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PECAA 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

PECAA Health Plan logo

PECAA HP is a Member-exclusive health benefits solution that provides affordable health care coverage for you and your employees.

With insurance premiums on the rise and no end in sight, PECAA HP 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 purchasing power to obtain health care benefits at competitive rates, no matter your individual practice size.

Why A Level-Funded Program?

A level-funded health plan is a type of plan that combines the cost savings and customization of self-funding with the financial safety and predictability of traditional, fully insured plans. Level funding was previously available only to large employers, but not anymore. Experience the advantages of level-funding through PECAA HP 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, and after you’ve chosen your plan.

Key Advantages of Level-Funding

  • One Predictable Monthly Payment

    Your monthly payment is determined up front and is 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 practice.

  • Quality Benefits

    All plans satisfy minimum essential coverage requirements under the Affordable Care Act (ACA).

  • Full Coverage for Preventative Services

    Preventative services are covered 100% when received from in-network providers.

Exciting New Program Added To PECAA HP’s PPO Plan: The Care Advocate Program

PECAA HP’s newest offering — the Care Advocate Program — is a flexible and affordable option because it gives insureds access to three tiers of coverage:

  • Care Advocate: Full coverage is provided when a Care Advocate, a personal health care consultant who can help insureds find the highest quality care at the most affordable price, is contacted prior to hospital and facility care, with no copay required.
  • In-Network: Coverage is available for care received from a Preferred Plan Provider, subject to copay. 
  • Out-Of-Network: Coverage applies for services received from Non-Plan Providers, with both copay and/or coinsurance required.

View the summary of benefits for the Care Advocate Program. To see if your practice qualifies for the Care Advocate Program or other insurance plans, complete the Group Health Questionnaire.

Choose Your Plan

Available Benefit Options

Traditional PPO

A Preferred Provider Organization plan is a level-funded health insurance plan.

Unlike with fully insured plans, employers that do not meet the underlying medical underwriting requirements can be turned down.

  • Requires medical underwriting through census data.
  • Rates can be 20% less than fully insured health plans.
  • Various networks are offered throughout the country.
  • Use of the Care Advocate Program can eliminate deductibles.

ICHRA

An Individual Coverage Health Reimbursement Arrangement, or ICHRA, is a group insurance option that empowers employees to choose their own medical plan while still allowing employers to contribute to the cost of premiums:

  • Takes the employer out of the middle of employee health care concerns.
  • Cost effective way to control health insurance costs.
  • No minimum participation requirements, unlike many employer-based plans.
  • Allows employer to contribute different levels of premium assistance based on employee class.

IHP

An Individualized Health Plan or IHP is a Limited Day Medical Plan with limitations on coverage. Medical underwriting relies on census data and may reject high-risk groups. Features include:

  • Zero-dollar deductibles, except for the HSA plan.
  • Affordability with low premiums.
  • Utilization of the PHCS/Multi-Plan network as the Nationwide PPO Physician Network.
  • Requirement for most outpatient services to be done at freestanding clinics, not hospitals, with some exceptions.
  • Plan limits for number of annual doctor visits, hospital days, and outpatient services.

Quotes & Enrollment

Pick The Plan And Rate That Meets Your Needs

Discover more about our exciting plan options and find the perfect fit for both you and your practice. We’re confident you’ll find at least one plan that will meet your unique needs.

Not Sure Which Plan To Choose?

Complete the benefits request form below to have quotes for all three plans generated, and we will make a recommendation for your practice’s needs.

Use the “Request Benefits” link below to see if your practice qualifies. This brief two-page form will help us better understand the needs of your practice. You will be notified within 48 hours if your practice is approved.

SandStone Insurance Partners will guide you through all the paperwork that is necessary for you to enroll in PECAA HP.*

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

What Members Are Saying About PECAA HP:

“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, Kalispell Vision Clinic

“My practice has worked with the PECAA Health Plan team for a few years. This year, we are scheduled to receive a premium dividend check back from the insurance plan for just over $2,500. Patrick and his team have been easy to work with and helpful. We are always given multiple plan options and the rates are good.”
— Chris Arnold, OD, VisionCare Associates, LLC

Questions?

Don’t see your question on the list? You may email or call 800.578.5578.