Alternative Group Benefits

Take Full Control of Your Group Health Benefits with a Self-Funded Plan

Employers are looking for new ways to support their teams without the high costs of traditional major medical insurance. Alternative group benefits offer flexible, cost-effective solutions that meet compliance requirements and give employees meaningful access to healthcare. These options can be especially valuable for small and mid-sized businesses that want to provide benefits without taking on the expense of a full health insurance plan.

Virtual Primary Care (VPC)

Virtual primary care gives employees access to board-certified doctors through telemedicine platforms. Members can schedule appointments, get prescriptions, and manage ongoing conditions—all without the need to visit a clinic in person.

• Convenience: Employees can connect with providers from home or work.

• Affordability: Virtual care often reduces the need for urgent care or ER visits.



• Limitations: While VPC covers many everyday needs, it does not replace comprehensive hospital or catastrophic coverage.
  

Minimal Essential Coverage (MEC) Plans

MEC plans are designed to satisfy Affordable Care Act (ACA) employer mandate requirements by covering certain preventive services at no cost to the employee.

• What’s Included: Preventive screenings, immunizations, annual wellness visits, and other ACA-required services.

• What’s Not Included: MEC plans typically do not cover inpatient hospital stays, surgeries, or catastrophic events.



• Best Fit For: Employers seeking compliance and employees who want baseline preventive care access..
  

Individual Coverage Health Reimbursement Arrangements (ICHRAs)

ICHRAs allow employers to reimburse employees for individual health insurance purchased through the marketplace or directly from carriers.

• Flexibility: Employees choose the plan that fits their needs and use employer contributions to offset costs.

• Employer Control: Companies can set contribution amounts and define eligibility groups.

• Coverage Scope: Because employees select their own health plans, they may choose options that do or do not include catastrophic coverage, depending on the plan purchased.
  

Understanding Catastrophic Coverage

Catastrophic coverage protects against very high medical costs—such as hospitalization, surgeries, or emergency care. Not all alternative group benefit options provide this level of protection.

• Included: Typically available through individual plans employees might choose with an ICHRA.

• Not Included: Virtual Primary Care and MEC plans generally do not offer catastrophic coverage.



• Employers should carefully evaluate whether catastrophic coverage is necessary for their workforce and consider supplementing alternatives with additional insurance if needed.