Simplicity Health Your Health Your Money Your Choice. It's That Simple IBM Business Partner

Contact Us: 877-747-1113

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



Simplicity Health Plans Management Team

Simplicity Health Plans’s core Management Team is an experienced group of medical services, software development, insurance and entrepreneurial practitioners. They contribute well over 100 years of relevant experience, backed by a number of successful medical ventures, to Simplicity Health Plans corporate knowledge base.

Name & Title Relevant Experience
Dr. Gregory J. Hummer, M.D.
Chairman and CEO




16 years experience as a trauma surgeon
Managed a practice of over 100 physicians
Co-founded a successful start-up, IVY Medical Group, which developed 12 ambulatory medical centers
Co-founded PBM Corporation, a 15 year old successful software development company that created the underlying technology for Simplicity Health Plans (technology now processing close to $5 billion in annual medical claims)
R. Stephen Barrett
Vice Chairman



26 years experience in high level corporate financial positions, most recently as Group CFO for Procter & Gamble Global Fabric & Home Care Division and CFO of Whirlpool Corporation
Key strategy positions in launch and building of new brands, to include “Aleve” pain medication
Extensive experience in business organization & value creation
John Guiher, CPA
CFO


25 years experience in software development for medical & financial applications
CIO for IVY Medical Group
Co-founded PBM Corporation
James J. Hummer
President, Luxemburg Capital


25+ years in human resources consulting and onsite medical clinic administration
Co-founded IVY Medical Group
Founded Whole Health Management and for 19 years successfully delivered medical services to many large national corporations, providing on-site services to over 300,000 employees
Lisa M. Holland RN, MBA
President: StayFit Plan






Past Experience Aetna: Clinical Program Consultant dedicated to Bank of America
Independent Consultant: Health and Welfare Benefits
CDHP/HSA Consultant
Provant Health Solutions: Vice President Business Development
United HealthCare: National Director Wellness Marketing & Strategy
Blue Cross Blue Shield RI: Accreditation Specialist
Harvard Pilgrim Healthcare: Clinical Laboratory Generalist