PPO
EPC 1500
Tier 1$0. Everything.
Tier 2 · Unity Network
- Deductible (ind. / family)
- $1,500 / $3,000
- Out-of-pocket max
- $6,000 / $12,000
- Coinsurance
- 30%
- Primary care
- $25
- Specialist
- $45
- Urgent care
- $65
- Emergency room
- 30%
- Generic drugs
- $0
For employers · 5 employees+
A health plan built around the hospital your people already want.
Northwestern Medicine at $0 to your members. Every fee disclosed, line by line.
Plan analysis · Sample group
Illustrative11–20% year-one savings
Today
EPC expected
EPC worst year
Fees
Fixed
Pharmacy
Pass-through
Bad year
Capped
What your member pays
Three tiers. One obvious answer.
That's the design, not a discount.
Tier 1 · Preferred
$0
Northwestern Medicine and direct contracts
No deductible, no copay, no coinsurance. Facility and physician.
Tier 2 · Participating
Standard
The Unity Network
Deductible, copays and coinsurance at a contracted rate.
Tier 3 · Non-participating
50%
Out of network, by choice
Higher deductible. The only place reference pricing applies.
What you pay, and to whom
Your monthly cost, in three numbers.
Flat PEPM, fully unbundled. Nobody here makes more when your claims cost more.
- No percentage of savings
- No undisclosed overrides
- No spread
Stop-loss premium
Insurance against catastrophic claims.
Claims allocation
Your money, paying your people's claims.
Fixed admin fee
Flat PEPM. Every vendor, line by line.
Side by side
A traditional carrier vs. EPC.
Traditional carrierEPC
Your best hospital
Traditional carrier: In network, same cost share as everyone else
It is the plan, at $0 to the member
What you pay
Traditional carrier: One bundled rate you can't break apart
Three numbers, each disclosed
How vendors earn
Traditional carrier: A cut of what they claw back
Flat fees to run your plan
Your data
Traditional carrier: The carrier's
Yours, every month
The math
Built on data. Priced in the open.
We model your census and claims before we quote. After launch, the same analytics run monthly.
- Utilization, unit cost, steerage and outcomes
- By population and by site
- The data is yours, not the carrier's
Where the savings come from
More care moves to Tier 1, where the direct contract pays a lower unit cost than a carrier network. Sample 80-employee Chicagoland group, $1.46M premium today: 35%, 50% or 60% of spend moving to Tier 1. Illustrative, not a quote.
For plan fiduciaries
Can you explain where your money went?
Under ERISA you have to. Fiduciary suits target employers who can't. EPC fits it on one page.
$0 at Northwestern
Direct contract, lower unit cost.
Pass-through pharmacy
Rebates and spread return to the plan.
Navigators
Members booked at Tier 1.
Nominate a doctor
Members text one in. We call within 24 hours.
What EPC is not
Real contracts. Not a workaround.
Not reference-based pricing
Real signed contracts. No repricing after the fact.
Not a discount card
A real plan with a real network.
Not a bundled level-funded rate
Every fee broken out and disclosed.
Not percentage-of-savings
Nobody earns more when claims cost more.
Calculator
What would quality save you?
Enter your annual plan cost. See three illustrative scenarios.
Enter your annual plan cost to see three scenarios.
Illustrative, from a sample group. Not a quote. How it's built
Plan designs
Seven designs. $0 at the center.
Low deductible through HSA qualified. Pick off the shelf and move fast.
Pick one, or two to compare
Compare all seven
| Tier 2 | 1500 | 3500 | 4500 | HSA 5000 | 6000 | MVP 7000 | 8000 |
|---|---|---|---|---|---|---|---|
| Tier 1, everything | $0 | $0 | $0 | $0 after ded. | $0 | $0 | $0 |
| Deductible (ind. / family) | $1,500 / $3,000 | $3,500 / $7,000 | $4,500 / $9,000 | $5,000 / $15,000 | $6,000 / $12,000 | $7,000 / $14,000 | $8,000 / $16,000 |
| Out-of-pocket max | $6,000 / $12,000 | $7,000 / $14,000 | $8,700 / $17,400 | $5,000 / $15,000 | $8,700 / $17,400 | $8,500 / $17,000 | $8,700 / $17,400 |
| Coinsurance | 30% | 30% | 20% | 0% after ded. | 20% | 30% | 30% |
| Primary care | $25 | $25 | $40 | 0% after ded. | $40 | $40 | $40 |
| Specialist | $45 | $45 | $60 | 0% after ded. | $60 | $60 (first 3) | $80 |
| Urgent care | $65 | $65 | $70 | 0% after ded. | $70 | $30 | $100 |
| Emergency room | 30% | 30% | 20% | 0% | 20% | 30% | 30% |
| Generic drugs | $0 | $0 | $0 | 0% after ded. | $0 | $0 | $0 |
Plan design summary, not an SBC. Custom designs available for eligible groups.
Implementation
Live in 60 to 90 days.
One owner on our side, start to finish.
Contract
Services agreement and one-page fee schedule.
BAA and census
Census goes to the secure upload, not email.
Feeds and cards
TPA and PBM feeds connected. ID cards mailed.
Go-live
Navigators on day one. Reporting every month.
Get the sample proposal
The illustrative proposal for a sample group, by email.
FAQ
Questions benefits leaders ask.
What size employer is EPC built for?
Employers Preferred Choice (EPC) is built for employers with 5+ employees in Arizona, Texas, Illinois and Florida.
Do we have to change our TPA or stop-loss carrier?
Not necessarily. EPC works with your third-party administrator, stop-loss carrier and pharmacy benefit manager. Some groups keep their current stop-loss carrier.
How do you estimate savings?
We model your census, 12 to 24 months of paid claims and current plan designs across conservative, expected and strong scenarios. The figures on this site are illustrative; your analysis uses your data.
How long does implementation take?
Typically 60 to 90 days from contract to go-live.
What do you charge?
Three numbers: a stop-loss premium, your claims allocation and one flat per-employee-per-month admin fee, disclosed line by line. No percentage of savings, no overrides, no spread.
We're fully insured today. Can we still look at EPC?
Yes. EPC is self-funded, and your analysis compares it with what you pay now, including what a bad year could cost with stop-loss in place.
What happens in a bad claims year?
Stop-loss caps it. Your analysis shows the worst-case range next to the expected case, so your CFO sees the ceiling before signing.
Will our people lose their doctors?
Tier 2, the Unity Network, gives broad access, and Tier 3 is out of network. A navigator helps members find Tier 1 doctors. Final benefits are set by the plan document and SBC.
What does it cost members?
Tier 1 is $0: no deductible, copay or coinsurance at Northwestern Medicine and direct contracts. The HSA design applies its deductible first. Tier 2 follows the plan design you choose.
Which states do you cover?
Illinois is live. Arizona, Texas and Florida are in development.
What do you need for an analysis?
It depends on how you're funded today. Fully insured: census, benefit summaries, rates and renewal, and 18 months of claims if available. Self-funded: census, SPD, current vendors and fixed costs, and 24 months of monthly paid claims. Files go to a secure upload, never this site.
Is the analysis a firm quote?
No. It's an illustrative estimate built from your data. Firm pricing follows underwriting.
How do you protect our data?
This website collects business contact details only. Census and claims go to a secure upload covered by a business associate agreement.
Can we keep our broker?
Yes. EPC works with brokers and consultants, and your broker can run the quote with you.
Find out how much you'll save.
Send your census and claims. We model your population.