Defend Plans Collateral

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Safe

With administration by Acuity Group and stop-loss through A.M. Best-rated A carriers.

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Simple

Because all of our PPO plans are backed by quality, national networks.

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Refund Assisters™

Our unique Refund Assisters™¬† help employees improve their health and employers their costs.

2021 Summaries of Benefits Samples (SBCs):

 

Network, PMB and MGU Links:

Referenced Based Pricing Collateral

The standard Defend Plans are PPOs. They provide higher benefits when clients seek services from an in-network provider, but still provides some coverage for out-of-network treatment and services.

Clients also have the option of choosing our Referenced Based Pricing (RBP) plans. These plans act like a PPO for physicians and specialists. Facilities (including hospitals and clinics), however, are reimbursed based on a percentage in excess of what Medicare reimburses those facilities for the same care (or an HHS cost calculator, whichever is higher).

The Defend Plans provide clients with patient advocacy through ClaimDoc or through 6 Degrees Health. They help your clients minimize balance billing and educate patients and providers about RBP before claims are incurred.

ClaimDoc serves as a co-fiduciary of the plan, accepting responsibility to pay any legal liability. No physician network is available with ClaimDOC.

6 Degrees Health does not serve as co-fiduciary, but a physician network is available.

Clients should consult with their broker to determine if Referenced Based Pricing is the best option for them.