Introducing PECAA’s Association Health Plan

We are proud to introduce PECAAHP, a Member-exclusive health care solution that provides affordable health care coverage for you and your employees.

With insurance premiums on the rise and no end in sight, PECAAHP was developed to help Member practices gain control of their expenses while providing quality benefits to employees – helping your practice attract and retain a quality team.

Leverage PECAA’s group buying power as part of a larger, combined unit to purchase health care benefits at competitive rates, regardless of your individual practice size. Join your fellow PECAA colleagues by taking advantage of this private, non-profit, level-funded benefits plan (offered through the Aetna network).

Learn More In Our Introductory Webinar

Watch the webinar recording below to learn more about the new level-funded benefits plan offered through the Aetna network and how you go about getting your free no-obligation quote.

Why A Level-Funded Program?

Level funding used to be a concept only available to large employers. Not anymore. Experience the advantages of level-funding through PECAAHP without taking on added risk.

  • Customizable Plan Designs making it easy for you to find the right fit for your practice
  • Receive Money Back in years when claims are lower than expected
  • An Experienced Team is always ready to provide expertise before, during & after you’ve chosen your plan

Level-Funded Program Key Advantages

  • One Predictable Monthly Payment
    -Your monthly payment is determined upfront and guaranteed not to increase for a full year as long as there are no changes to your group’s benefits or enrollment
  • Plan Administration & Account Management
    -Payments of claims, customer service and reporting is all done for you, leaving you to focus on your business
  • Quality Benefits
    -All employer-established benefit plans are minimum essential coverage
    -Preventative services are paid 100% when received from in-network providers

Medical Benefits

With a growing nationwide PPO network of over 800,000 health care professionals and more than 6,000 facilities, Aetna can offer you and/or your employees a variety of quality choices to help you stay well.

A range of prescription drug plans that deliver comprehensive pharmacy coverage will also be available for you to select.

Choosing Your Plan

PECAAHP offers multiple Medical Plans that include PPO & HSA Options:

Aetna/Multi-Plan National Network
Preferred Provider Organization (PPO) plans give you flexibility. You can go to any health care professional you want without a referral – inside or outside of your network. Staying inside your network means smaller copays and full coverage. If you choose to go outside of your network, you’ll have higher out-of-pocket costs, and not all services may be covered.

Health Benefit Plan Features

We provide flexible options to help you select the plan designs that will benefit your practice most.

  • Deductible options range from $500 to $7,900
  • Coinsurance options: 100%, 90%, 80%, 70% and 50%
  • Multiple office-visit copay options
  • Urgent care and emergency room copay options
  • Prescription copay options available
  • Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) options available
  • Access to large, national networks with discounts for using in-network doctors & hospitals
  • First-dollar diagnostic x-ray and lab options
  • Teladoc: A convenient and valuable telehealth service that can save money for both you and your employees
  • Preventative care coverage aligns with Affordable Care Act requirements
  • COBRA administration
See plan inserts for specific product details, plan options and terms & conditions here.

*Certain restrictions apply to practices located in NY and NC. Call for information 813-979-1588.

ENROLLING IS SIMPLE!

Here’s What to Expect… 

1) Get Your FREE No Obligation Quote

To begin the process of getting a quote for your practice, please complete the census document below. Once the census document has been completed, please e-mail it to PECAA@AndersonThornton.com.

You will receive a link for a Personal Health Questionnaire (PHQ) to distribute to each of your employees. Once all employees have completed the PHQ, your quote will be generated.

GET A QUOTE

2) Select A Plan

Once you are contacted with your underwriting results, you can select the medical plan that meets your needs.

3) Complete Your Paperwork

You will be guided through all the paperwork that is necessary for you to enroll in PECAAHP.*

*Please note that you must maintain a PECAA Membership and be in good standing to qualify for the PECAAHP plan. 

FREQUENTLY ASKED QUESTIONS

Employer FAQ’s

What Size Employer Can Join PECAAHP?
Employers with as few as two employees can join.
What Network of Providers Do You Use?
PECAAHP uses the Aetna Signature PPO Network. This is a nationwide network, contracting with hospitals and other providers.

View the Provider Network List here.
How Does the Billing Work?
Each practice receives a bill from the plan administrator.
What Does the Employer Need to Provide to Obtain a Quote?
The practice will provide a census of all eligible employees to PECAA@AndersonThornton.com. If current health coverage is in place, the practice should also send rates and plan designs along with the census to PECAA@AndersonThornton.com. Then, you'll receive a secure link to share with employees so they can complete a Personal Health Questionnaire (PHQ). Once all employees on the census have completed and submitted the PHQ, underwriting will review and generate a quote. Upon review of the quote, the practice can either accept or reject the quote. If accepted, there will be additional paperwork for the practice to submit to Anderson Thornton Consultants.
Can the Employer and Employee Pretax These Benefits?
Yes, the cost of these benefits can be taken on a pretax basis. Anderson Thornton Consultants can assist you in setting up a section 125 plan that will allow you to pretax your benefits.
Who Handles COBRA and Other Compliance Concerns for this Plan?
The administrator handles COBRA and other compliance requirements.
How Will Enrollments Be Done?
Once all employees have completed their applications and the quoted rates have been issued, the employer will either accept or reject the offer. If the offer is accepted, employees will be given the option to sign up or waive.
Will This Interface With My Payroll System?
There are certain payroll systems that accept electronic data feeds.
There's a Court Challenge to Association Health Plans. Is This Legal?
In a traditional association health plan, the association is contracting with the insurance carrier and/or third party administrator. The association then puts all their members on the plan and it looks as if the entire association membership is employed by the association.

Under the PECAAHP plan, each PECAA practice is individually contracted with NatGen, not PECAA for their health plan. That contract does no go through PECAA. It is direct to the practice. This contractual arrangement makes the plan legal and not subject to the same regulations that a traditional association health plan faces.

Employee FAQ’s

Is My Doctor In the Network?
The network that is being used is the Aetna Signature PPO Network. To see if your doctor is in the network, View the Provider Network List here.
How Much Will This Plan Cost Me?
The rates are based on enrollment and underwriting. The actual cost of the plan to the employee will be based on the underwritten rates and the employer’s contribution.
When Can I Enroll?
Benefit eligible employees will be able to enroll once the employer has accepted the PECAAHP. New hires will be required to meet the waiting period set by the employer prior to joining the plan.
How Do I Enroll?
Benefit eligible employees will enroll via the online portal set up by the plan administrator.
How Do I Add My Spouse Or Child to the Plan?
Enrolled employees can make changes to their benefit at open enrollment and when a qualifying event occurs. Qualifying events include but is not limited to marriage, divorce, birth of a child and loss of other coverage. Employees have 30 days to notify the administrator when a qualifying event happens and changes need to be made.
What Happens If I Leave My Employer?
Employees will be eligible for COBRA, continuation coverage. Employees have 60 days to elect COBRA after termination.

Questions? 

Please reach out to Sara Campbell, Membership Manager, at 270.535.8677 or by e-mailing Sara@pecaa.com.

You may also book a discovery session with a member of our team here.

READY TO BECOME A
PECAA MEMBER?

Get started today and start realizing the benefits of PECAA membership in your own practice.

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