Frequently Asked Questions

HBA plan(s) may be offered alongside other plans provided that none of the other plans carry a lower “plan value” than the HBA offerings. For example, we will not permit a customer to offer a series of HBA metallic plans while simultaneously offering a competing MEC plan.

Health questions are limited to an Employer General Health Questionnaire (GHQ) to be completed to the best of [the employer’s] knowledge. GHQ requirements may vary based on the underwriting practices of the reinsurance carrier that the Employer chooses to employ. HBA plans do not include any exclusions or limitations due to pre-existing conditions.

In addition to the standard “open hospital care network” [RBP] design options, the MVP Ultra plans (Platinum and HDHP) are available with a full PPO option, similar to traditional PPO plans. These plan options may be offered in concert with a lower-level MVP metallic plan and/or an HBA MEC plan option. Note, however, that only the MVP Ultra plan would be non-RBP.

The PHCS Physician Network is the primary network utilized for HBA plans. Our program is also compatible with several other networks, the availability of which is subject to each network’s contracting status with any of our TPA partners [Note – CIGNA network is only available for [non-RBP] MVP Ultra plans and requires a minimum of 25 covered lives under the applicable MVP Ultra plan].

The HBA headquarters is located in Norwalk, CT. HBA plan designs are agnostic toward the Employer’s reinsurance selection for Plan claim risk. The Employer’s preference and circumstances will determine the most suitable option among qualified, A-rated, domestic carriers that support HBA solutions. The Employer as Plan Sponsor reserves ultimate discretion in the reinsurer selection, domestic or otherwise, and shall not be directly influenced by HBA or any of its representatives.

HBAadministrators℠ provides a paperless online enrollment experience to support any combination of HBA plan options your client chooses to offer.

Simply put, the HBA target market consists of employer groups with employees who, for an array of reasons, have been relegated to the ranks of the underinsured or functionally uninsured. These employer groups are often comprised of a small cadre of salaried, management-level employees whose economic means conflict with that of the group’s more moderately-paid employees to whom high premiums and/or high deductibles and out-of-pocket plan limits prove to be intractable barriers to care. By enabling a small employer to offer several plan design options that empower its employees to select benefit levels that balance their specific medical needs with their economic means, HBA provides the choice and affordability missing in today’s health benefit marketplace.

While there is no contractual limit to the number of plan options that can be offered, and group-specific needs will vary, experience shows that three (3) plans tend to be a common maximum. Payroll deduction is required but no minimum employer contribution.

Full ASO funding arrangement is available to any group with at least 100 enrolled employees and claims experience from a current plan.