ClaimLinx helps businesses cut costs on their health plan without sacrificing benefits — such as increasing deductibles or copays. As a combination consultant, insurance agency and third party administrator, we use an alternative strategy for purchasing insurance that benefits everyone.
It combines the best of traditional insurance through a major carrier with self-funding without changing a company’s current benefits package. We call it the Simple Option Solution.
First, we help you choose a high deductible insurance plan either with a major carrier or with of an alternative that has different styles of plans, such as a level funded plans, VEBA plans, MEWA plans and more. This plan provides:
- Wide physician and facility network
- Discounts on office visits and procedures
- Stop loss in case an employee has high medical costs
Then, we combine this with a self-funded Medical Expense Reimbursement Plan (MERP) administered through ClaimLinx with a schedule of benefits exclusive to your company. This part of the overall plan provides:
- Customized copays and deductible
- Real data on employee usage
- Tax benefits of self-funding your medical plan
Combining these two types of health plans creates a seamless benefits package your employees will love at a price you can’t resist. On average our customers save 20% on their health insurance costs in the first year. And we can continue this savings year after year as full service consultants who are able to provide continuous solutions for challenges in the healthcare industry.
We know how important it is that your employees have the benefits they need without busting your company budget. It’s a challenge for all business, but we have a unique solution you won’t find anywhere else. So let us guide you on a path to a new type of plan.
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Your employer was shown the Medical Expense Reimbursement Plan (MERP) because he or she is looking out for your best interests by examining ways to cut costs while still providing you with the same benefits. Some employers have told us they would not have been able to provide health benefits or would have been forced to severely cut benefits without instituting a MERP.
A Medical Expense Reimbursement Plan (MERP) utilizes Section 105 of the tax code, a provision that has been included for more than 50 years. It allows business owners to deduct any portion of a medical expense for its employees. It includes any business with one or more employees, so any sole proprietor is able to take advantage of this code.
No. ClaimLinx is an insurance consultant, agency and third party administrator for employer-sponsored plans. We service “you,” the client, not the insurance company. Part of our expertise is in making sure each individual claim has been reviewed for the maximum pay-out allowed. In addition, we act as an educational resource for employees and their families in order to better educate themselves on the healthcare system.
This is ClaimLinx’s premier product, the trailblazing solution for purchasing benefits at a lower cost. In the simplest terms, a Simple Option Solution plan combines a high deductible insurance plan from a major carrier with a company self-funded Medical Expense Reimbursement Plan (MERP).
The high deductible plan provides a stop-gap for the company in case of high employee medical costs as well as a comprehensive physicians network, which typically includes discounts for office visits and procedures. The company MERP provides the benefits people are used to, including a lower deductible and copays for regular visits and procedures.
Claims are processed first through the high deductible plan with a major carrier. Then they go to ClaimLinx as third party administrator for the company MERP to determine the correct payout for both the company and the patient, according to the company’s customized schedule of benefits. See the process in a diagram.
Each client’s Simple Option Solution plan is different, based on the benefits it provides and the high deductible insurance plan, or plans, chosen as its base. This can be a group plan, a combination of group plans or even individual plans — all based on the client’s needs and its employees. The plans work as a way to provide great benefits without paying high premiums to an insurance company for services employees are not using.