their pharmacy benefit manager. The CVS pharmacy benefit manager controls what drugs are on the drug formulary and the pricing of that medication.

CVS also owns the well known CVS pharmacy found inside most of their drug stores. 

Not only does CVS own the health insurance provider, the physician groups that use the insurance provider, health payor solutions, and the pharmacy that the physicians prescribe medications out of, they also own Red Oak Sourcing. Red oak sourcing is a drug manufacturer. 

Health Care Reform Law
The healthcare reform law mandates that insurance carriers must pay 85% of the premiums they collect from large employers (over 50 employees) to cover the cost of  care for the members of the plan. (For small employers, under 50 employees, insurance carriers must pay 80% of the premiums they collect to cover the cost of care for their members).
With each carrier owning the healthcare ecosystem, carriers are incentivized to increase the cost of care because they make money in the entire system which they own. 
 
 
 

The Solution

The only way to solve this problem is to take the system apart and reconstruct the ecosystem so that these regulations do not apply. When we reconstruct the healthcare ecosystem, we typically see 30% rate reductions in premiums, better benefits, and a leveling out of premiums. 

Let us show you how it is done.