PPO
EPC 1500
Tier 1$0 on most plans*
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 want.
[Anchor system — name pending written approval] at $0 to your members on most plans*. Every fee disclosed, line by line.
- $0 at [Anchor system — name pending written approval] on most plans
- Every fee disclosed, line by line
- Built for groups of 5+
Plan analysis · Sample group
11 to 20% year-one savings
Year-one savings, sample group
Today
EPC expected
EPC worst year
Illustrative figures from a sample group. Source: EPC sample plan analysis.
What your member pays
Three tiers make the right choice the easy one.
Tier 2 · Participating
$1,500 deductible
Sample plan: EPC 1500
The Unity Network
Deductible, copays and coinsurance at a contracted rate.
Tier 3 · Non-participating
50% coinsurance
Out of network, by choice
Higher deductible. The only place reference pricing applies.
What you pay, and to whom
Every price is modeled on your data and shown in full.
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.
| Plan feature | Traditional carrier | EPC |
|---|---|---|
| A leading hospital | In network, same cost share as everyone else | Tier 1 is $0 on most plans* |
| What you pay | One bundled rate you can't break apart | Every cost disclosed |
| How vendors earn | Often paid a share of savings | Flat fees to run your plan |
| Your data | 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.
For plan fiduciaries
Can you explain where your money went?
ERISA and the CAA expect you to know what you pay and to whom. EPC fits it on one page.
$0 at [Anchor system — name pending written approval] on most plans*
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.
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. How it's built
- Illustrative figures are not firm quotes.
Plan designs
Choose from seven plan designs.
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, covered care* | $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.
FAQ
Questions benefits leaders ask.
What size employer is EPC built for?
Employers Preferred Choice (EPC) is built for employers with 5+ employees. Live in Illinois; Arizona, Texas and Florida next.
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.
Find out how much you'll save.
Send your census and claims. We model your population.
A note on plan design
On HSA-qualified HDHP plans, Tier 1 applies after the deductible (preventive care $0).
Illustrative figures are not quotes.