Medium Group
Medium Group Enrollment
Made Simple
Clara Care Self-funded plans are specifically designed to meet the needs of small businesses. This plan also includes a robust platform with hundreds of training resources and HR tools to assist in managing your compliance needs.
From comprehensive major medical plans to ancillary benefits, it’s easy for you to get quotes on the plans that best fit your needs.
Employees
When you deploy a Clara Care Small Group solution, employees can utilize the platform to fully customize their own personalized benefits package from a broad selection of available benefits. If an employee needs help along the way, our qualified professional support team is available via phone or email.
Brokers/Agents
Licensed Health and Accident Brokers and Producers can use the Clara Care quote process to provide more efficient, effective, and timely Stop Loss proposals to your clients. All you have to do is complete the Broker Licensing Agreement, provide a copy of your E&O, agree to provide superior customer service and become appointed with Clara Care.
The Product
Clara Care provides employers with an Affordable Care Act (ACA) compliant Self-funded Stop Loss product. For groups with one hundred or fewer employees, you will receive coverage via an Aggregate Only Stop Loss policy. Even though these products are self-funded, they will look and feel very much like a traditional pre-ACA Fully Insured plan due to the way you fund the claims:
- Premium: Part of your monthly payment will go to pay for Aggregate and/or Specific Stop Loss coverage for your group.
- Claims Funding: Part of your monthly payment will go into a Claims Fund account to pay for your claims, and your claims only, for that month.
- Administration: Part of your monthly payment goes to pay for Claims Administration expenses.
Deliver Additional Value
Clara Care’s Small Group plan includes the Clara Care HR solution, which provides employers with an additional software tool to manage all human resources responsibilities, including healthcare.
Streamlined to Save Time
Implementing the Clara Care Small Group plan is streamlined to save time, headaches, and ensure that employees fully understand their new healthcare insurance.
3G Minimum Value Plan
ACA-compliant Minimum Value Plan (MVP)
| Bronze 400 | Bronze 401 | Bronze (MVP) | Silver 300 | Silver 301 | Silver 302 | |
|---|---|---|---|---|---|---|
| Deductible (lndiv – Family)2 | $5,000 / $12,700 | $6,000 / $12,700 | $5,000 / $12,700 | $2,000 / $4,000 | $2,000 / $4,000 | $3,000 / $9,000 |
| Deductible Type | Embedded | Embedded | Embedded | Embedded | Embedded | Embedded |
| Wellness / Preventive | Covered 100% | Covered 100% | Covered 100% | Covered 100% | Covered 100% | Covered 100% |
| X-Ray /Lab | 20% Coinsurance | 0% Coinsurance | 30% Coinsurance | 20% Coinsurance | 30% Coinsurance | 0% Coinsurance |
| Emergency Room1 | 20% Coinsurance | 0% Coinsurance | 30% Coinsura | 20% Coinsurance | 30% Coinsurance | 20% Coinsurance |
| Plan Type | HSA | HSA | Co-pay | Coinsurance | Co-pay | Co-pay |
| Primary/Specialist/Urgent Care | 20% Coinsurance | 0% Coinsurance | $40 / $80 / $30 Coinsurance | 20% Coinsurance | $40 / $60 / $30 | $35 / $55 / $20 Coinsurance |
| Coinsurance | 20% Coinsurance | 0% Coinsurance | 30% Coinsurance | 20% Coinsurance | 30% Coinsurance | 20% Coinsurance |
| OOP Max (Indiv – Family) | $6,000 / $12,700 | $6,000 / $12,700 | $6,350 / $12,700 | $6,000 / $12,000 | $6,350 / $12,700 | $6,350 / $12,700 |
| Inpatient Hospitalization | 20% Coinsurance | 0% Coinsurance | 30% Coinsurance | 20% Coinsurance | 30% Coinsurance | 20% Coinsurance |
| Outpatient Hospitalization | 20% Coinsurance | 0% Coinsurance | 30% Coinsurance | 20% Coinsurance | 30% Coinsurance | 20% Coinsurance |
| Prescription Drugs3 | 20% Coinsurance | 0% Coinsurance | $0 / $50 / $100 No Specialty Drug Coverage |
$0 / $50 / $100 / $150 | $0 / $50 / $100 / $150 | $0 / $50 / $100 / $150 |
| Gold 200 | Gold 201 | Gold 202 | Platinum 100 | Platinum 101 | Platinum 102 | |
|---|---|---|---|---|---|---|
| Deductible (lndiv – Family)2 | $1,000 / $3,000 | $6,000 / $12,700 | $5,000 / $12,700 | $200 / $750 | $1,250 / $3,750 | $0 / $0 |
| Deductible Type | Embedded | Embedded | Embedded | Aggregate | Embedded | N/A |
| Plan Type | Co-pay | HSA | Co-pay | Co-pay | Co-pay | Co-pay |
| Primary/Specialist/Urgent Care | $15 / $40 / No Charge | No Charge | $30 / $50 / No Charge | $25 / $45 / 20% Coinsurance | $25 / $45 / No Charge | $25 / $45 / No Charge |
| Wellness / Preventive | Covered 100% | Covered 100% | Covered 100% | Covered 100% | Covered 100% | Covered 100% |
| X-Ray /Lab | 0% Coinsurance | 0% Coinsurance | 0% Coinsurance | 20% Coinsurance | 0% Coinsurance | 0% Coinsurance |
| Emergency Room1 | $300 Copay | 0% Coinsurance | 30% Coinsurance | $300 Copay | $300 Copay | $300 Copay |
| Coinsurance | 0% Coinsurance | 0% Coinsurance | 0% Coinsurance | 20% Coinsurance | 0% Coinsurance | 0% Coinsurance |
| OOP Max (Indiv – Family) | $3,500 / $10,500 | $3,000 / $9,000 | $3,250 / $9,750 | $1,250 / $3,750 | $1,250 / $3,750 | $1,250 / $3,750 |
| Inpatient Hospitalization | 0% Coinsurance | 0% Coinsurance | 0% Coinsurance | 20% Coinsurance | 0% Coinsurance | 0% Coinsurance |
| Outpatient Hospitalization | $100 Copay | 0% Coinsurance | $150 Copay | 20% Coinsurance | $100 Copay | $100 Copay |
| Prescription Drugs3 | $50 / $35 / $75 / $150 | 0% Coinsurance | $0 / $35 / $75 /$150 | $0 / $35 / $75 / $150 | $0 / $35 / $75 / $150 | $0 / $35 / $75 / $150 |
2. Deductible applies to all services that indicate Coinsurance or “No Charge”
3. On HSA Plans, copays apply after the deductible has been met
(SBC) or Plan Document for a more detailed explanation of benefits. If any discrepancies
exist between these documents, the Plan Document will be the controlling document.
Clara Care HR has representatives available to provide answers and assist you.
Contact us today about this time-saving service
for your business with 10–100 employees.
