Building a plan
What you need to know when designing a HealthbyChoice Achievements® plan for your client.
Funding options
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HealthbyChoice Achievements is available with fully funded, shared funded and self-funded plans.
- Employers can customize self-funded benefits.
- Additional administrative cost for self-funded and shared funded HealthbyChoice Achievements plans. Employers should experience cost savings through their claims.
- To ensure plan designs meet HIPAA requirements for being qualified wellness plans, employers should only use the existing predefined plans options.
Plan options
- There are 9 plan options:
- These plan options can be used for both small groups and large groups.
- There are different pharmacy options for small groups and large groups.
- Each design features a Standard and Choice benefit level. The 3 differences between the 2 levels: deductibles, coinsurance and copays (all out-of-pocket costs).
See plan options for small groups, mid-market groups or large groups.
Riders
- Riders must be offered on both the Standard and Choice benefit levels for all plan options.
- Small groups can add two riders: contraceptives and domestic partner
- Large groups have more options available. Go to the rider listing under plan options to see available riders.
