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.

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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:

  1. Premium: Part of your monthly payment will go to pay for Aggregate and/or Specific Stop Loss coverage for your group.
  2. 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.
  3. 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

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
Bronze (MVP) Plan – a thorough explanation of this plan is beyond the scope of this overview – please consult with your benefits consultant.

 

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
1. $500 Penalty applies if used for non-urgent services
2. Deductible applies to all services that indicate Coinsurance or “No Charge”
3. On HSA Plans, copays apply after the deductible has been met
This is a summary overview of benefits – please refer to your Summary Benefits of Coverage
(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.

 

 

If you have questions at any time during the account setup or enrollment process,
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.

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