Medical care doesn’t end when a patient walks out of the doctor’s office or hospital. The next step in the healthcare journey often arrives in the mail or on an online portal. An Explanation of Benefits (EOB) plays a crucial role in helping employees understand how their claim was processed. Issued by the insurance company, it […]

Navigating health insurance can be challenging, especially during emergencies. That’s why in this edition of the Benefits Architecture: Learn the framework. Elevate the design, we’re taking a deep dive into one of the most useful, but often overlooked, tools in your benefits toolkit: the Summary of Benefits and Coverage (SBC).The Summary of Benefits and Coverage […]

Benefits Architecture: Understanding Copay Plans. Behind every medical decision, there’s a benefits plan quietly working in the background—determining what gets billed, what’s covered, and what the patient ultimately pays. Choosing the right health plan for your people can be challenging, and the best option often depends on your workforce’s healthcare needs and financial situation. While […]

Navigating health insurance can feel like decoding a secret language—especially when you’re trying to help your team make sense of their employee benefits. That’s why we created the Benefits Architecture series—to help employers and employees better understand their benefits and how they work in the real world.Recently, we explored the life of a medical claim, […]

Self-Funded vs Fully Insured: An Employer’s Guide to Medical Claims. When an employee experiences a medical emergency that lands them in the ER, their health and recovery take center stage. But for employers, there’s another layer running silently in the background: the claims process. What happens before, during and after the claim depends on whether […]

Benefits Architecture: Understanding the Life of a Medical Claim. When an employee rushes to the emergency room with abdominal pain, a broken bone or difficulty breathing, the immediate concern is their well-being and recovery. But behind the urgent medical situation is a complex series of administrative, financial, and regulatory processes, and each one can impact […]

There has never been more opportunity to rethink how employee benefits are delivered, but the problem is, many employers are stuck with outdated plans simply because their broker or consultant isn’t keeping up.In a field that’s constantly evolving, relying on a cookie-cutter plan year after year is no longer enough. You could be missing out […]

The Hidden Cost of Last-Minute Benefits Decisions. You wouldn’t wait for your car to break down before changing the oil, and an operations manager wouldn’t let a key piece of equipment grind to a halt before scheduling maintenance. Yet when it comes to employee benefits, many companies only start thinking about strategy once renewals begin—and […]

Most business owners face a tough choice when it comes to employee health benefits: pay predictable monthly premiums or take control of actual healthcare costs. The difference between self-funded insurance vs fully insured plans can mean thousands of dollars in savings or budget certainty, depending on what works best for your company. How Self-Funded Health […]

Health care costs continue to rise, making it harder for employers to provide quality health care benefits without breaking the bank. Self funded insurance gives businesses a practical alternative to traditional insurance plans by putting control back in your hands while delivering real savings. The benefits of self funded insurance extend beyond just cost control, […]