Association Health Plan

A Forward-Thinking Health Care Strategy

Leverage PECAA’s group buying power to take advantage of a Member-only health care solution at competitive rates through a private, non-profit, level-funded benefits plan.

Take Advantage of PECAA’s Association Health Plan

We are proud to offer PECAAHP, a Member-exclusive health care solution that provides affordable health care coverage for you and your employees.

With insurance premiums on the rise and no end in sight, PECAAHP was developed to help Member practices gain control of their expenses while providing quality benefits to employees – helping your practice attract and retain a quality team.

Leverage PECAA’s group buying power as part of a larger, combined unit to purchase health care benefits at competitive rates, regardless of your individual practice size. Join your fellow PECAA colleagues by taking advantage of this private, non-profit, level-funded benefits plan.

Why A Level-Funded Program?

A level funded health plan is a type of health insurance plan that combines the cost savings and customization of self-funding with the financial safety and predictability of traditional, fully-insured plans. Level funding used to be a concept only available to large employers. Not anymore. Experience the advantages of level-funding through PECAAHP without taking on added risk.

  • Various Plan Design Options make it easy for you to find the right fit for your practice
  • An Experienced Team is always ready to provide expertise before, during & after you’ve chosen your plan

Level-Funded Program Key Advantages

  • One Predictable Monthly Payment
    -Your monthly payment is determined upfront and guaranteed not to increase for a full year as long as there are no changes to your group’s benefits or enrollment
  • Plan Administration & Account Management
    -Payments of claims, customer service and reporting is all done for you, leaving you to focus on your business
  • Quality Benefits
    -All employer-established benefit plans are minimum essential coverage
    -Preventative services are paid 100% when received from in-network providers

ENROLLING IS SIMPLE!

Here’s What to Expect… 

1) Review Each Plan’s Summary of Benefits

Click on the plans below to see the summary of benefits for each. We’re confident you’ll find at least one plan that will meet your unique needs.

MVP Bronze | MVP Silver | MVP Gold | MVP Ulta Copay | MVP Ultra HDHP

2) See If Your Practice Qualifies

Use the “Apply Now” link below to see if your practice qualifies. This brief 2 page form will help us better understand the needs of your practice. You will be notified within 48 hours whether or not your practice is approved.

APPLY NOW

3) Complete Your Paperwork

Anderson Thornton Consultants will guide you through all the paperwork that is necessary for you to enroll in PECAAHP.*

*Please note that you must maintain a PECAA Membership and be in good standing to qualify for the PECAAHP plan.

FREQUENTLY ASKED QUESTIONS

Employer FAQ’s

Who is the Carrier?
The HBA program is a unique, level-funded, self-insured program in which each employer is its own Plan Sponsor and Plan Administrator as defined within ERISA and is free to pursue the claims funding/reinsurance strategy of its own choosing. While the HBA is not a traditional insurance carrier and does not participate in or facilitate any transaction of insurance, employer inquiries will be referred to appropriate, informed parties for appropriate action to protect employer interests.
What are the Underwriting Requirements?
Must have at least 2 W2 employees, employer must complete group questionnaire
What Network are we Using?
The largest network nationwide, the PHCS Network
How Do I Get A Quote?
The rates that you see listed above are fixed rates for everyone. Fill out the employer health questionnaire above, you will hear back within 48 hours whether or not your group qualifies.
How Does Billing Work?
Invoices are sent electronically directly from HBA administrators between the 7th-12th of every month. Premiums are collected via ACH on the first business day of the following month.
Is There a Minimum Participation Requirement for the Plan to be Written?
Depending on the plans offered, the HBA program requires participation of 25-50% of eligible employees who are not covered as a dependent under another group health plan.
How Much Does the Employer Have To Pay Towards the Employee's Coverage?
The employer must contribute at least 50% of the employer only cost.
Can the Employer and Employee Pretax These Benefits?
Yes.
Who Handles COBRA for this Plan?
HBA administrators will provide COBRA administration services for all groups.
How Are Enrollments Done?
They will be done electronically online.
Will This Interfere With My Payroll System?
No, in many cases it can integrate with the payroll system.
Could Additional Benefits Be Offered Through PECAAHP?
Yes, Vision, Dental, and Life benefits can be added to supplement medical coverage.
What If Our Group Doesn't Qualify?
If your group doesn't qualify we will work to find you a plan that will suit your needs.

Employee FAQ’s

How Can I Find Out If My Doctor In the Network?
View the Provider Network List Here.
What Age Are Dependents Covered Up To on this Policy?
Till their 26th birthday
How Do I Add My Spouse and Children to the Plan?
Employees who want to add coverage for dependents should add their dependents during the initial enrollment period. Dependents not enrolled at the initial enrollment can be added at the next open enrollment or when a qualifying event occurs. Qualifying events include, but are not limited to marriage, divorce, birth of a child and loss of other coverage. Employees have 30 days to notify the administrator when a qualifying event happens and changes need to be made.
Is There In and Out Of Network Coverage? How Does It Work?
Yes there is out of network coverage, Please refer to the plan summaries for details.
What Is My Emergency Coverage for Urgent Care, the ER, or Emergency Surgery?
Please refer to the plan summaries.
What If I Leave My Employer?
If you leave your employer you are eligible for COBRA benefits which allow you to stay on your employers plan for up to 18 months.
What is the Coverage for Covid Testing?
HBA plans will reimburse for up to eight (8) verified COVID-19 rapid at-home tests per person/month.
How Do I Enroll?
You employer will provide you with the link you need to enroll.
What Are My Coverage and Copays for Primary Care and Specialist Visits?
Please refer to the plan summaries .

What Members Are Saying About PECAAHP:

We participated in PECAA’s health plan last year with the help of Patrick Thornton who walked me through every step of putting it into place.  He was very helpful in explaining the plan costs, benefits and how it would work.  He followed up multiple times through the year making sure it was working well for us.  It was a better plan than we’ve had and saved us around $6,000 for the year. Glad we did it.

-Dr. Shawn Brittain, Westside Eye Center

We have had a great experience with Anderson Thornton and all that were involved in us enrolling in an affordable health plan.  Before 2021, we were not able to provide health insurance to our employees.  After joining PECAA and dealing with Anderson Thornton, we are able to offer our employees an affordable health plan for themselves and their families. It was an easy process and the team at Anderson Thornton made it enjoyable.  

-Terri Grace, Vision Clinic

Questions?

Don’t see your question on the list? You may e-mail pecaa@andersonthornton.com or call 813-979-1588.

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