Simplicity Health Plans

Mission & Vision

Our Mission:

To offer our Clients and their Employees an elite package of integrated, consumer-driven health plan tools that empower them to become responsible, health conscious, market-driven consumers of healthcare.

Our Vision:

To provide infrastructure that fosters lasting market-driven changes in the US Healthcare System
To eliminate fraud, paperwork and the confusion associated with traditional transactions
To save costs and to redistribute healthcare savings to Members, Employers & Providers
To empower our Members with the tools necessary to live healthier and wealthier lifestyles
To become the national standard for a consumer-driven healthcare system

Our Business Model - SaaS Transaction Integrator

Simplicity Health Plans is a transaction integrator that creates SaaS technologies for comprehensive consumer solutions
that offer an "End to End" cure for rising healthcare expenditures that includes the best implementation of a CDHP/HSA.
Simplicity Health Plans aligns the interests of the Provider, Employer, and the Employee to provide
a turn-key, fully integrated Consumer Directed Health platform, which fuses
unparalleled technology, point of service adjudication, real-time data, and anti-fraud
controls. Our technology portfolio includes: the Health Index Calculator™
(Health2Cash™ App); the StayFit Plan wellness platform; and the first of its kind,
the proven CDHP/HSA Point of Service payment system for healthcare.

We partner with TPAs, insurance companies and brokers to provide self funded
CDHP/HSA health plans, HSA administration, banking, and all other necessary services.
Plus a host of on-line tools for Providers, Employers and Members.

Plan Benefits

For the Employee

Convenience of selecting Providers who accept Simplicity Health Plans� price with paperless, rapid payment
Inspires a sense of personal responsibility for one�s health & define a greater awareness of costs
Employees have less anxiety over health decisions with physician guidance
Curbs spending and empowers Employee to assure accuracy of every bill
Saves time and frustration by eliminating forms, checks and debit cards
Greater wealth building with interest bearing HSAs and NO FEES
Access to StayFit Plan and 24/7 Telephonic Physician Consults
Greater confidence in managing health care expenses with on-line consumerism tools
Improved satisfaction with a high deductible benefit aligned with an employer Cash Advance

For the Provider

No collection costs or paperwork, substantially lowering the cost of doing business
No debit card transaction fees deducted from payments
Payment in 5-7 business days after adjudication and Employee approval
Easy-to-use paperless claim submission with integrated accounting system to track every claim
Eliminates credit risk with payment guarantee from Employee�s HSA and/or Employer�s integrated Cash Advance account

For the Employer

Employee relations improve and fears are reduced with the Employer integrated Cash Advance
Anti-fraud devices eliminate �piggy-back� fraud & defines valid employees and dependents
Employees get healthier, stay better fit, and are more productive with the StayFit Plan
Lower claims costs in the self-insured retention; savings are driven to the bottom line
Avoids the mismanagement of Debit Cards and Credit Cards
Eliminates human resource implementation hassles and headaches
Significant administrative cost savings
Billing errors decrease significantly
Lowers reinsurance costs
Flattened annual cost increases due to utilization control
Improved Employee financial wellness as HSA balance grows with interest tax-free
Real-time claims data (medical procedure codes and pharmacy data) enables
IMMEDIATE intervention and Case Management supervision of emerging chronic and
catastrophic claims
PEPM Fee makes Simplicity Health Plans a savings advocate with no profit incentive on expenditures
Integrated financial HSA accounting system for audit control with individual and group claims

Plan Features

UNPARALLELED MANAGEMENT OF DATA AND TRANSACTIONS

On-line, real-time & transparent transaction information sharing between Members, Employers, Healthcare Partners & Providers
Real-time integration of all Member Services with Providers and Healthcare Partners
Easy-to-use on-line, real-time Employer and Member financial reporting
Paperless transactions; no insurance forms or snail mail
On-Line, real-time HSA Account Administration

SEAMLESS INTEGRATION OF CONDITION MANAGEMENT WITH STAYFIT PLAN

Secure data exchange to Condition Management vendors
Biometric secure data exchange for early identification and outreach
Biometric risk statification files available
Streamlined online administration of tobacco affidavit
Data exchanges are HIPAA compliant

UNPARALLELED REAL-TIME SECURITY

Line item billing procedures helps eliminate fraud and theft typically associated with Debit Cards, Credit Cards
Comprehensive Employee audit & validation requirements with Dependent Eligibility Program
PIN Codes and on-line, anti-fraud Security Photos for Employees and Dependents
On-line real-time Member bill approval, denial or hold system
Financial Auditing of each transaction

CUSTOMER SERVICE

Member HSA overdraft protection with an integrated Employer Cash Advance
Simple HSA account management for Employers, Members and Providers
Direct deposits for Employers, Members and Providers
Automated real-time withdrawals for Employers and Members
All transactions are ACH and paperless