Direct Partnership:

A Better Way to Provide Employee Benefits

You need health coverage for your employees, but did you know that you don’t have to work with a carrier? As healthcare prices keep rising year after year, it’s become clear that the traditional insurance company-based employee benefits system is not meeting the needs of many employers. A direct partnership offers an alternative.

How Does a Direct Partnership Work?

In a direct partnership, employers contract directly with the health system in their community to provide healthcare benefits for employees and their families.

What is a direct provider partner?

The community health system you contract with is your direct provider partner. This is the hospital and providers where your employees and their families receive healthcare.

Contract Development

As your program manager partner, H2B works with your direct provider partner to create a Direct Corporate Health Partnership Agreement that is mutually beneficial to all parties.

Designing the Plan

H2B helps design the deductible, coinsurance, copays, and out-of-pocket maximum for plan members.
Tiered plan designs are structured to steer usage toward your direct provider partner in order to provide quality care while controlling costs.

Receiving Care

Once enrolled in the H2B Direct program, your employees and their families receive coverage for all services offered by your direct provider partner.

Filling Prescriptions

A transparent, pass-through Pharmacy Benefits Manager handles prescription drug benefits.

Paying Claims

This is a self-funded program. As the employer, you are also the payer.
Captive participation is an optional way to band with like-minded employers for the first layer of reinsurance.
A second layer of reinsurance covers catastrophic claims that exceed the captive layer.

Adjudicating Claims

An independent third-party administrator handles claims.
When claims occur outside of the direct partnership, a re-pricer adjudicates the claims.

Why Make the Switch?

A direct partnership completely changes the status quo. You’re not just tweaking your current health plan or trading one carrier for another. You’re adopting a completely different model – and that can feel intimidating.

So why do it?

Because real change delivers real benefits. If your current health system is broken, a minor tweak here and there won’t fix it. When you take the plunge and switch to a direct partnership, you and your employees can reap the rewards of a truly novel approach to healthcare.

The Broken, Yet Still Used Method	The New Direct Partnership Way

A carrier decides what coverage to offer and how much to charge, resulting in plan designs that many not fit the needs of your workforce.	You take control of your coverage and costs. Want to cover childbirth with no out-of-pocket costs? You can.
The high cost of coverage puts pressure on your company.	Employers typically save an average of 24% in total costs in the first year.
Some of the cost increases are passed on to employees, effectively resulting in pay cuts and leading to dissatisfaction.	Employers keep more of their pay, resulting in greater satisfaction and supporting the company’s recruitment and retention.
Every year, you brace for enormous price hikes at renewal.	The average renewal increase is just 1.9%. That’s less than the average inflation rate.
High out-of-pocket costs discourage members from receiving care, contributing to worse health and higher costs over time.	You can design a plan with low out-of-pocket costs when seeing direct partner providers, encouraging routine and preventive care.
Annual uncertainty over plan changes creates stress for employers and their employees and eats up time each year.	Renewals are predictable, alleviating a major source of stress and freeing up time and energy.
There may be no money left to spend on other employee benefits.	You can reinvest some of your savings to provide additional employee benefits.
You spend a lot of money for health coverage that doesn’t meet your needs. No one is happy.	You save money while securing high-quality healthcare and enhancing corporate well-being. Workers are happy and engaged.