SimplePay Health

SimplePay Health is a $0 Deductible, Copay-Only Plan for Self-Funded Employers that Maximizes the Aetna Network. Copays vary by provider value: Higher Value = Lower Copay. Lower Value = Higher Copay.


What is SimplePay Health?

SimplePay Health is an alternative health plan for self-funded employers. It uses the Aetna network and is administered via Meritain, the TPA that's owned by Aetna. SimplePay has three parts. One, it is a zero-deductible copay-only plan. That means copays for all services, not only office visits and prescriptions, but also lab, imaging, hospitalization, surgery, labor and delivery, everything is a copay, which is great. No bills, no EOBs, the member only pays the copay. Part two, those copays vary depending upon provider quality, where the higher quality providers have lower dollar copays, and the lower quality providers have higher dollar copays, because at SimplePay, we want to incentivize plan members to use the higher quality providers within the network. Part three is the member never pays the copay to the provider at the time of service. Instead, they get one monthly statement, like a credit card statement, and then they can pay off those copays over 12 months at 0% interest.

How is SimplePay Health different?

There are other alternative health plans out there. However SimplePay Health is different, one, in that it has the one monthly statement with the 0% interest financing. No other alternative health plans offer that. And then two, SimplePay offers concierge navigation support embedded within the health plan. It replaces traditional health insurance customer service so all that hand holding navigation with all the administrative challenges with health insurance and healthcare, that is baked in and part of SimplePay Health.

Who is a good fit for SimplePay Health?

SimplePay is for self-funded employers with a minimum of 51 subscribers on the plan. However, most of our groups are mid-market and national accounts. The groups need to be open to using the Aetna Choice POS II network. It's really for employers that want to decrease their employees' out-of-pocket costs, they want to decrease their overall plan costs, and they want to do so through better steerage within their network. To learn more about SimplePay Health, just click on the link.

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Duration: 02:46

Posted: Wednesday, September 6, 2023

Video tags: 101 - 250 EEs, 251 - 500 EEs, 501 - 1000 EEs, 1001 - 2500 EEs, 2501 - 5000 EEs, Over 5000 EEs